Author: Veronica Jauriqui
Source: University of Southern California (www.usc.edu)

Oral Cancer Awareness Week begins April 16. Even though the disease has maintained a low public profile, the American Cancer Society estimates that more than 34,000 new cases will be diagnosed in 2007. Here is what you should know to reduce the risk of oral cancer.

Nearly every hour of every day, someone in the United States dies of oral cancer, according to the Oral Cancer Foundation, a national non-profit agency dedicated to prevention, education and research in oral cancers.

Oral and pharyngeal cancers (cancers of the lip, mouth, tongue and throat) account for about 7,500 deaths per year and have a higher fatality rate than cancers of the lung, breast, prostate and cervix. While it does not share the same high public profile as these other diseases, oral cancer is the eighth most common cancer in this country. And in many developing countries—like India, China and Vietnam—it is number one.

The statistics are disturbing, especially since oral cancer is highly preventable, explains Parish Sedghizadeh, D.D.S., assistant professor at the USC School of Dentistry.

In fact, the Oral Cancer Foundation says that when oral cancers are found early, patients have an estimated 80 to 90 percent survival rate.

“Like most cancers, early screening is the key,” Sedghizadeh says. “The first line of defense is knowing who is at risk and what to look for.”

What are the signs?
The majority of oral cancers—those on the lips, tongue, inside the lining of the cheeks, on the gums or in the upper throat—are squamous cell carcinomas, which are cancers found on the skin or mucous membranes. These cancers may begin as white or red patches of discolorations in the mucous membrane. As precancerous plaques tucked away in the smallest crevices within the oral cavity, they generally go unnoticed. Otherwise, symptoms can take innocuous forms, such as a sore in the mouth or on the lip that does not heal, intraoral bleeding, loose teeth, a lump in the neck or difficult or painful swallowing.

“Almost half of the cases of oral cancers are diagnosed at advanced,” Sedghizadeh says. “In the precancerous stages, there are few noticeable symptoms. By the time the symptoms are apparent, it has reached the cancerous stage and has often spread to the lymph nodes or other parts of the body.”

What are the risks?
According to the Oral Cancer Foundation, two-thirds of oral cancers are caused by tobacco use in any of its forms—cigarettes, cigars, pipes and chewing tobacco. Alcohol use, especially in conjunction with tobacco use, increases the risk.

Ultraviolet light exposure, in the form of sun bathing and tanning beds, has been linked to lip cancer. Previous studies suggest that diets lacking in fruits and vegetables may increase risk of oral cancer. In addition, scientists are also studying the link between oral cancer and certain viruses including the human papilloma virus.

Sedghizadeh cautions against lesser-known and more culturally specific risk activities—such as chewing areca nut, also known as betel nut, or drinking maté, a tea-like beverage—that are prevalent in Asian, Middle Eastern and South American countries, but that are becoming increasingly popular in the United States as the practices cross cultural borders.

“Drinking maté, for example, is becoming more common in the U.S.,” he says, “and it’s easy to find at some health-food stores.”

But in most cases, Sedghizadeh says, it is lifestyle choices that increase the risk.

“When you engage in these behaviors, whether it is alcohol or smoking, each one of these activities has a little bit of risk associated with it. These risks add up. Doctors cannot determine who will or who won’t get the disease, but the cumulative risk increases the potential,” he says.

What you can do
Prevention and early detection are key to battling oral cancer. Sedghizadeh recommends that everyone—especially those people in high-risk groups—do the following to reduce risk:

• Make oral cancer screenings part of your biannual dental checkup. Dentists and dental hygienists are on the front lines of the disease and know how to identify possible abnormalities.
• Moderate alcohol use and eliminating tobacco, areca nut and maté use reduces the risks of developing oral cancers and other cancers, including cancer of the lung, larynx and esophagus.
• Use sunscreen or lip balm with SPF 15 to reduce the risk of lip cancer. Wearing a hat with a wide brim may also reduce lip cancer risk and the risk of developing skin cancer.

For more information, visit the Oral Cancer Foundation online at
www.oralcancerfoundation.org.