Reduce Your Risk for Oral Cancer
Bt Tareq Khalifeh, DDS

Many adults don’t realize that their twice-yearly teeth cleaning is also an important part of cancer-prevention. When your dentist takes a look at your teeth and gums, he or she is checking for overall oral health. This check has also enabled Americans to reduce the incidence of cancers of the mouth, lips, and surrounding tissues in adult men and women.

What is oral cancer?
Cancer of the lip and oral cavity is a disease in which malignant cells are found in the tissues of the lip or mouth. The oral cavity includes the front two thirds of the tongue, the upper and lower gums (the gingiva), the lining of the inside of the cheeks and lips (the buccal mucosa), the bottom (floor) of the mouth under the tongue, the bony top of the mouth (the hard palate), and the small area behind the wisdom teeth (the retromolar trigone).

Cancers of the head and neck are most often found in people who are over the age of 45. Cancer of the lip is more common in men than in women, and is more likely to develop in people with light-colored skin who have been in the sun a lot. Cancer of the oral cavity is more common in people who chew tobacco or smoke pipes.

Suspicious symptoms include any lump in the lip, mouth, or gums, a sore in the mouth that doesn’t heal, or mouth bleeding or pain. Another sign of a cancer of the mouth or gums is when dentures no longer fit well.

How is oral cancer diagnosed?
Your doctor will examine the mouth using a mirror and lights, and may order x-rays of the mouth. If tissue that is not normal is found, the doctor will need to cut out a small piece and look at it under the microscope to see if there are any cancer cells. This is called a biopsy. The patient will be given a substance to take feeling away from the area for a short time (a local anesthetic) so no pain is felt. The doctor will also feel the throat for lumps.

The chance of recovery (prognosis) depends on where the cancer is just in the lip or mouth or has spread to other tissues (the stage), and the patient’s general state of health. Treatment varies by the stage of the disease and may include srgry, radiation therapy, and chemotherapy,

Once cancer of the lip and oral cavity is found, more tests will be done to find out if cancer cells have spread to other parts of the body. This is called staging. A doctor needs to know the stage of the disease to plan treatment.

What types of treatment are used?

Two kinds of treatment are used:

1. Surgery (taking out the cancer)
2. Radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer cells)

Chemotherapy (using drugs to kill cancer cells) is being tested in clinical trials.

Surgery is a common treatment of cancer of the lip and oral cavity. The doctor may remove the cancer and some of the healthy tissue around the cancer. The doctor may also remove the lymph nodes in the neck (lymph node dissection).

Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes or needles in the area where the cancer cells are found (internal radiation therapy). If smoking is stopped before radiation therapy is started, the patient has a better chance of surviving longer.

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in a vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells throughout the body.

If the doctor removes all the cancer that can be seen at the time of the operation, the patient may be given chemotherapy after surgery to kill any cancer cells that are left. Chemotherapy given after an operation to a person who has no cancer cells that can be seen is called adjuvant chemotherapy. Chemotherapy given before surgery to try and shrink the cancer so it can be removed is called neoadjuvant chemotherapy.

Hyperthermia is a new treatment being tested in certain patients. It uses a special machine to heat the body for a certain period of time to kill cancer cells. Because cancer cells are often more sensitive to heat than normal cells, the cancer cells die and the cancer shrinks.

Because the lips and mouth are needed to eat and talk, a patient may need special help adjusting to the side effects of the cancer and its treatment. The doctor will consult with several kinds of doctors who can help determine the best treatment for the patient. Trained medical staff can also help a patient recover from treatment and adjust to new ways of eating and talking. A patient may need plastic surgery or help learning to eat and speak if a large part of the lip or mouth is taken out.

Early Detection
It is important to find oral cancer as early as possible when it can be treated more successfully. An oral cancer examination can detect early signs of cancer. Oral cancer exams are painless and quick — and take only a few minutes. Your regular dental check-up is an excellent opportunity to have the exam. During the exam, your dentist or dental hygienist will check your face, neck, lips, and entire mouth.

Some parts of the pharynx are not visible during an oral cancer exam. Talk to your dentist about whether a specialist should check your pharynx.

Possible Signs & Symptoms
See a dentist or physician if any of the following symptoms lasts for more than two weeks.

• A sore, irritation, lump or thick patch in your mouth, lip, or throat
• A white or red patch in your mouth
• A feeling that something is caught in your throat
• Difficulty chewing or swallowing
• Difficulty moving your jaw or tongue
• Numbness in your tongue or other areas of your mouth
• Swelling of your jaw that causes dentures to fit poorly or become uncomfortable
• Pain in one ear without hearing loss
  

Dr. Khalifeh owns the Philmont Family Dentistry located on Rte 217 in Philmont, NY. A graduate of the New York City School of Dentistry, he completed his residency at Albany Medical Center and practiced in Albany until 2004. For more information, call 672-4077.