Oral Cancer

Lydia Valdez thought she had a canker sore.   The 70-year-old California woman never dreamed the spot on her tongue could be oral cancer.

She didn’t smoke.  She had no history of cancer in her family.  She didn’t have any of the known risk factors.  When she felt a sore spot on her tongue, she thought it was just caused by an old crown rubbing against her tongue.

She hadn’t been to the dentist in a few years.  Seventy years old and still working, she had health benefits, but no time.  Finally, when she had an appointment with her regular physician, she mentioned the sore.  He sent her to an Ear-Nose-Throat specialist, who recommended Lydia see a dentist.

As soon as Coast Dental dentist Dr. John Tchaboukian examined the spot, he suspected it might be cancerous.  Dr. Tchaboukian, who has 20 years of experience as a family dentist, recommended Lydia have an Identafi® oral cancer screening test.  Identafi uses different light spectrums to detect tell-tale cancer signs, including elevated levels of blood that tumors need to grow.  After the exam, Dr. Tchaboukian recommended Lydia have the spot biopsied.  The results shocked Lydia: She had Stage 1 oral cancer.

“Even my regular doctor was surprised, because I’m not a smoker,” Lydia said.

The Face of Oral Cancer is Changing

Oral cancer is also known as mouth cancer, tongue cancer, throat cancer, cheek cancer, pharynx cancer and sinus cancer.  Consider this:

• More than 37,000 people in the U.S. will be diagnosed with oral cancer this year.
• The fastest-growing at-risk group is sexually-active 25 to 50-year-olds
• Oral cancer has been linked to two strains of HPV, a sexually-transmitted disease
• HPV is expected to lead to more cases of oral cancer than cervical cancer by 2020, researchers say
• About half of oral cancer patients will not be alive 5 years after diagnosis
• With early detection, the survival rate jumps to almost 90%

A lot of times, people don’t realize they have oral cancer.  They may think they have a bit of a cold and that’s why they’re hoarse, or they bit their tongue and it’s just taking a long time to heal.

“I let my patients know that it may look like a bite mark, but it needs to get checked,” Dr. Tchaboukian said. “To feel like you’re saving a life, it just makes you feel very good.”

In the early stages, there may be no symptoms at all. That’s why it’s important to have an oral cancer screening.

“I hated going to the dentist, which is why I put it off,” Lydia said.  “Even though I have a good job and everything, it had been four years since I had been to the dentist.  Fortunately, they were able to catch it early, and it could be removed through surgery.  I don’t need any radiation or chemo, I’m able to talk and eat, and I feel good.”

Now Lydia is telling others to get checked.  “I thought oral cancer could only be caused by smoking.  Now I’m telling everyone they need to go to the dentist.  I know I’ll never miss another appointment!”

When your dentist suggests you have an oral cancer screening test, it can be a shock.  You might think, “But I don’t smoke,” or “No one in my family has ever had oral cancer. I don’t need that.”

Oral cancer is on the rise.  It’s no longer mostly smokers or tobacco-users; it’s sexually-active people between the ages of 25 and 50. The percentage of head and neck cancers linked to the sexually-transmitted human papillomavirus (HPV) disease increased by 225% in the last two decades, according to a study published in the Journal of Clinical Oncology in October 2011.  The authors predict HPV may lead to more cases of oral cancer than cervical cancer by 2020.

Already, more than 35,000 people are diagnosed with oral cancer each year, and because it is often caught late, only half of those diagnosed will survive more than five years.  But if it’s detected early, patients have a nearly 90% survival rate.

Eva Grayzel was 33 when she was diagnosed with oral cancer.  “It was April 1, 1998, the cruelest April Fool’s joke of my life,” she said. “I ate well, exercised and had no risk factors commonly associated with oral cancer.  I didn’t drink and I had never smoked.”

Grayzel developed a sore spot on her tongue, and had a biopsy done. “My first biopsy was misread, and I had no obvious symptoms for two years,” she said.   “When the sore returned over the biopsy site, I was bounced among dental professionals for nine months while the sore on my tongue got more prominent  and painful.”

Grayzel went through a radical neck dissection surgery, partial tongue reconstruction and radiation.  She still can’t feel the left side of her tongue, and has to chew on the right.    She has severe itching along her neck scar when she eats spicy food and can’t lift her head out of the sink at the hairdresser’s without assistance.  Now she’s founded the Six-Step Screening campaign to raise oral cancer awareness and educate dentists on how to screen patients for signs of cancer.

Early Detection Is Key

Another oral cancer survivor, Allen Paul, is a big believer in early detection.  “Last spring, I developed a little sore under my tongue,” the 69-year-old Dallas man said, “I probably waited longer than I should have, but I waited until my next dental appointment to have it checked.”

