Oral Cancers Are Largely Preventable

Oral health is not only important to our appearance and sense of well-being, but also to our overall health. Cavities and gum disease may contribute to many serious conditions, such as diabetes and respiratory disease, and untreated cavities can be painful and lead to serious infections. Poor oral health has been linked to sleeping problems, as well as behavioral and developmental problems in children. It also can affect our ability to chew and digest food properly.

But there’s a more insidious nature to poor oral health. While genetics can play a role, lifestyle and poor choices are major contributors to a cancer that kills approximately 10,000 Americans annually. In fact, the American Cancer Society’s latest estimates for 2017 forecast that approximately 50,000 people will get oral cavity or oropharyngeal cancer this year.

April is National Oral Cancer Awareness Month. Oropharyngeal cancer is a disease in which malignant (cancer) cells form in the tissues of the oropharynx. The oropharynx is the middle part of the pharynx (throat) behind the mouth. It includes the back one-third of the tongue, soft palate, side and back walls of the throat, and our tonsils. The rest are found in the lips, the minor salivary glands (which often occur in the roof of the mouth), and other sites.

These cancers are more than twice as common in men as in women. The average age of most people diagnosed with these cancers is 62, but they can occur in young people. They are rare in children, but a little more than one-quarter occur in patients younger than 55.

Smoking is a major risk factor for oral and dental disease, including oral cancer. Tobacco smoke (including the smoking of cigars and pipes) is very harmful to gum tissues and other tissues in your mouth. Toxins in smoke can cause oral cancer and also damage the bone around your teeth, a major cause of tooth loss. In fact, smoking and tobacco products that are chewed or held in the mouth are one of the biggest risk factors for gum disease and perhaps the biggest risk factor for oral cancer.

Oral tobacco products (snuff or chewing tobacco) are linked with cancers of the cheek, gums, and inner surface of the lips. Using oral tobacco products for a long time poses an especially high risk. These products also cause gum disease, destruction of the bone sockets around teeth, and tooth loss.

The most common risk factors for oropharyngeal cancer include the following:

  • Being infected with human papillomavirus (HPV) — the number of oropharyngeal cancers linked to HPV infection is increasing annually
  • A history of smoking a pack or more a day for greater than 10 years
  • The use of chewing tobacco, snuff, and other “smokeless” tobacco products
  • Heavy alcohol use
  • A diet low in fruits and vegetables
  • Drinking maté, a stimulant drink common in South America
  • Chewing betel quid, a stimulant commonly used in parts of Asia

Sometimes oropharyngeal cancer does not cause early signs or symptoms, but common signs include a lump in the neck and a sore throat. These and other signs and symptoms may be caused by oropharyngeal cancer or by other conditions. Check with your doctor if you have any of the following:

  • A sore throat that does not go away
  • Trouble swallowing
  • Trouble opening the mouth fully
  • Trouble moving the tongue
  • Weight loss for no known reason
  • Ear pain
  • A lump in the back of the mouth, throat, or neck
  • A change in voice
  • Coughing up blood.

When patients newly diagnosed with oral and oropharyngeal cancers are carefully examined, a small portion will have another cancer in a nearby area such as the larynx (voice box), the esophagus (the tube that carries food from the throat to the stomach), or the lung. Some who are cured of oral or oropharyngeal cancer will develop another cancer later in the lung, mouth, throat, or other nearby areas. For this reason, people with oral and oropharyngeal cancer will need to have follow-up exams for the rest of their lives. They also need to avoid using tobacco and alcohol, which increase the risk for these second cancers.

The good news is that the death rate for these cancers generally has been decreasing over the last 30 years. That’s primarily attributable to better health education, outreach from national organizations like the American Cancer Society, and changing patterns in the use of tobacco and alcohol. But oral cancer from human papillomavirus (HPV) is increasing significantly, and risk factors for youth who indulge in smoking or the use of smokeless tobacco also is on the rise. Another questionable practice is the use of “vapes” or electric cigarettes, but research on the long-term effects of these devices is still in its infancy.