Brett Miles, DDS, MD, FACS
Associate Professor of Otolaryngology, Head and Neck Surgery
Icahn School of Medicine at Mount Sinai, and
Co-Chief, Division of Head and Neck Oncology
The Mount Sinai Health System
About 40,000 Americans will be diagnosed this year with oral cancer, a form of head and neck cancer found inside the mouth, including on the tongue, floor of the mouth, and cheeks. Oral cancer can be deadly; historically, the cure rates for oral cancers diagnosed in advanced stages have been very low. That's why finding them early is so important.
Screening through clinical examination of the oral cavity is one tool we use for early detection of oral cancer, particularly in groups at higher risk. While the U.S. Preventative Services Task Force recently found insufficient evidence to recommend screening of the general population by primary care providers, recent studies published in the Cochrane Database of Systematic Reviews and Oral Oncology found that screenings targeting people who use tobacco, alcohol or both led to a significant reduction in deaths due to oral cancer.
Major Risk Factors
Most oral cancers are a type called squamous cell carcinoma, which starts in the thin, flat cells that line the interior of the mouth. By far, the most important risk factor for oral cancer is tobacco use, especially cigarette smoking. Even moderate smoking puts you at increased risk, and that risk grows the more cigarettes you smoke per day and the longer you've smoked. The second biggest risk factor is heavy alcohol consumption. If you smoke and drink a lot of alcohol, your risk of getting oral cancer skyrockets.
People at higher risk for oral cancer (and anyone else concerned about it) will have the opportunity to get screened and learn more about this disease during Oral, Head and Neck Cancer Awareness Week 2015, April 12-18. That's when many hospitals and health centers across the country will offer free oral cancer screenings and educational materials. The Head and Neck Cancer Alliance, which helps organize the week, offers an online list of screening sites to help you find a location near you.
HPV-Related Oral Cancers on the Rise
Unlike breast, prostate, or other well-recognized cancers, oral, head, and neck cancers have traditionally received little media attention. That is starting to change with the rise in the number of cases of a type of head and neck cancer linked to human papillomavirus (HPV). The most common sexually transmitted infection in the United States, HPV is the same virus that causes cervical cancer. Cancer caused by oral HPV is found primarily in the oropharynx (the area at the back of the throat), most notably in the tonsils and base of the tongue. While the average age of people diagnosed with oral cavity cancer is 62, individuals with HPV-related oropharyngeal cancer tend to be younger and healthier.
At this time, there is no FDA-approved test to diagnose HPV in the mouth or throat, so a key way to catch HPV-related oropharyngeal cancer early is to learn about and monitor any symptoms. This is also important for oral cancers linked to tobacco and alcohol.
Be sure to talk to your dentist or doctor or attend a free oral cancer screening if you notice any of the following symptoms that last longer than a week or two:
- Pain in the mouth or throat
- Bleeding in the mouth or throat
- Numbness of the lips or tongue, especially if it's one-sided
- Any difficulty with speech and swallowing
- Any mass or lump in the neck
- An enlarged tonsil
What's the best way to protect yourself from oral cancers? Avoid preventable risk factors. In particular, this means stopping or avoiding the use of all forms of tobacco and consuming alcohol only in moderation (up to two drinks per day for men, one for women) or not at all.