Friday, August 22, 2014

Oral Cancer - Part 1

Sigmund Freud, Babe Ruth, Roger Ebert, Sammy Davis Jr. all impacted the world with their career defining legacies and will always be remembered for their contributions in their respective fields but they all share one common trait: they were all victims of oral cancer.

Within the US and Canada 1 person dies from oral cancer every hour of every day. Incidence rates are almost twice as high for men vs woman. According to the American Cancer Society incidence rates showed that death rates have been slightly decreasing over the past 3 decades but the number of HPV related oropharynx cancers is on the rise. Currently the WHO estimates that over 450,000 new cases of oral cancer are diagnosed every year. While historically the majority of people are over the age of 40 when diagnosed the number of young people diagnosed with oral cancer is on the rise.

Signs and Symptoms:
  • A sore in the throat or mouth area that does not heal and bleeds easily
  • A persistent red or white patch or a lump or thickening in the mouth, throat, ear, neck or coughing up blood
  • Difficulty chewing, swallowing, or moving the tongue or jaw often indicates a more advanced state

Risk Factors:
  • All forms of smoked or smokeless tobacco products
  • Alcohol
  • A strong correlation exists between the combined use of alcohol and tobacco and a higher susceptibility to oral cancer.  For individuals who smoke and drink heavily studies have shown more than a 30-fold increase in risk 
  • HPV infections are commonly associated with the tonsils or base of the tongue and are believed to be transmitted through sexual contact

Early Detection:
  • Cancer can affect any part of the oral cavity and dentists are often the first line of defense in detecting premalignant abnormalities 
  • Treatment will be less invasive if a cancer can be found in stages 1 or 2 of development
  • A yearly visual cancer screening is essential to catching this disease early
  • A biopsy is the gold standard for confirming a cancer diagnosis

Treatment:
  • This may involve surgery, chemotherapy or radiation individually or as a combined therapy
  • Cetuximab (Erbitux) is a epidermal growth factor receptor (EGFR) drug that has been used successfully in the treatment of head and neck squamous cell carcinomas
  • A multidisciplinary approach involving the efforts of surgeons, radiation oncologists, chemotherapy oncologists, dental practitioners, nutritionists, and rehabilitation and restorative speech specialists will have the highest success rate for therapy

Survival Rates:
  • For combined stages 1-4 approximately 84% of people diagnosed survive 1 year after diagnosis
  • The 5 year survival is 62%
  • The 10 year survival is 52%


In our next BLOG I’ll go over the dental professionals role in cancer treatment

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