Oral Cancers and Prevention

While oral cancers may not be the most talked about, they’re still prevalent among adults, especially those who are at risk due to lifestyle choices like smoking and substance use. Sometimes oral cancers occur due to genetics, or simply without warning, making prevention all the more critical. Knowing how to screen for the most common oral cancers can be the difference for life and death, and dental providers are always on the lookout for warning signs when examining their patients, making them a vital component for prevention.

Oral Cavity, Pharyngeal, and Laryngeal Cancer

The lips, gums, tongue, inside lining of the cheeks, floor, palate, and the trigone are all areas of the oral cavity that can be affected by cancer in the form of squamous cells. These squamous cells are thin and flat and line the inner tissue of the oral cavity, pharynx, and larynx.

Pharyngeal cancer affects the tissues in the throat, including the upper part behind the nose, the oropharynx that includes the middle part of the throat and mouth, back of the tongue, back of the roof of the mouth, uvula, tonsils, and the side and back walls of the throat. Cancer can also occur in the hypopharynx or bottom of the throat as well.

Laryngeal cancer forms in any tissues that make up the larynx or “voice box,” including the vocal cords, the area just above called the epiglottis, the middle part called the glottis, and the subglottis or lowest part of the larynx that reaches to the top of the trachea.

Quick Facts:

• Men are more than twice more likely than women to have oral cancer and have a higher mortality rate directly as a result of oropharyngeal cancer.
• Due to the decrease in the popularity of smoking cigarettes, pharyngeal cancer rates have dropped in the past two decades and are now considered rare cases.
• Cancer of the back of the throat and nose, also known as nasopharyngeal cancer, is rare in the US and more common in Asia, the Middle East, North Africa, and the arctic.
• Laryngeal cancer rates have also dropped due to a decrease in the popularity of cigarette smoking over the last decade and are now much less common than oral cavity cancers.

Oral Cancer Risk Factors

Various conditions and lifestyle choices can predispose someone to oral cancers and increase their risk. While some of these factors can be avoided, some simply cannot, but recognizing them can raise awareness and screening efforts as well as prevention.

• Tobacco use: It is by far the most common cause of all oral cancers. The risk of oral cancer for smokers is five to ten times higher than those who do not use tobacco. This includes all forms and types of tobacco, including cigarettes, pipes, cigars, and chewing tobacco.
• Alcohol consumption: The risk of oral cancer increases with the number of alcoholic drinks consumed per day. For people who drink five or more servings a day, the risk of oral cancer is increased five to six times more than those who do not drink alcohol.
• Tobacco & alcohol use: When combined, those who use both of these substances regularly increase their chances of oral cancers by as much as 35 times, especially for those who smoke two packs a day and have more than four servings of alcohol per day.
• HPV: Human papillomavirus, primarily type 16, increases the risk of oropharyngeal cancer about 15 times more than those who are not infected.
• Epstein-Barr virus: Those with EBV are at risk of nasopharyngeal cancer about 33 times higher than those who do not.
• Family history of neck and throat cancer.
• Immunosuppression medications for an organ transplant.

Oral Cancer Screening

As with all types of cancer, early prevention and screenings can increase a person’s chances of survival. Avoiding the most common risks associated with oral cancers is a surefire way to reduce the chances of cancer cells developing, but going for regular dental checkups can also increase awareness. Dentists are trained to spot and monitor areas that look like they may be early stages of various oral cancers, and can speak with patients about other symptoms that occur that may also be warning signs of potential cancer risk.

Some symptoms to look for in early warning signs of oral cancer include sores in the mouth that don’t heal, bleeding from the mouth that lasts more than a week, slow emerging bumps in the mouth or neck, pain in the mouth that lasts more than two weeks, inexplicable voice changes, frequent earaches, and numbness of the lower lip and chin. In the case of concerning areas that could potentially be oral cancer, biopsies are the best route to accurately diagnosing oral and oropharyngeal tumors or lesions.

Tips for Oral Cancer Prevention:

• Boosting the immune system by eating a diet that is full of fruits and vegetables can add much-needed vitamins, minerals, and antioxidants that the body needs for protection. Foods like carrots, Brussel sprouts, and squash are particularly beneficial.
• Using SPF on the lips when in the sun is an important yet often overlooked step in preventing cancerous cells from forming near the mouth, especially on sensitive and thin lip tissue.
• Staying up to date with dental visits is one of the best ways to spot and treat any potential oral cancers. Dental providers are more likely to identify problem areas during examinations that people can’t see on their own.
• Quitting smoking and staying away from secondhand smoke can significantly decrease cancer exposure.
• Reducing alcohol intake is an essential and overlooked way to reduce oral cancer risk as every serving of alcohol increases inflammation in the throat and mouth and can lead to cell mutation.

Oral cancers are not talked about as frequently as other cancers that are common among the US population; however, they still occur, and all too often, these cancers are not identified in time to prevent their spread. Identification, screening, and prevention are the most critical steps towards avoiding fatal oral cancers, along with regular dental and oral health examinations from certified dental professionals.