Oral Cancer: Improvements Needed for Survival Rates

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The overall survival rate for oral and pharyngeal cancer in the United States is only about 50 percent at five years after diagnosis, and has not improved over the past 50 years. This is a dismal statistic because most oral cancers occur in the surface epithelium where they can be easily detected. Advances in treatment for breast, colorectal, and prostate cancers have improved survival rates significantly for these more common cancers. Researchers at the UCLA School of Dentistry explain how oral cancer survival rates can and should be improved as well.

Oral cancer is relatively uncommon, accounting for about 3 percent of all cancers diagnosed in the United States. However, it is responsible for approximately 9,000 deaths per year. Several studies indicate that head and neck cancers in general, and tongue cancer in particular, are increasing in young adults worldwide. Risk factors are believed to include:
1. Tobacco use, associated with 70 to 80 percent of cases
2. Alcohol and drug abuse
3. Human papilloma virus, HPV-16, which is also linked to cervical cancer
4. Poor dental and oral hygiene
5. Chronic irritation from dentures, fillings, or rough teeth
6. Possible environmental factors

According to the UCLA authors, it takes only 90 seconds for a dentist to perform a screening exam for oral cancer. This should be done at least once every three years for patients age 20 to 40 with no symptoms and average risk, and at least once a year for patients over age 40. Smokers and alcohol users are considered high risk, and should be examined once a year at any age.

Any lesion, lump, or ulcer in the mouth should be checked out by a health care professional. Oral cancer is usually painless at first. Early detection is essential for a cure.

The standard diagnostic test is a biopsy, but less invasive methods are available. These include tolonium chloride or toluidine blue dye, Oral CDx brush biopsy kits, ViziLite, salivary diagnostics, and imaging devices. Dentists are the ones most likely to perform annual check-ups of their patients' mouths, so Reference 1 recommends improved training in oral cancer detection for dentists.

Surgery followed by radiation or chemotherapy is the usual treatment. Rehabilitation therapy may be required for chewing, swallowing, and speech skills. More information is available from the Oral Cancer Foundation.

References:

1. Messadi DV et al, “Improving oral cancer survival: The role of dental providers”, J Calif Dent Assoc. 2009 November; 37(11): 789-798.

2. Oral Cancer Foundation:
http://oralcancerfoundation.org/

3. More online information:
https://health.google.com/health/ref/Oral+cancer

Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.

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