Cancer in the mouth
Thursday December 7, 2006 

Dear Dr. Mady: I have a small bump on the floor of my mouth that has slowly increased in size over the past six months. I finally went to see my dentist and was given a referral to an oral surgeon for a biopsy. I have no symptoms but I am now afraid that it may be cancer. Is cancer common in the mouth, how do you know if you have it and is it treatable ?-—Marco in South Windsor.


Dear Marco: I don’t know your entire history from your brief explanation, but I do know that oral cancer is real and the only reason it is not on the rise is because patients and dental practitioners are knowledgeable and are detecting it. Habits such as smoking and drinking, especially on a daily basis will increase the chance of oral cancer. The two together consistently is like “dynamite” for healthy oral cells in the tissues of your mouth and throat.
Oral cancer is also more common in males than in females, but females are still at risk. This type of cancer, if not detected early is a death sentence. It will eventually spread like a wild fire and metastasize to other areas of your body and kill you. Often individuals don’t even know something is wrong until it is too late, especially if the cancer is in the esophageal or throat area.

That small bump, if it is cancer, can progress rapidly and invade the cells throughout your entire body. If oral cancer is detected, diagnosed and treated in the early stages, it is almost one hundred percent curable. Having a complete and comprehensive oral exam by your dentist and maintaining it with bi-yearly checkups is highly recommended for anyone. I have seen patients develop oral cancer when they never even touched a cigarette or an alcoholic beverage.

Today there is such a focus in dental practices on preventive dentistry. This is not just the prevention of tooth decay, but the prevention and treatment of all types of oral diseases and conditions including cancer. Oral cancer is not as common as other types of body cancers, but it is more preventable and sometimes easier for the patient to detect it.
Not all oral cancers are the same type and not all grow at the same rate. The most common type of oral cancer is squamous cell carcinoma and the sad part is that this type has the poorest prognosis associated with it. The reason for this is that it gets into the lymph nodes more easily and spreads through them to other areas of the body.

What is important for anyone to remember is that if you feel anything abnormal in your mouth or throat that lasts more than two or three weeks, contact your dentist immediately for an oral examination. Do not attempt to self examine. It is far too difficult to do and the average person does not have the education or knowledge to make a differential diagnosis of what could possibly be happening. The inside of the mouth is not like breasts on women or testicles on men that can be easily palpated during a self examination. Lumps and bumps in the oral cavity are sneaky. They hide in places like under or at the side of the tongue, on the floor of the mouth, in the back of the throat and under the lip
Anyone who notices, suspects or experiences any of the following should be concerned:

  1. a white red or blue patch inside the mouth (especially on the floor of the mouth)
  2. a persistent sore or lump anywhere inside the oral area
  3. trouble swallowing and sometimes chewing
  4. a constant feeling that something is caught in your throat
  5. changes in your voice like hoarseness
  6. a persistent sore throat that won’t go away
  7. numbness anywhere in the mouth
  8. problems moving the tongue
  9. any unwarranted changes in your mouth or throat

Denture wearers that are having no trouble with looseness, sore spots or chewing, often do not visit the dentist and some see denturists who are not trained in detecting and treating oral cancer. Edentulous people (those without natural teeth) are just as much at risk as people with natural teeth and they should be examined at least once a year to check for oral cancer.

If yours has been caught early, treatment may be as simple as the use of a local anesthetic and the excision of the lesion for biopsy by an oral surgeon. I am confident that oral cancers can be reduced to something non life-threatening and manageable through regular dental checkups. Dentistry can effect the quality of lives and sometimes even save them!

This column is reprinted with the permission of the author and The Windsor Star. "Ask the Dentist" is written by Windsor dentist (and ECDS member), Dr. David Mady Jr.. The column appears the first Thursday of each month in the Windsor Star. Readers with questions can write to "Ask The Dentist", c/o The Windsor Star, 167 Ferry St., Windsor Ontario, N9A 4M5



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