Source: www.everydayhealth.com
Author: Oladimeji Ewumi, Medically Reviewed by Walter Tsang, MD of American College of Lifestyle Medicine

Oral cancer, also called mouth cancer, is a collective term for cancers that affect the mouth or oral cavity. This form of cancer can develop anywhere in the lips, gums, tongue, salivary glands, inner lining of the cheeks, roof of the mouth, or floor of the mouth. It also affects your oropharynx, which is the back part of your tongue, the roof of your mouth, tonsils, and the back of your throat.

According to the American Cancer Society, there are about 54,540 new oral cavity and oropharyngeal cancer cases each year, which translates to 3 percent of all cancer diagnoses in the United States, per the National Institute of Dental and Craniofacial Research (NIDCR).

Of these, Black Americans are more likely to receive a late diagnosis at an advanced stage of the disease, are less likely to get adequate treatment, and have worse overall survival rates than other racial-ethnic groups, according to a study published in Anticancer Research.

The NIDCR reported that the five-year survival rate for oral cancer for Black people is 52 percent, compared with a 70-percent survival rate for white patients — even though there is a higher incidence of oral cancer in white Americans.

These reflect a low awareness of oral cancer among Black Americans and hidden biases in the healthcare system.

Reasons for Delayed Diagnosis in the Black Community
A study published in OTO Open found that Black Americans were disproportionately affected by a lack of health insurance and sought medical care at later stages — lowering their chances of survival.

“Some [other] factors might be mistrust of the medical system, lower awareness of head and neck cancers, and lower rates of dental care and screening,” says Paul Walker, MD, a head and neck oncologic surgeon at Loma Linda University Medical Center in Loma Linda, California.

According to Beomjune Kim, DMD, MD, head and neck and microvascular reconstructive surgeon at City of Hope Atlanta, these disparities might also be a result of socioeconomic factors (employment, income, education, community safety, and social support) or simply lifestyle habits, like higher rates of smoking and alcohol consumption.

“Genetic differences can affect survival outcomes, and Black patients have a significantly higher number of mutations in their tumors when compared with white patients,” says Dr. Kim.

How to Maximize Chances of a Good Prognosis
The American Society of Clinical Oncology suggests that the overall five-year survival rate is 86 percent for all people if oral cancer is diagnosed early. The survival rate drops to 69 percent if the cancer has spread to surrounding tissues and organs, and 40 percent if the cancer has spread to distant parts of the body.

“Like any other patient, Black people should seek professional help as soon as possible. Early diagnosis and treatment are keys to success,” says Kim.

Dr. Walker recommends seeking care at an institution with experience treating head and neck cancer. “It often takes the care of surgeons, radiation oncologists, medical oncologists, and speech and swallowing therapists to treat this cancer successfully.”

Quitting smoking and limiting alcohol consumption is important not only for prevention but also for treatment outcome, according to Kim. “Smoking reduces the level of oxygen in your blood, which can significantly limit the effectiveness of radiation therapy,” he explains. “Smoking and alcohol may also prolong the recovery process during and after treatment.”

“[Black Americans] can also better advocate for [their] health by participating in clinical trials to access cutting-edge therapies,” says Kim.

Importance of Regular Dental Exams and Self-Advocacy
To ensure that oral cancer is diagnosed and treated as soon as possible, you can do the following:

  • Go to your dentist for regular cleanings and checkups, every six months.
  • Find out about options for medical insurance, if you don’t already have insurance.
  • Do self-exams and make note of any pain or worrisome findings.
  • Ask any questions that are troubling you.

“Regular dental care is essential and can often help the doctor find a worrisome spot early,” says Walker. “If you have noticed a sore or painful area in your mouth for more than two weeks, it should be reviewed by a doctor as soon as possible, and if your doctor doesn’t know what it is, request to see a specialist trained in head and neck cancer,” he says.

“If you are not feeling seen and heard by your physician, speak up. Don’t hesitate to request for screening, seek a second opinion, and advocate for the care you deserve,” Walker says. “The mouth allows us to eat and communicate, both of which are very important to who we are, so surviving this cancer is crucial.”

There are no established guidelines for oral cancer screening, according to Kim, but you can learn how to perform oral self-exams.

To perform an oral cancer self-exam:

  • Stand in front of a well-lit mirror to see the inside of your mouth clearly.
  • Carefully remove any dentures.
  • While looking for any swelling, changes in color, red or white patches, sores, or lumps:
  • Check the inside and outside of your lips and gums.
  • Stick out your tongue and examine its sides and surfaces.
  • Gently pull out and inspect the inside of your cheeks.
  • Move your head backwards to see the roof of the mouth.
  • Use your fingers to feel around your neck and lower jaw for any unusual lumps or pain.