• 4/22/2005
  • Beverly, MA
  • Roger W. Sachs, D.M.D
  • Damvers Herald on Townline.com

The majority of oral carcinoma is preventable and the earlier the diagnosis, the better the cure. Oral cancers that are caught early have probably well over a 90-95 percent cure ratio, whereas those cancers that have gone on for a year or more, have cure rates that are greatly reduced.

Oral cancer can be seen in any part of the mouth. The most common areas are the sides of the tongue and back of the mouth, at the point where the lower ridge meets the back of the mouth. Other areas include the lips and cheeks and under the tongue. Oral cancer can certainly start at any age, but the average s between the ages of 50-75.

In my over twenty-five years of practice, with the exception of three cases, all of the cancer cases I have treated have been caused by smoking or alcohol abuse. The more recent phenomena of chewing tobacco may also cause oral carcinoma, but at present there is no conclusive proof.

In oral surgery there is a saying that states “if you smoke long enough, you will get cancer.” The medical and dental community would practically go out of business if smoking completely ceased. There would be hardly any oral cancer, lung cancer, emphysema and heart disease would be greatly reduced.

In addition to smoking and alcohol abuse, other causes of oral cancer include spreading from other cancer sites, called metastasis, or cancers from bony structures of the upper and lower jaw. However, both are much less frequent than from those arising from the oral tissues themselves.

Oral cancer can have any appearance, but usually looks like a cold sore, and lasts more than ten days. Many areas of cancer start as white patches, called leukoplakia, then turn to red patches and finally to carcinoma.

Another variant of oral cancer is that which is caused on the lips by the sun. It’s signs and symptoms are very similar, including a non-healing sore or crusted or ulcerated area about the lips.

It is very important to have routine dental examinations. These include noting to your dentist or oral surgeon any lesions that have not healed within ten days. A lesion that has been diagnosed within one month is vastly more suitable to cure than that which has gone untreated for two years.
Prevention is the key to success. In almost all cases, oral carcinoma can be prevented by not smoking and drinking. If you are prone to skin cancers, you should also stay out of the sun or at least wear a UV protectant on your lips.

For those of you who are in a high risk category, self-examination is very important. To self examine, you need good light to shine into the mouth. Look into a mirror and first check the tongue on the right and left lateral sides. Then lift up the tongue towards the palate and inspect the floor of the mouth. Then check your right and left cheeks, especially near the last molars. Finally, check the inner surfaces of the lips, especially the lower lip.

If you are a denture wearer, check for any denture sores. Check on the edges of the denture, especially under the tongue and where the edge of the denture meets the cheek. If there are any lesions present, consult your dentist or oral surgeon as soon as possible.

Treatment for oral cancer usually consists of a biopsy to confirm the diagnosis, followed by surgery to remove the cancer. If it has spread to the surrounding tissue and bone, that will also be removed. Following surgery the patient usually undergoes radiation or chemotherapy.

I believe that oral cancer is 95% preventable. Remember, the key to a cure is prompt medical attention.

OCF Note: I would like to point out something here, not to nit pick someone who is trying to do good by informing the public, but to see that the facts are indeed straight. The doctor’s statement that there is no conclusive proof that spit tobacco causes cancer is incorrect. There is plenty of published, peer-reviewed information documenting the development of oral cancer as a result of chewing tobacco use. Also he fails to mention the HPV virus as a factor in the development of the disease, which is far more prevalent than he is aware of from this article. It may account for the majority of oral cancers in non-smokers. This lack of current knowledge is a problem in dentistry today. If a patient is not over 50 and has not been a tobacco user, (the historical stereotype oral cancer patient) they are most times not considered a patient that needs an oral cancer screening by dentists. The decline in tobacco use over the last ten years in the US has not decreased the incidence of oral cancers. This fact means that a different etiology and cause is at work. The one most spoken of and documented by researchers and treatment institutions is the HPV virus, versions 16 and 18, the very same one responsible for 98% or all cervical cancers, and which is sexually transmitted between partners. Dentistry is behind the knowledge curve here, and they clearly do not realize that young, non-smoking 25-50 year olds are a fast growing segment of the oral cancer population. This lack of awareness is troubling. Lastly, white patches are leukoplakia, and they are frequently, though not always, a precursor to development of a malignancy. Red patches are erythroplakia and they are very dangerous and more frequently become malignant. There are also mixed red and white lesions with components of both in them… but leukoplakia does not become erythroplakia. They are different lesions. Cancers from the “upper and lower jaw” are oral cancers, and they are not a cause. With respect to someone who desires to help people by publishing this article, it is important that we provide the public with the most accurate and complete information available.