Paul’s dentist, Dennis M. Abbott, DDS, is the founder of Dental Oncology Professionals in Garland, TX.  He used a new cancer screening device called Identafi® to evaluate the spot.  The device is a little bigger than a pen and uses three kinds of light to illuminate problem areas.  White light checks for suspicious masses and lesions.  Violet light helps identify any areas of abnormal tissue growth.  The green-amber light illuminates the blood vessels around the lesions.  Cancerous cells require a greater blood supply to feed them.

“Identafi® allows us to magnify the scope of our visual exam,” said Dr. Abbott.  “If I can see more things with Identafi® than I can with my naked eye, then it’s useful.  In this case, all the readings came up positive, so we sent him out for a biopsy right away.”

The biopsy came back positive and Paul went in for surgery to remove part of his tongue.  The team did a skin graft and Paul is able to talk normally still.  The cancer was caught early enough that the entire mass was removed, and Paul did not need any radiation or chemotherapy.

Education and Action

Often, somebody with oral cancer doesn’t realize that anything is wrong.

“A lot of it is asymptomatic,” said Oliver Roberts, DMD, a dentist in Lutz, Florida.  Like all Coast Dental dentists, Roberts offers his patients the advanced Identafi® screening technology to supplement the conventional physical exam.

“People tend to think they bit their cheek and forget about it.  Or they may be hoarse, but they don’t realize it’s a sign that something can be seriously wrong,” Dr. Roberts said.

Oral cancer signs and symptoms can include:

• A sore in the mouth that bleeds easily or doesn’t heal
• A color change of the oral tissues
• A change in the way the teeth fit together
• A lump, thickening, crusty spot, or a small eroded area
• Pain, tenderness or numbness in the mouth or lips
• Trouble chewing, swallowing or moving the jaw or tongue

If you have any of these symptoms, make sure you call your dentist.

“Oral cancer is so disfiguring if it gets to a certain stage,” Dr. Roberts said. “You may lose part of your tongue or have to have part of your jaw removed.”

For Paul, the Dallas man whose cancer was caught early, it made sense to have his dentist use the advanced cancer screening technology. “It’s a simple process.  It’s not invasive at all, so why not do it?” Paul said. “You certainly don’t want to have a lot of your tongue cut out if you don’t have to.”

Oral cancer is on the rise, and more people like actress Blythe Danner and Oscar winner Michael Douglas are speaking out about this hidden disease to help save lives.

Danner’s husband, television and film director Bruce Paltrow, was celebrating his daughter Gwyneth Paltrow’s birthday when he died from complications of oral cancer. Oral cancer is one of the deadliest forms of cancer – deadlier than cervical, brain, ovarian, or skin cancer. That’s because it often has no symptoms in the early stages, when it would be easiest to treat.

When Michael Douglas disclosed his late-stage oral cancer diagnosis, new light was shed on this hidden health threat. The fastest growing segment of oral cancer cases are now young non-smokers who have been exposed to HPV, the same virus that causes cervical cancer.

Oral cancer can affect the:

• lip
• tongue
• mouth
• throat

What You Can’t See Can Hurt You

About 70% of the time, oral cancer cannot be detected in a conventional dental examination until it reaches a more advanced and potentially disfiguring stage. Surprisingly, oral cancer is one of the most curable cancers if treated early. When detected in the early stages, patients have a nearly 90% survival rate. Health care experts recommend a complete oral soft tissue exam at least once a year. Because early detection is so important, Coast Dental has made a commitment to screen patients for oral cancer using advanced technology.

We supplement a conventional oral examination with Identafi®, the world’s first multi-spectral imaging device that can help a dentist detect oral cancer at its earliest and most curable stages.

Identafi uses varying colors of light to detect abnormalities that are not visible in a conventional exam. There is a charge for this quick, painless and non-invasive advanced oral cancer screening exam that is covered by some insurance plans.

Watch an Identafi Exam

Signs and Symptoms of Oral Cancer

If you or a loved one have any of the following symptoms it’s time to see your dentist. These common signs and symptoms could indicate oral cancer:

• a sore in the mouth that bleeds easily or doesn’t heal
• a color change of the oral tissues
• a change in the way the teeth fit together
• a lump, thickening, crust spot, or a small eroded area
• pain, tenderness or numbness in the mouth or lips
• trouble chewing, swallowing or moving the jaw or tongue

But remember, oral cancer doesn’t always have symptoms in the early stages. That’s why it is so important to get screened annually.

Anyone Can Get It – Even You

Don’t think you’re at risk? Think again. In the U.S., more than 40,000 people are diagnosed with oral cancer each year. Other notables diagnosed with this serious disease include:

• Gwyneth Paltrow’s father Bruce Paltrow
• television producer Aaron Spelling
• baseball great Babe Ruth
• movie critic Roger Ebert
• rock star Eddie Van Halen

Startling Statistics

Sexually active people between the ages of 25 – 50 are the fastest growing segment of the oral cancer population. That is because it has been linked to two strains of the human papilloma virus (HPV 16/18).

Think you can’t get it? Watch this touching story.