Dr. Yarbrough takes Oral Cancer Screening very seriously. If checked regularly during your routine cleaning and exam, Oral Cancer can be caught in the early stages of development. We utilize the Velscope, an Oral Cancer Screening tool that using a blue spectrum light, to make “abnormal soft tissues” far more noticeable than using the naked eye.
Any cancerous growth that can be found in the oral cavity is classified as oral cancer, which is a subtype of head and neck cancer. This type of cancer may arise in several ways. It may develop as a primary lesion in any of the oral tissues. It may also arise due to a metastasis from a distant site or origin. This could be from a neighboring anatomic structure like the nasal cavity. It is also possible for oral cancer to develop from other tissues of the mouth. It can be of various histological types and these include teratoma; adenocarcinoma derived from a major or a minor salivary gland; lymphoma from a lymphoid tissue such as tonsillar or even melanoma from the oral mucosa. Oral cancers are of several types. However, 90% of them are squamous cell carcinomas and they originate in the tissues lining the lips and the mouth. Oral cancer mostly involves the tongue. However, it can also occur in other regions such as the floor of the mouth, gums, cheek lining, roof of the mouth or the lips.
Signs and symptoms:
A lesion on the skin, a lump or an ulcer that does not resolve in 2 weeks that can be found:
- On the tongue, lip, or other mouth areas
- Usually small
- Most often pale colored, be dark or discolored
- Early sign may be a white patch (leukoplakia) or a red patch (erythroplakia) on the soft tissues of the mouth
- Usually painless initially
- May develop a burning sensation or pain when the tumor is advanced
- Behind the wisdom tooth
- Even behind the ear
Additional symptoms that may be associated with this disease:
- Tongue problems
- Difficulties in swallowing
- Sores in the mouth
- Pain and paraesthesia are late symptoms.
Causes and risk factors
The main cause of oral cancer is the activation of oncogenes due to DNA mutation. The cause of this is not yet clear. The good news is that no matter what the cause is, treatment is usually the same. Treatment is mostly through surgery and radiation coupled with or without chemotherapy. Epidemiological studies have revealed the causal factors of oral cancer. India, which is a member of the International Cancer Genome Consortium, is spearheading efforts to map oral cancer’s complete genome.
The chewing of paan, betel and Areca, a common practice in many Asian cultures, has been strongly linked with the development of oral cancer. In India, where this practice is most common, 40% of all cancers are oral cancers. This is compared to a mere 4% in the United Kingdom.
Several oral cancers start as leukoplakia. This is could be a white patch, a red patch or sores in the mouth that have been there for more than two weeks. There is twice the number of cases of oral cancer in men as compared to women. This is particularly the case for men in their 40s, 50s and 60s. Oral submucous fibrosis is very common in India. The main characteristics of this condition are a limited ability to open the mouth and a burning sensation when you eat spicy foods. This is usually a progressive lesion. This means that as it develops, opening of the mouth becomes harder and at its worst, it becomes difficult to eat normally. The occurrences of this are almost exclusively among Indians, Indians living in foreign countries and people of Indian descent.
75% of all oral cancer cases can be attributed to smoking. Smoking irritates the mouth’s mucous membranes. This is mainly due to the smoke as well as the heat produced by pipes, cigarettes and cigars. The primary culprits are the over 60 known carcinogens that are found in tobacco together with the by-products of their combustion. Direct contact of chewed tobacco or snuff causes irritation of the mucous membranes.
Consumption of alcohol and other toxic drinks is also a causal factor of oral cancer. The combination of heavy alcohol drinking with constant smoking is a definite cause of oral cancer. Studies done in Australia, Brazil and Germany have shown that some brands of mouthwash contain alcohol. Constant usage of these mouthwash brands accounted for most of the oral cancer cases in the countries where the study was conducted. This was the case even when the consumer was neither a smoker nor a drinker. However, subsequent studies done in 1985, 1995 and 2003 found out that there was no link between oral cancer and brands of mouthwash that contained alcohol.
Another known cause of oral cancer is the human papillomavirus (HPV), especially type 16 HPV. A growing number of people diagnosed with HPV do not match up to the historic stereotypical demographics. The traditional demographics for people suffering from oral cancer are those over 50 years old, a ratio of 2 blacks to 1 white, more males than females in the ration 3 to 1 with 75% of these people being smokers and/ or drinkers. However, this new demographic is that of people younger than 50 who do not smoke, and are white (but males still outnumber females). HPV 16 as well as HPV 18 is the exact same virus that causes cervical cancer.
Hematopoietic stem cell transplantation.
Patients who come from a hematopoietic stem cell transplantation (HSCT) are at a higher risk of contracting squamous cell carcinoma than other people. Poorer prognosis may also bring about post-HSCT oral cancer. This could be due to the continuous lifelong immune suppression and chronic oral graft-versus-host disease.