Worrisome new findings and comparatively low survival rates highlight the need for more education and earlier detection.
4/01/09
By Beth Dunham

Dentists fight on the front lines against oral cancer, an aggressive, deadly disease that hasn’t seen the same improvements in survival rates as other cancers, said Parish Sedghizadeh of the USC School of Dentistry.

“Oral cancer has one of the highest mortality rates among cancers,” said Sedghizadeh, assistant professor of clinical dentistry. “It’s usually not noticed until the later stages, when a recovery is less likely.”  People have heard of oral cancer, but they don’t know what it looks like.”

The disease rarely causes pain or other noticeable symptoms until it reaches a very advanced stage, he said. And while many people stay vigilant for the symptoms of more common cancers, dental care access challenges and a lack of oral cancer education means that most patients don’t know the early signs of oral cancer.

“Oral cancer will often start as a small red or white plaque or sore that doesn’t go away with time, unlike other normal mouth, tongue, or lip sores that usually heal within a week or so,” Sedghizadeh said.

Even if the disease is spotted and treated, fighting the disease can be especially traumatic, even compared to battling cancer in other regions of the body.

“Oral cancer, given its location, can seriously affect a patient’s quality of life,” Sedghizadeh said. “The disease, as well as the methods used to treat it, can impact a person’s ability to breathe, speak and eat and can permanently disfigure the face.”

Oral cancer is unique in that its diagnoses usually come from dentists instead of physicians. A visual screening for oral cancer involves examining every surface in the mouth, from the lips to underneath the tongue, but physicians may only give the back of the throat a brief examination during a checkup and do no further oral investigation if any at all, Sedghizadeh said.

“Most physicians aren’t looking for problems in the mouth,” he said. “It’s the oral health care professionals that should be performing the oral cancer screenings and diagnosing cases.”

The majority of oral cancers are seen in older patients with several years of exposure to risk factors, including the use of alcohol, tobacco, and other drugs. But new findings recently published in the New England Journal of Medicine highlight a possible connection between human papilloma virus (HPV) infection in young adults and higher rates of oral cancer, including a type of cancer previously found only in older smokers.

While the study needs to be replicated and the findings need to be further supported, it’s clear that people of all ages and backgrounds need to maintain good oral health practices, stay vigilant for the signs of oral cancer and make sure that they receive a regular oral health checkup from a dentist or other oral health professional, Sedghizadeh said.

“Even though treatment has improved, we need to be catching oral cancer much earlier,” he said. “And the people best prepared to detect it are dentists.”