The Tribune

By Dr Andre Clarke

THE early detection of mouth and throat cancer can be achieved by regular checks of the mouth and throat, by a competent oral healthcare professional.  Sometimes, tissue changes in the mouth and throat may signal the beginning of cancer. These indicative changes will be seen and felt by a thorough dental examination and appropriate action can be taken.

Our mouths and throats have many parts. The parts include our lips; the lining of our cheeks; our salivary glands; the roofs of our mouths; the backs of our mouths; the floors of our mouths; our gums; our tongues; and our tonsils.  Any of these parts can be affected by squamous cell cancer, the most common type of mouth and throat cancer.

In order to diagnose mouth and throat cancer, the dentist relies on the patient’s presentation and on the physical examination. Often time, a biopsy is used for confirmation.  The management of the cancer then depends on a number of factors, including how quickly it was diagnosed. Squamous cell cancers can be treated successfully, if they are removed promptly. Studies have confirmed that survival rates are linked to the timing of the diagnosis, the spread of the cancer and the treatment options available.

Of note, despite advances in surgical techniques, radiation therapy technology and the combination of chemotherapy and radiation therapy, the survival rates of mouth and throat cancers, have NOT shown appreciable changes in decades. On average, 60% of those diagnosed, will survive more than 5 years. Those that do survive, often endure major functional, cosmetic, and psychological burdens. The ability to speak, swallow, breathe, and chew, being affected forever.

It is believed that 75% of all head and neck cancers begin in the mouth cavity.  A National Cancer Institute’s program, the “Surveillance, Epidemiology, and Ends Results Program”, reports that 30% of mouth cavity cancers originate in the tongue, 17% in the lip, and 14% in the floor of the mouth. Tobacco and alcohol associated lesions, tend to favour the front part of the tongue and mouth, and the Human Papilloma Virus (HPV) positive lesions, tend to favour the back of the mouth.  

Historically, persons with oral cancer are believed to be smokers or alcoholics above the age of 50, but recent research is showing that HPV positive disease is rapidly changing this perception. Non-smoking patients, under the age of 50 are now the fastest growing segment of the oral cancer population.  The infection of the mouth with HPV occurs as a result of a large number of males and females performing oral sex acts.  

In reality, any person using tobacco, alcohol or has had more than 3 oral sex partners, has a significant risk of developing a mouth, head and neck cancer.

Do not be alarmed! A thorough and systematic examination of the mouth and neck will only take a few minutes and can detect mouth cancers at an early and less destructive stage. Without a doubt, alcoholics and smokers require frequent examinations to ensure that they are cancer free.  

In fact, everyone should have frequent examinations. Remember, 1 out of 4 persons diagnosed with mouth, head and neck cancers, do not smoke or drink alcohol. Everyone needs to be screened at least once a year by their dentist.

Two mouth changes that could be precursors to cancer are leukoplakia (white lesions) and erythroplakia (red lesions).  Leukoplakia is commoner than erythroplakia, but erythroplakia and lesions with erythroplakic components are more likely to become cancerous. Any white or red lesion that does not resolve itself in 2 weeks, should be examined by a heath care professional and considered for biopsy to obtain a definitive diagnosis.

In addition to white and red changes in the mouth, an individual may complain of a lump or thickening in the mouth; a soreness or a feeling that something is caught in the throat; or a difficulty chewing or swallowing.  Other common complaints are ear pain; difficulty moving the jaw or tongue, hoarseness; numbness of the tongue or other areas of the mouth; and swelling of the jaw that could cause dentures to fit poorly or become uncomfortable.  If you have any of the above problems and they persist for more than 2 weeks, a thorough clinical examination is necessary, and should be performed to obtain a definitive cause.

The American Cancer Society advises that dentists and doctors examine the mouth and throat as part of a routine oral cancer related examination. This is to ensure early detection of any suspicious changes.  Please visit your dentist or doctor if you have one or more of the risk factors mentioned above or if you do not want to “play numbers” with your mouth health.

This article is for informational purposes only.  It is not intended and may not be treated as, a substitute for professional medical/dental advice, diagnosis, or treatment. Always seek the advice of a physician or dental professional with any questions you may have regarding a medical/dental condition. Never disregard professional medical/dental advice or delay in seeking it because of a purely informational publication.

Copyright © 2012 by Dr. Andre R. Clarke.  All rights reserved. Reproduction of this article, in whole or in part, is prohibited without written permission.  If you have questions, please send email to dr_andreclarke@hotmail.com.

Dr André R Clarke, DDS, MBBS

Special Care Dentistry