The very start of cancer begins when a cell, or small group of cells changes. The cells will then start to divide and multiply. Obvious signs of cancer such as a lump, ulcer, changing mole etc may not even be visible at this stage.
Oral and throat cancer is the sixth most common cancer reported worldwide.
Unfortunately, oral cancer has a higher percentage of deaths than other cancers, for example breast or cervical cancer. The reason for this is because of late detection by the sufferer. Is this because people are not aware of the causes of this cancer, or because they are not aware of the warning signs?
Smoking is one of the main risk factors; smokers are 6 times more likely to develop oral cancer than non-smokers. Studies show that 75% of mouth and throat cancers have occurred in tobacco users. This will include people who do not necessarily smoke, but who chew tobacco. Another cause could be the consumption of alcohol, or a diet that has an insufficient fruit and vegetable intake, and a high content of red meats and fried foods.
People are now more aware of the risks of leading an unhealthy lifestyle - smoking, drinking and maintaining a poor diet. However, from these studies, it is seen that approximately 25% of people diagnosed with oral cancer were non-smokers. So, why are they suffering with this disease? It could be because they are unlucky, but another reason could be that they have HPV. One of the most common causes of oral cancer can be from a virus called Human Papilloma Virus (HPV). HPV is part of a group of 150 related viruses. Some of these viruses - known as ’low risk HPVs’ - are not likely to cause cancer, but can present themselves in other ways such as common skin warts or genital warts. Then there are the ’high risk HPVs’ that can lead to cancer.
Many carriers of the Human Papilloma Virus will not be aware that they are infected. Once contracted, any signs may be invisible for months or even years. Usually the body’s immune system can fight off the infection naturally within 2 years. There are some cases where this does not happen and the virus lingers. Over time the virus can start to change normal cells into abnormal cells, which can lead to precancerous lesions and eventually to cancer.
If people are aware of HPV then they are more likely to be aware that this virus can cause cervical cancer. However, many are still not aware that the virus has also been linked to oral cancer. HPV is highly contagious, and therefore can be spread from skin to skin contact but the main cause of this virus spreading is sexual contact. This is why the HPV has been linked to cervical cancer. Sexual contact does not only constitute full intercourse, but can also include oral contact with areas infected with high risk HPV.
There is a debate about whether this virus is curable, but the general consensus seems to be that once you have contracted HPV, you have it for life. The virus can lie dormant and may never seem to present itself, but having a low immune system or leading an unhealthy lifestyle can cause the virus to become active.
As more and more people become aware of the different causes of cancer, among the charities that help to support studies (for example the recent walk to help funding and build awareness of oral cancer in Hyde Park), and the doctors and scientists who are working every day to find new and innovative ways to spot and cure cancer, it is possible that all the questions we currently have could be answered in a few short years.
Until such a time that there is a cure for both Human Papilloma Virus and, indeed, for oral cancer, the best we can do as dental professionals is to be ever vigilant to look for the signs and take action where we deem it to be necessary. Don’t be afraid to gain a second opinion from your colleagues, or even to refer a patient if you have even a mild suspicion that they could have any of the warning signs of cancer.
Don’t just look in their mouths either! You may feel as if this is your forte, but take a moment to check your patients’ medical history, too. Just a few simple questions could give you a keen insight into the health of your patient and their propensity for contracting the disease. Have they had cancer before? Does this marry up with your potential findings in their mouth? (Think lesions, ulcers, any abnormalities).
The bottom line is this: currently, the best weapon that we have in the fight against oral cancer is early detection. Spotting an anomaly early on could mean much less aggressive treatment for someone - better still, it could mean that your vigilance has saved a life. Do something extraordinary; start combating cancer in your own small way!
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