article is provided for information purposes only. It is not intended
to be used for medical advice.
cancer represents approximately 3% of all cancers. This, however, translates
to 30,000 new cases every year in the United States. The single greatest
risk factor is tobacco. While cases of oral cancers are seen in patients
who do not use tobacco, these constitute a very small percentage of all
oral cancers. All forms of tobacco have been implicated as causative agents
including cigarette, cigar, and pipe tobacco as well as chewing tobacco.
In India and Sri Lanka, where chewing tobacco is used with betel nuts
and reverse smoking (placing the lit end in the mouth) is practiced, there
is a striking incidence of oral cancer- these cases account for as many
as 50% of all cancers! Heavy alcohol usage is an additional causative
factor. Lip cancer, while included in statistics for oral cancer, is more
similar to skin cancers. Sun exposure is the primary cause of these, while
pipe smoking is also a factor.
of the mouth present in various forms. Any persistent white patch must
be regarded as being suspicious. Additionally, velvety red patches- particularly
those with white speckles- should be areas of concern. Finally, any non-healing
ulcer (erosion) merits evaluation. More often than not, these areas are
tongue is the most common site of oral cancer. Typically, the side of
the tongue (farthest back in the mouth) is involved. The floor of the
mouth (that area beneath the tongue) is next in order of frequency followed
by the insides of the cheeks with involvement of other areas showing a
self-examination is advised, some areas cannot be adequately viewed and,
of course, there is no substitute for examination by a professional. The
best method for detection is to be sure to have semi-annual check-ups
by your dentist. Should an area of concern appear in between these appointments,
arrangements should be made for examination. If your dentist has any concern
or question, he or she will refer you to an oral and maxillofacial surgeon
for evaluation and possible biopsy. Biopsy is a quick office procedure
which allows the surgeon to take a sample of the tissue in the area of
concern for examination under a microscope.
it is best to err on the side of caution. However, one should not be unduly
alarmed by every white area in the mouth nor by every ulcer since there
can be a multitude of harmless causes.
with any other cancer, treatment of oral cancer is best undertaken at
the earliest stage. This maximizes chances of successful treatment. Smaller
areas may be treated by radiation or surgery while larger areas will often
necessitate combined therapy. Prevention, of course, is the best approach
and can best be achieved by avoiding risk factors- refraining from all
tobacco products and consuming alcohol in moderation.