How Does Oral Cancer Happen?

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Andra Mahoney BS RDH

Two weeks ago, Becky gave us some great info raising our Awareness to Oral Cancer.  She touched on the importance of screenings and mentioned the risk factors.

But How Does Oral Cancer Happen?

According to the Oral Cancer Foundation, about 48,000 people are diagnosed each year.  Of those, about 9,500 people will loose their battle with oral cancer.  Of the 48,000 people diagnosed, only 57% of them will be alive 5 years after diagnosis.  Sadly, the number of diagnosis and deaths have not decreased over the last decade.

Let’s review the risk factors in detail…

Age

Probability dictates that the older you get, the more likely you have a chance of getting cancer.  Therefore, age will be a risk factor.  Oral Cancer is more often detected in those over the age of 40.  However, this statistic is changing with the prevalence of HPV.  We will talk more about this in a following section.

Although age does play a part, around 91% of all diagnoses of Oral Cancer are linked to “lifestyle” choices.
These following risk factors will show us why.

Sun Exposure

Excessive and unprotected exposure to the sun is linked with cancer in the lip area. To reduce your risk of lip cancer, decrease your unprotected exposure to sunlight and other sources of ultraviolent (UV) radiation.  (1)

Sun exposure and other sources of UV radiation can damage lip cells.  This damage can cause them to multiple when naturally they should die.  Fast reproduction of abnormal cells is how we classify cancer.

Tobacco Use (use of any kind, including cigarettes, cigars, pipes, chewing tobacco and snuff, among others)

The report from the Institute of Medicine (2007) says that tobacco kills more Americans annually than AIDS, alcohol, cocaine, heroin, homicides, suicides, car accidents, and fires combined.

Nationally, tobacco contributes to about one-third of U.S. cancer, one-quarter of heart disease and about 490,000 premature deaths each year. Tobacco is a known cause of lung, bladder, mouth, pharyngeal, pancreatic, kidney, stomach, laryngeal, and esophageal cancer. About ten million people in the U.S. have died from causes attributed to smoking and tobacco use (including heart disease, emphysema, and other respiratory diseases) since 1964. Tobacco is the most global cause of cancer, and it is preventable. (2)

There are thousands of chemicals contained in a single cigarette, and their point of entry is the mouth.  Smoking helps to transforms saliva into a deadly cocktail that damages cells in the mouth and can turn them cancerous. (3)

If you would like help on quitting, please check out the resources on this page: http://smokefree.gov

Alcohol Use

People who consume approximately 3.5 or more alcoholic drinks per day, or 21 drinks in a week, have at least a two to three times greater risk of developing cancer than nondrinkers. (4)

Those who both smoke and drink, have a 15 times greater risk of developing oral cancer than others.

Alcohol’s effect on the mouth may be the key to understanding how it works with tobacco to increase the risk of developing cancer. The dehydrating effect of alcohol on cell walls enhances the ability of tobacco carcinogens to permeate mouth tissues; additionally, nutritional deficiencies associated with heavy drinking can lower the body’s natural ability to use antioxidants to prevent the formation of cancers. (5)

HPV Infection

The human papilloma virus (HPV) is a common, sexually transmitted virus, which infects about 40 million Americans today. There are about 200 strains of HPV, the majority of which are thought to be harmless. Most Americans will have some version of HPV in their lifetimes, and most immune systems will be able to fight off the virus.  Those who get specific strains, and lack the ability to fight those strains off, are the ones who develop cancer.

The two strains that are mainly associated with oral cancer are HPV16 and HPV18.  HPV is a double-stranded DNA virus that infects the epithelial cells of skin and mucosa.

It is likely that the changes in sexual behaviors of young adults over the last few decades, and which are continuing today, are increasing the spread of HPV, and the oncogenic versions of it.  You can get HPV by vaginal, anal, or oral sex.  Condoms can limit, but do not prevent HPV.  HPV significantly increases with multiple (especially more than four) sexual partners. (6)

How to Spot it

One of the real dangers of this cancer, is that in its early stages, it can go unnoticed. It can be painless, and little in the way of physical changes may be obvious. The good news is however, that your Physician or Dentist can, in many cases, see or feel the precursor tissue changes, or the actual cancer while it is still very small, or in its earliest stages.

It may appear as a white or red patch of tissue in the mouth, or a small ulcer which looks like a common canker sore. Because there are so many normal tissue changes that happen normally in your mouth, and some things as simple as a bite on the inside of your cheek may mimic the look of a dangerous tissue change. It is important to have any sore or discolored area of your mouth, which does not heal within 14 days, looked at by a professional. Other symptoms include; a lump or mass which can be felt inside the mouth or neck, pain or difficulty in swallowing, speaking, or chewing, any wart like masses, hoarseness which lasts for a long time, or any numbness in the oral/facial region. (7)

But like any cancer, even if you do not do these risk factors, there is still a possibility of getting it. 

