How do you detect Mouth or Oral Cancer? What you need to know

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How do you detect Mouth or Oral Cancer? What you need to know

As part of our oral health series we wanted to address a serious health concern. Oral Cancer. According to the Oral Cancer Foundation, the disease is responsible for 10,000 deaths in America each year. Early detection is a must. Regular dental visits and exams can help detect oral cancer, but if you develop symptoms outside your regular check-ups you may want to investigate. How do you know when to worry? Read on to learn more.

What is mouth/oral cancer?

Oral cancer is also known as mouth cancer, though the term mouth cancer is more specific. Mouth cancer refers to cancer that develops in any of the parts that make up the mouth (oral cavity). According to the Mayo Clinic, mouth cancer can occur on the:

  • Lips
  • Gums
  • Tongue
  • Inner lining of the cheeks
  • Roof of the mouth
  • Floor of the mouth (under the tongue)

Cancer that occurs on the inside of the mouth is sometimes called oral cancer or oral cavity cancer since oral cancer includes these areas and the oral cavity at the back of the throat.

Mouth cancer is cancer involving the lips and inside of the mouth, tongue, palate etc, and oral cancer includes these areas and the back of the throat.

How do these cancers begin?

The Mayo clinic states that, “Mouth cancers most commonly begin in the flat, thin cells (squamous cells) that line your lips and the inside of your mouth. Mouth cancers form when cells on the lips or in the mouth develop changes (mutations) in their DNA. The accumulating abnormal mouth cancer cells can form a tumor. With time they may spread inside the mouth and on to other areas of the head and neck or other parts of the body.”

They also indicate that it’s not known what cause the mutations in the first place, which is why early detection is key.

How do you detect mouth/oral cancer?

There’s no routine screening for oral cavity and oropharyngeal cancers. Many pre-cancers and cancers in these areas can be found early (when they’re small) during routine screening exams by a dentist, doctor, dental hygienist, or by self-exam. This is why it’s important to have regular check-ups!

The American Cancer society outlines that though there are times early cancers will produce symptoms, most are asymptomatic until they’ve grown or spread to other tissues. Another problem is that common symptoms (earache and jaw pain) can mimic other conditions. If you have a symptom on the list below that persists for longer than two weeks make an appointment to see your dentist or doctor.

Another thing you can do for early detection, especially if you happen to be at higher risk (drink alcohol and use tobacco) is to check your mouth with a mirror on a monthly basis. If you notice any chances such as white patches, sores or lumps then contact your dentist immediately.

What are the signs and symptoms of oral cancer?

According to the American Cancer Society, possible signs and symptoms of oral cavity and oropharyngeal cancers include:

  • A sore in the mouth that doesn’t heal (the most common symptom)
  • Pain in the mouth that doesn’t go away (also very common)
  • A lump or thickening in the cheek
  • A white or red patch on the gums, tongue, tonsil, or lining of the mouth
  • A sore throat or a feeling that something is caught in the throat that doesn’t go away
  • Trouble chewing or swallowing
  • Trouble moving the jaw or tongue
  • Numbness of the tongue or other area of the mouth
  • Swelling of the jaw that causes dentures to fit poorly or become uncomfortable
  • Loosening of the teeth or pain around the teeth or jaw
  • Voice changes
  • A lump or mass in the neck
  • Weight loss
  • Constant bad breath

What do the early stages of mouth cancer look like?

A white or red patch is the most common sign of mouth or oral cancer. These patches or tissue changes are referred to under the following classifications:

Leukoplakia: a white or gray patch

Erythroplakia:  a flat or slightly raised, red area that often bleeds easily if it’s scraped

Erythroleukoplakia: is a patch with both red and white areas.

Why regular check-ups are important

Your dentist or dental hygienist may be the first person to find these coloured patches. They may be cancerous or they may indicate a pre-cancerous condition called dysplasia.  Dysplasia is diagnosed as mild, moderate, or severe, based on how the tissue appears under the microscope. The degree of dysplasia helps predict if it will likely progress into cancer or go away on its own or after treatment. Severe dysplasia is more likely to become a cancer, while mild dysplasia will more than likely resolve on its own.

How is oral cancer diagnosed?

Tests and procedures used to diagnose mouth and oral cancer include:

  • Physical exam. Your doctor or dentist will examine your lips and mouth to look for abnormalities — areas of irritation, such as sores and white patches.
  • Biopsy- removal of tissue for testing. If a suspicious area is found, your doctor or dentist may remove a sample of cells for laboratory testing with a cutting tool to cut away a sample of tissue or needle to remove a sample. The sample will then be sent to the lab to analyze the cells for cancer or precancerous changes that indicate a risk of future cancer. A biopsy is the only way to know for certain if an area of leukoplakia or erythroplakia contains dysplastic (pre-cancerous) cells or cancer cells.
  • Examination by ENT specialist- If you have are suspected of having oral cavity or oropharyngeal cancer, you will be likely sent to an ear nose throat specialist to have your neck and throat examined. The tests for Oral Cavity and Oropharyngeal cancers vary and include endoscopy.

Who is at risk for mouth and oral cancer?

The Mayo Clinic outlines the following as factors that can increase your risk of mouth cancer.

  • Tobacco use of any kind, including cigarettes, cigars, pipes, chewing tobacco and snuff, among others
  • Heavy alcohol use
  • Excessive sun exposure to your lips
  • A sexually transmitted virus called human papillomavirus (HPV)
  • A weakened immune system

How do I prevent mouth cancer?

While there is no proven way to prevent mouth cancer, you can reduce your risk by making the following lifestyle changes:

  • Avoiding tobacco use. If you don’t smoke, or chew tobacco you’re already ahead of the game. If you do, it’s time to stop. Using tobacco, whether smoked or chewed, exposes the cells in your mouth to dangerous cancer-causing chemicals.
  • Drinking alcohol in moderation or not at all. Chronic excessive alcohol use can irritate the cells in your mouth, making them vulnerable to mouth cancer. If you choose to drink alcohol, imbibe wisely. What does that mean? Up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men aged 65 and younger.
  • Avoid excessive sun exposure to your lips. We often forget while we’re slathering on sun protection about our lips. To protect the skin on your lips from the sun you can: avoid the sun, wear a broad-brimmed hat that effectively shades your entire face, or apply a lip product with SPF in addition to your sun protection regimen.
  • See your dentist regularly. As part of a routine dental exam, ask your dentist to inspect your entire mouth for abnormal areas that may indicate mouth cancer or precancerous changes.

To sum it up

Since there is no routine screening for oral cancers and dental professionals are often the first to spot the disease make sure you have regular check-ups and make an appointment if you notice any symptoms as outlined above, especially if you are in the higher risk category.

Just like with all cancers, the key to survival is catching it as soon as possible.

For more information you can visit the Oral Cancer Foundation’s Website or the American Cancer Society oral cancer page.