Saturday, August 1, 2009
I have a sore in my mouth – how can I be sure whether it is a canker sore or oral cancer?
In addition to checking for cavities and gum disease, oral cancer is one of the things dentists look for when we do an examination during a check-up. We look at the most common areas where oral cancer is found: under the tongue and on the floor of the mouth, on and around the sides of the tongue, in the back of the throat, on the sides of the cheeks, on the roof of the mouth and around the lips. Sometimes an x-ray will reveal cancer in the bones of the upper or lower jaw, or in the spaces of the sinuses. Dentists will also examine the neck for unusual swellings or hardening of the lymph nodes, which may indicate cancer in the throat. One of my patients noticed an unusual change in his voice and later found that he had a tumour on his larynx. Fortunately, it was operable and he continues to sing in his band today.
Oral cancers look like red sores or white patches. They are often painful, irregularly shaped, and bleed easily. Unlike canker sores or cold sores, they do not improve or disappear over time. Teeth around the area may be loose or uncomfortable to chew on. Patients may also notice a lump or thickening in the mouth or throat.
A biopsy is the only certain way to determine if tissue is cancerous. Your dentist, or an oral medicine or surgical specialist, can perform one. The tissue sample is then sent for a histological test at a lab to determine if it is a cancer. Different levels of severity from benign to malignant will be assessed and treatment recommended. Complete removal of the cancerous tissue is recommended to prevent spread or metastasis. Treatment may also involve radiation and chemotherapy if it is suspected that the cancer has spread to other parts of the body. Unfortunately, if the cancer is advanced, radical surgery to remove large areas is often required in order to save a patient’s life. This type of surgery can be disfiguring and debilitating to the patient, who will often have difficulty with chewing and swallowing, and may require speech rehabilitation. As with all forms of cancer, early detection is crucial.
There are new instruments being used by some dentists than can aid in the early detection of oral cancer. The most common of these uses a special light that causes abnormal tissue to appear different from healthy tissue. While these tools cannot replace the judgement of an experienced clinician, they are a valuable adjunct to the screening process.
There is no absolute prevention of oral cancers. There are ways to reduce your risk such as minimizing drinking, quitting smoking or chewing tobacco, and eating healthy foods. The combination of alcohol and tobacco is particularly risky, as alcohol thins out or strips away the lining of the oral tissue, which then allows the carcinogens in tobacco to damage the cells. Limiting sun exposure and using a lip balm containing sunscreen will help to prevent cancer on the lips. Infection with the human papilloma virus (HPV) has been linked to several types of cancer including oral, so practicing safe sex can also help to reduce your risk.
Going to the dentist isn’t just about getting your teeth cleaned or your gums checked. It is an important part of your total wellness and should be done on a regular basis. Ask your dentist to evaluate your oral health with a thorough cancer screen.
Keep smiling!
