• 8/12/2004
  • St. Paul, MN
  • by Michael Rohrer, D.D.S., M.S.
  • The Pilot-Independent

When people think about cancer, the mouth is not usually the first place that comes to mind. Breast, lung and prostate cancer are all forms of the illness we read and hear a lot about.

But oral cancer is a major cause of severe disability and death every year, killing more people nationwide than cervical cancer, Hodgkin’s disease, cancer of the brain, kidney, liver, testes or malignant melanoma skin cancer.
While oral cancer is not much talked about, dentists and physicians would like to change that. Although those who use tobacco and drink alcohol heavily are at a higher risk for contracting oral cancer, 25 percent of people with oral cancer don’t use either substance.

One possible culprit is the human papilloma virus, the virus that causes cervical cancer, which also has been linked to the disease. Oral cancer appears initially in the mouth as small, unexplained white or red spots, as well as lumps, bumps, thick or crusty patches, or sores that don’t heal. If a dentist suspects oral cancer, the dentist or an oral surgeon will take a biopsy of the tissue to look for abnormal precancerous or malignant cells. If those are found, treatment generally includes surgery to remove all of the abnormal cells. If the abnormal cells have already progressed to cancer, extensive surgery, often combined with radiation treatment, may be required.

The best way to survive oral cancer is to prevent its occurrence. If a precancerous or cancerous area occurs, swift treatment gives the greatest hope for survival. If treated early, oral cancer has an 80-90 percent cure rate. But prevention is the best approach. To prevent oral cancer, the most important things to do are to quit smoking or chewing tobacco, and to drastically cut back on alcohol consumption. If people only use tobacco or just drink heavily, they are four times more likely to develop oral cancer. But if they both drink excessively and use tobacco, they are 16 times more likely to contract oral cancer. Cancer of the lip is caused by sun exposure, so people should also avoid excessive sun exposure and use sun block.

It’s also important to visit a dentist twice a year for regular check-ups, which should include an oral cancer screening. The screening is quick and painless. The dentist will look at and feel parts of the patient’s mouth and soft tissue, such as underneath their tongue, cheeks, back of the throat and the side of the tongue. For patients who have had oral cancer once, it’s especially important to remain vigilant about screening for the disease. These people have a 20 times higher chance of developing a second oral cancer, and the heightened risk lasts for five to 10 years after the first occurrence.

A 90-second oral cancer screening should be part of every regular dental check-up. It’s a value-added service patients should expect to receive when they go to the dentist. So be sure to ask your dentist to do a cancer screening at every appointment.

Michael Rohrer, DDS, MS, is a professor and director of the Division of Oral and Maxillofacial Pathology at the University of Minnesota School of Dentistry. This column is an educational service and advice presented should not take the place of examination by a health-care professional.