The best way to detect oral cancer is to do self exams and to see your Dentist regularly.  The Dental Team is the forefront in prevention and detection as their main focus is your mouth!  Your Dentist and/or Hygienist will perform a visual and tactile screening at each appointment.  If they do not, please ask for one.  There are also additional screenings available, and they can tell you more about them during your appointment.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

(1) http://www.cancer.net/cancer-types/oral-and-oropharyngeal-cancer/risk-factors-and-prevention

(2) http://www.oralcancerfoundation.org/tobacco/

(3) http://www.mouthcancer.org/risk-factors/

(4) http://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet

(5) http://www.oralcancerfoundation.org/understanding/alcohol-connection.php

(6) http://www.pureeducation.org/index.asp?N=Pure-Education-Lake-Stevens-WA-HPV-Coaching&C=577&P=7764

(7) http://oralcancerfoundation.org/facts/

http://www.mayoclinic.org/diseases-conditions/mouth-cancer/symptoms-causes/dxc-20157232

http://www.oralcancerfoundation.org/hpv/

Oral Cancer Awareness

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Becky Larson, RDH

Oral Cancer Awareness

It’s April again!  Which means Oral Cancer Awareness month.  I can’t even begin to tell you how critical it is to receive regular oral cancer screenings.  Your dentist and/or dental hygienist should perform a basic screening at your six month check-ups.  We also recommend having a more in depth oral cancer screening (such as the Velscope, Oral ID, or Identafi) annually.  These more in depth screenings use florescent or ultra violet lights that can detect signs of oral cancer much earlier.  The earlier cancer is caught, the sooner treatment can begin and the better the prognosis.

Oral cancer is any abnormal growth of cells in the oral cavity (mouth).  Abnormal cell growth can be benign (no cause for concern) or malignant (can be life-threatening).  The oral cavity consists of the lips, cheek lining, salivary glands, hard and soft palates, uvula, tongue, floor of the mouth (underneath the tongue), gums, and tonsils.  The tongue and the floor of the mouth are the most common areas for oral cancer to occur.  However, the cancer can spread to other areas of the oral cavity and/or other areas of the body.

Oral cancer can manifest itself in many ways including swellings, lumps or bumps, numbness, abnormal bleeding, white patches, red patches, speckled patch, sores that do not heal, sore throat, pain when chewing/speaking/etc., changes in voice, ear pain, and dramatic weight loss.  If you are experiencing any of these symptoms please visit your dentist or primary care physician.

Risk factors for oral cancer include tobacco use, alcohol use, sun exposure, having HPV (Human papillomavirus), and a history of having oral cancer previously.  Tobacco use is the reason for most oral cancers, especially in those individuals who have used tobacco for lengthy amounts of time.  The risk increases when tobacco users become heavy alcohol drinkers.  Three out of every four oral cancers occur in people who use alcohol, tobacco, or both.  The Human papillomavirus is mainly linked to oropharyngeal cancers.  Limiting sun exposure and the use of sun screen and lip balm can help reduce the risk.  Men are twice as likely to develop oral cancer than women.  It is also important to note that more than 25% of oral cancers are found in individuals with no risk factors.

Everyone is at risk!  Make sure to visit your dentist and dental hygienist for regular oral cancer screenings.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

http://www.medicinenet.com/oral_cancer/article.htm

http://www.webmd.com/oral-health/guide/oral-cancer

http://www.cdc.gov/std/hpv/STDFact-HPVandOropharyngealCancer.htm

 

April is Oral Cancer Awareness Month

Sharma RDH

Sharma Mulqueen RDH

April is Oral Cancer Awareness Month

OC Awareness

Early detection is key with oral cancer. When found early, oral cancer patients can have an 80 to 90% survival rate. Unfortunately 40% of those diagnosed with oral cancer will die within five years because the majority of these cases will be discovered as a late stage malignancy.

Oral cancer is particularly dangerous, because the patient may not notice it in its early stages. It can frequently prosper without producing pain or symptoms. As a result, Oral Cancer often goes undetected until it has already metastasized to another location.

Who does oral cancer screenings?

Most oral cancer screenings are done by a Dentist or Hygienist. It is very important at all of your dental appointments you have a screening completed.

When should I have my first oral cancer screening?

