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Published on April 23, 2018

If you’re in this group, get screened for oral cancerIf you’re in this group, get screened for oral cancer

April is Oral Cancer Awareness Month, but any month is a good time to be screened for this deadly cancer. That’s especially true if you’re young and in good health.

Young, healthy, non-smokers make up the fastest-growing segment of the oral cancer population, according to the Stony Brook School of Dental Medicine

As a result, it’s essential to respond quickly to any changes in your oral health, said Molly Sullivan, MD, a radiation oncologist at the Davenport-Mugar Cancer Center at Cape Cod Hospital and the Clark Cancer Center at Falmouth Hospital.

“Early diagnosis, in any cancer diagnosis, is better than late diagnosis,” she said. “Young, healthy people tend to feel like they’re immortal. They slough off things, thinking, ‘This will get better. This is nothing.’ They’ll let things slide for weeks, if not sometimes months, when they really should seek medical attention.”

Nearly 50,000 Americans are diagnosed with oral or oropharyngeal cancer each year, and they cause over 9,750 deaths, according to the Oral Cancer Foundation.

“We’re seeing an increase of the cancers of the head and neck that are most associated with the HPV infection, the human papillomavirus infection,” said Dr. Sullivan. “They can be cancers of the tonsils and the base of the tongue.”

The other head and neck malignancies that are more associated with smoking and drinking are actually on a decline, she said.

Dr. Sullivan urges teenage boys as well as girls to be vaccinated against the HPV virus.

“Most people know that cervical cancers in women are associated with HPV positivity, and they know about the move to get teenage girls vaccinated for HPV. But young men should also be vaccinated, to decrease their risk of HPV-related head and neck cancers.”

Oral cancers, especially HPV-related cancers, most commonly come to the attention of a medical provider because of a lump in the neck, she said.

“They very often present as an enlarged, involved lymph node within the neck. Sometimes they’re picked up because of an asymmetry in a tonsil, or if an individual has complaints of a sore throat, particularly one side over the other, or pain on one side of their tongue or the other.”

See Your Dentist Or PCP

Dentists often play a key role in detecting oral cancers, according to Dr. Sullivan.

“They are great at picking up oral cavity lesions, like white plaque on cheeks and things underneath dentures,” she said. “People who have HPV-positive oral cancers tend to have a better prognosis than people who have head and neck cancers that are associated with smoking and alcohol.”

Treatment options include radiation therapy and chemotherapy, often concurrently, she said. Surgery is an option when the tumor is on the tonsil or tongue. Some cancer centers are studying whether less intensive radiation or less intense chemotherapy can be effective, which could lead to a change in treatment paradigms in the future, she said.

Lip cancers are associated with both cigarette smoking and smokeless tobaccos.

“The bottom line is that smoking is the single biggest contributor that people have control over,” said Dr. Sullivan.

Some lower lips cancers are sun-related, so preventive measures include using lip balms with a high SPF and wearing a broad brimmed hat that will keep sunlight from landing on your face.

“Cancers of the throat can masquerade as many things, such as ear pain, sore throat, hoarse voice, difficulty swallowing, coughing up blood or loose teeth,” said Benjamin Greene, M.D., Department of Otolaryngology Assistant Professor at University of Alabama at Birmingham, in a press release.

“Anything that is concerning should prompt a visit to a dentist, primary care doctor or otolaryngologist. It is extremely important to note that any enlarged lymph node or enlarged gland in a person over 40 is not normal and should be examined immediately. In general, people who have their head and neck cancers diagnosed early do much better in the long run and often need less-aggressive treatment.”