Oral Cancer
Are You At Risk?
In the US, one person dies from oral cancer every hour of every day,
averaging about 8000 deaths a year. The reality is that most oral cancers
are found as latter stage cancers, after they have either metastasized or
invaded deeply into local structures. Of the 30,000 diagnosed every year,
only one half of those people will be alive in 5 years, mostly because so
many of them are diagnosed too late. Oral cancers have a high rate of
metastasis, meaning that they will migrate to other areas of the body, usually
the lymph nodes, lungs and liver. They also aggressively invade their local
original site, requiring surgical treatment of the primary tumor, which can
leave the patient horribly disfigured. Surgery, chemotherapy and radiation
are the first line of treatment, followed by rehabilitation involving dentists,
nutritionists, osteopathic, plastic and oral surgeons and physical therapists.
Oral cancer usually first starts as a small, innocuous-looking white or red
spot that cannot be brushed or rubbed off. During its early stages it is usually
not painful, which is why it often goes unnoticed. As it starts to mature, the
margins of the lesion may become irregular, the lesion may change in color and
it may increase in size. Nowadays, early detection of any suspicious lesion can
be followed up non-surgically, using a product called ViziLite. The Vizilite
enhances the examiner's ability to see the difference in the appearance of dysplastic
(cancerous or pre-cancerous) cells. After rinsing with a dilute acetic acid solution,
the dense nucleus of abnormal squamous epithelium tissue (cancer or pre-cancer)
will appear white when viewed under a diffuse low-energy wavelength light. Normal
epithelium (healthy tissue) will absorb the light and appear dark. ViziLite can
identify an abnormality, but a definitive diagnosis can only be made by biopsy.
In addition, we have another tool available to us, called Oral CDX. This is a
system that combines a painless brush biopsy, rather than a surgical biopsy, with
advanced computer analysis. If the Oral CDX biopsy comes back positive, meaning
that there are dysplastic changes, the patient is then scheduled for a surgical
biopsy to determine the extent and stage of the lesion.
The most common form of oral cancer is squamous cell carcinoma, which accounts
for 90% of all oral cancers diagnosed. When diagnosed and treated early in the
disease process, patients can expect an 80-90% cure rate. Causative factors for
squamous cell carcinoma include, but are not limited to: excessive alcohol
consumption, tobacco use in any form (piper, cigars, cigarettes, and chewing
tobacco), and betel nut chewing. Combining alcohol and tobacco use increases
a person's risk factor by 15 times. Diets high in fruits and vegetables reduce
a person's risk of developing cancer. This type of diet is high in anti-oxidants
which include vitamins C and E and beta-carotene. In fact, studies have shown that
adhering to this type of diet while undergoing cancer treatment can even assist the
body in fighting the disease by helping to repair defective DNA.
Oral cancer kills more people than prostate and ovarian cancer combined. This
doesn't have to be the case. With proper screening on a regular basis, oral cancers
can often be diagnosed and treated at an early stage, greatly increasing the patient's
chance of recovery. There is no one better trained or qualified to be conducting
regular oral cancer screenings than your own dentist.
Dr. Alfe, her team, and Gilda's Club are striving to raise the public's awareness
of this disease, its process and its detection. If your dentist or dental hygienist
is not performing an oral cancer and head and neck screening at each of your dental
visits, you should be asking, "Why not?" A two-minute screening could save your life!
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