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Oral Cancer: Signs and Symptoms

What Is Oral Cancer?
Oral cancer is cancer that occurs on the lips (usually the lower lip), inside the mouth, on the back of the throat, the tonsils or salivary glands. It occurs more frequently in men than women, and most likely to strike people over 40. Smoking in combination with heavy alcohol use is a key risk factor.
If not detected early, oral cancer can require surgery, radiation therapy and/or chemotherapy. It can also be fatal, with an overall five-year survival rate of approximately 50 percent.* Part of the reason for this poor prognosis is a failure to recognize the early symptoms, so detecting oral cancer early is the key to successful treatment.

What are the Symptoms of Oral Cancer?
You won't always be able to spot the earliest warning signs of oral cancer, which is why regular check-ups with both your dentist and physician are so important. Your dentist is trained to detect early warning signs of oral cancer. However, in addition to check-ups, you should see your dentist if you do notice any of the following:

  • A sore on the lips, gums, or inside of your mouth that bleeds easily and doesn't heal
  • A lump or thickening in the cheek that you can feel with your tongue
  • Loss of feeling or numbness in any part of your mouth
  • White or red patches on the gums, tongue or inside of mouth
  • Difficulty chewing or swallowing food
  • Soreness or unexplained pain in your mouth, or feeling that something is caught in your throat with no known cause
  • Swelling of the jaw causing dentures to fit poorly
  • Change in voice

How can I Prevent Oral Cancer?
If you don't chew or smoke tobacco — don't start. Tobacco use accounts for 80 to 90 percent of oral cancers.**

Smoking — the link between smoking, lung cancer and heart disease is well established1. Smoking also affects your general health, making it harder to fight infections and recover from injuries or surgery. Among young adults, smoking can lead to stunted growth and other developmental difficulties. Many smokers find they can't smell or taste as well as before, and risk developing bad breath and stained teeth.
Your oral health is also at risk every time you light up. Smoking cigarettes, a pipe or a cigar greatly increases your chances of developing cancer of the larynx, mouth, throat and esophagus. Because so many people are not aware of or ignore early symptoms, oral cancer often spreads before it is detected.
Chewing Tobacco — chronic users of smokeless tobacco are 50 times more likely to develop oral cancer than non-users.

It's best to avoid smoking cigarettes, cigars or pipes, chewing tobacco or dipping snuff. People who stop using tobacco, even after many years of use, greatly reduce their risk for oral cancer. Chronic and/or heavy use of alcohol also increases your risk of cancer, and alcohol combined with tobacco creates an especially high risk.

How is Oral Cancer Treated?
After a diagnosis has been made, a team of specialists (including an oral surgeon and dentist) develops a treatment plan to fit each patient's needs. Surgery is usually required, followed by radiation and chemotherapy. It's important to see a dentist who's familiar with the changes these therapies may cause in the mouth.

Each time you consume foods and drinks that contain sugars or starches, the bacteria in plaque produce acids that attack your teeth for 20 minutes or more. To reduce damage to your tooth enamel, limit the number or between meal snacks and drinks. And when you do snack, choose nutritious foods such as cheese, raw vegetables, plain yogurt or fruit.

What Oral Side Effects Occur with Radiation Therapy?
When radiation therapy is used for the head and neck area, many people experience irritation in the mouth, dry mouth, difficulty in swallowing and changes in taste. Radiation also increases the chances of getting cavities, that's why it is especially important to take good care of your teeth, gums, mouth and throat during radiation treatment.
Be sure to talk regularly with your cancer specialist and dentist about any mouth problems you might have during and after radiation treatment. Also, discuss with your dentist, prior to starting head and neck cancer therapy, what you can do before, during and after your therapy to help prevent the possible oral side effects.

How can I Maintain Oral Health During my Therapy?
Be sure to brush with a soft toothbrush after meals and floss daily. Avoid spices and coarse foods like raw vegetables, dry crackers and nuts. Also avoid tobacco and alcohol. Eat or chew sugar-free gum or candy to keep your mouth moist.
Before starting radiation therapy, notify your dentist and make an appointment for a complete checkup. Ask your dentist to consult with your radiation oncologist before your radiation treatment begins.

* The Complete Guide to Better Dental Care, Jeffrey F. Taintor, D.D.S., M.S., and Mary Jane Taintor, 1997.
** The National Cancer Institute, "What You Need to Know about Oral Cancer." Last revised, Sept. 28, 1998.
1Compendium of Continuing Education in Dentistry, Vol. 19, #1 (supp), Fall, 2000.

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