Lifestyle changes a factor in oral cancer

THE number of cases of mouth cancer is rising. Since the 1990s, the number of cases of oral cancer recorded in the UK has increased by nearly 30% for men in their 40s. It has also risen by nearly 25% for women. At least two Irish people die every week from oral cancer and the majority of health experts put this increase down to changes in lifestyle.
Mouth cancer is an umbrella term that covers a large number of different types of cancer. Oral cancer can affect the underside of your tongue, the floor of the mouth, the roof of the mouth, the gums and inside of the cheeks. There are also types of cancer that can affect the salivary glands, the tonsils and the lips. The most commonly occurring type of mouth cancer is known as squamous cell carcinoma. It attacks the cells lining the mouth and most commonly occurs on the floor of the mouth.
So why is mouth cancer on the increase? Smoking is certainly one reason but it is not the only reason. Experts also believe that an increase in the levels of alcohol drinking is another important factor. There are an increasing number of men and women, especially in their 20s and 30s, who drink more than the recommended amount.
However, smoking and drinking, while significant, are not the only causes of mouth cancer. Diet can also be a contributory factor and some foods are shown to help fight cancer, for example broccoli and other leafy vegetables. Some oral cancers are also similar to skin cancer, so if you spend a lot of time in the sun, make sure you protect your lips with sunscreen.
In many cases, the greatest protection against mouth cancer is early detection. While in the initial stages of mouth cancer, you may not feel any pain. However, you may notice mild symptoms such as stubborn mouth ulcers that refuse to go away. You may also notice that it is sore to talk, eat or move your tongue. Alternatively, you may notice numbness in your mouth or a discoloured area on your tongue or cheek. In all of these cases, the symptoms may be mild but the noticeable element may be the fact that you can’t get rid of them.
It’s worth remembering that even if you do not have any of your natural teeth and wear full dentures, you will still need to have an oral cancer screening.
If you think you have any of the symptoms of oral cancer, you should speak to your dentist immediately. Early detection of cancer greatly increases the possibility of successful treatment. Treatment at this stage is much more straightforward, much less debilitating for the patient and offers more chance of success.
There are two important elements in the detection of cancer. First of all, your dentist needs to identify whether cancer is definitely present. This requires a biopsy, during with a small tissue sample is taken from the affected area and analysed in a laboratory. This may involve a referral to a specialist dental surgeon. If the biopsy is positive, the next step is to discover how much the cancer has spread and this will normally require tests from a specialist surgeon.
Usually, if the cancer has been detected early enough, it can be removed through surgery. If the cancer is very small, this may be a very simple procedure that does not even require an overnight stay in hospital. In some cases, the procedure can even be done under local anesthetic, similar to the freeze used at the dentist for a filling.
If the cancer has spread too far for surgery to be effective, then other treatment options will include radiotherapy or chemotherapy. Radiotherapy destroys cancer cells through concentrated bursts of radiation onto the affected areas. Chemotherapy attacks the cancer cells through the use of medication. Both radiotherapy and chemotherapy can be difficult treatments to go through.
While watching out for symptoms is one way to detect mouth cancer early, your dentist will also have a vital role to play. You should view your dentist as the expert who takes care of your oral health, rather than simply someone who looks after your teeth. If you are visiting your dentist regularly for check-ups – this means at least once every six months – then they will be best placed to spot possible mouth cancer and refer you to a GP or oncologist.
Medical card holders are entitled to an annual examination and oral cancer screening free of charge. Also, if you are currently paying PRSI contributions, you may be entitled to a free exam.

Dr Niall McCarthy is a member of the governing body of the Irish Faculty of Primary Dental Care and practices in County Clare.