More people are being diagnosed with oral cancer than ever before. But surprisingly, research shows this increase is not due to the traditional risk factors of drinking, smoking and using chewing tobacco. Rather oral cancer is now being found in a younger population of men and women because due to their exposure to the HPV (Human Papillomavirus). That is why the Center for Disease Control recommends that all patients over the age of 17 be screened annually for oral cancer.

What types of screenings are there?

A routine “recall” exam usually includes a visual search for lesions and abnormal structures in the oral cavity with palpitations on neck, throat, tongue and cheeks.

The Identafi system uses the Identafi Multi-Spectral Fluorescence and Reflectance technology to enhance visualization of mucosal abnormalities such as oral cancer or premalignant dysplasia that may not be apparent to the naked eye. Unlike other fluorescence technologies and dye systems, the Identafi is Multi-Spectral with three distinct color wavelengths, making it easier to distinguish lesion morphology and vasculature.

Identafi System

The VELscope® Vx system is an adjunctive device which means it must be used together with and as a supplement to the traditional intra and extra oral head and neck exam. Unlike other adjunctive devices used for oral examinations, the VELscope® Vx does not require any dyes or prolonged testing procedures. In fact, a VELscope® Vx exam can be performed during a routine hygiene exam in about two minutes at your dental office.

Dentists, Hygienists, Periodontists, Oral Surgeons, Primary Care Physicians and Otolaryngologists now have the technology to detect morphological and biochemical changes which may lead to oral cancer and potentially save lives, thanks to the Identafi® and VELscope® Vx systems.

Where do I go if there is any concern with my screening?

You will be referred to an Oral and Maxillofacial Surgeons where they will check for lesions and abnormal tissue structures and perform a biopsy.

Oral Surgeons are not front-line detectors, because their patients are typically referred by dentist and other medical professionals as a primary source for cancer diagnosis and treatment.

OC Happens

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Source:

http://www.identafi.net/tools

http://www.dentalez.com/products/stardental/identafi/

http://www.velscope.com/velscope-technology/overview/

Oral Cancer Detection

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Lora Cook RDH

Your Dentist can play vital role in detecting cancerous cells in the mouth at stage 0 to stage 1.

“According to the National Cancer Institute, most mouth cancers start as small flat cells that are in the lining of the mouth.” These area’s include lips, inside lining of the cheeks, roof or floor of the mouth. Also area’s of the tongue, sides of the tongue and under the tongue. The back of the throat is another area in the mouth that cancer can form. When oral cancer is caught early before it grows deeper into the tissue and progresses into the lymph nodes the outcome for the patient is good.

  • Stage 0 – Is the precancerous stage, this is where cells are identified to be abnormal. They have the potential to develop into tumor.
  • Stage 1 – Is when the primary tumor is 2 centimeters or smaller. In this early stage there are no cancer cells present in the nearby oral tissues or lymph nodes.

So what can the dentist do to catch oral cancer in the precancerous and primary stage of development? Its is called the Velscope! This is a tool used by the dentist to help detect precancerous and cancerous cells in small and early stages not easily seen by the naked eye. This type of exam is more thorough. This scope helps the doctor check for abnormalities just under the tissue surface. It can show where abnormal cells are, months and even years before they become easily visible to just the naked eye.

velscope-vx-starter-kit[1]

http://www.leddental.com

 

Frequently asked questions:

What does the doctor look for?

The scope will direct fluorescence light to find abnormal cells. When looking through the scope healthy tissue will fluoresce, any tissue that is abnormal will appear dark. So the doctor is looking for any dark spots or areas. The dentist and your hygienist will also do a manual exam shown below feeling for lumps or bumps, and unilateral abnormalities.

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http://therightsmile.files.wordpress.com/2013/04/oral-cancer-screening.jpg?w=611&h=611

 

Is radiation involved when using the Velscope?

This exam is very safe, and there is no radiation involved. However the doctor will have you where some orange safety glasses to protect your eyes from the blue LED light from the scope.

How long does the exam take?

This exam takes all of one to two minutes to complete. Just long enough for the doctor to look at all the oral tissue in the mouth looking through the scope.

How often should I have this type of exam?

The doctor recommends thorough oral cancer screenings done at least once yearly.

American Cancer society recommends for people age 20 and older yearly screenings and exams for oral cancer.

 

Want to learn more? Visit us at http://www.alamedadentalaz.com

 

Sources:

http://www.livestrong.com/article/22882-early-stages-mouth-cancer/

http://www.webmd.com/oral-health/guide/oral-cancer

http://www.ddsgadget.com/ddsgadgetwp/velscop-early-detection-of-oral-cancer/

http://www.leddental.com