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Spreading the Word About Oral Cancer

Rates are inexplicably rising among people younger than 40

SUNDAY, Nov. 18, 2001 (HealthDayNews) -- There's been no shortage of awareness campaigns for a variety of cancers in recent years. But, experts say, with one person dying from oral cancer every hour in this country, and rates increasing among young people, it's time to raise the profile on this disease as well.

Spearheading the cause is the American Dental Association (ADA), which has launched a nationwide public service campaign to inform the public about oral cancer.

As the sixth most common form of cancer, oral cancer claims almost 8,000 American lives each year. Another 30,000 Americans are diagnosed with the disease annually, and about 20,000 of them are men, says the ADA.

Because the disease is often detected too late, only about half the patients survive more than five years after diagnosis. But with earlier detection, that number increases to about an 80 percent survival rate after five years, says Dr. Richard Price, an ADA spokesman.

So what are the symptoms of oral cancer?

First and foremost, says Price, is any persistent sore or lesion inside the mouth that doesn't heal within a few days.

"Normal things typically heal in the mouth very quickly," he says. "Think about whenever you bite your tongue or cheek, it usually heals within three to five days. So the warning sign is if you feel anything in the mouth that lasts more than five or seven days, get yourself to the dentist."

Other warning signs include color changes, such as the development of red and/or white spots or lesions; pain, tenderness or numbness anywhere in the mouth or lips; a lump; the appearance of a rough or crusty spot in the mouth; a small eroded area; difficulty chewing, swallowing, speaking or moving the jaw or tongue; or even a change in bite.

The disease occurs twice as often in men as women, and has typically been seen in adults over the age of 45, although research has shown a recent, inexplicable increase of cases in adults under the age of 40.

The two biggest risk factors for oral cancer -- smoking and excessive alcohol use -- are to blame for no less than 75 percent of all cases.

Tobacco is the worst offender, and not just smoking, says Dr. Ivo P. Janecka, executive vice president for cancer control and medical affairs at the American Cancer Society in Florida.

"Both cigarettes and cigars are risk factors, but the worst is, in fact, chewing tobacco," he explains.

"It offers the strongest dose of nicotine and other chemicals and they are in direct contact in your mouth over an extended period of time, because people will put a wad in and just leave it in their mouth for a while," he says.

Most dentists routinely check for signs of oral cancer without the patient even being aware of the exam, says Price.

If any worrisome spots, sores or lesions are found, dentists can perform a relatively new and simple test to detect potentially dangerous cells when the disease is still at an early stage.

The test works much like a pap smear, offering initial oral cancer screening with just a brush or swab of the inside of the mouth.

"It's just a screening method and certainly not a diagnostic tool, but it could at least offer an important first step," Price says.

"Previously, when dentists would see a symptom such as a white patch or suspicious area, they only had two choices -- one, just tell the patient about it and watch it for a week or so, or two, refer the patient to an oral surgeon, where the only way to confirm a cancer was to do a surgical biopsy," he says. "So this offers another option."

Regardless of screening tools, the most important steps in catching oral cancer early are having regular dental exams and calling the dentist when symptoms appear and don't go away, says Janecka.

"People will develop a little sore, and if it doesn't bother them too much they will go for months without seeking help," he says. "There's probably a fair amount of denial and even fear of cancer, but that's why it's even more important to see the dentist."

What to Do: Visit the ADA's site on oral cancer for more information on the disease. And this American Academy of Otolaryngology site contains research showing an increase in oral and tongue cancer rates among people under 40.

SOURCES: Interviews with Richard Price, D.D.S., spokesman for the American Dental Association; Ivo P. Janecka, M.D., executive vice president for cancer control and medical affairs, American Cancer Society, Florida
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