Oral cancer refers to all cancers of the oral cavity, which includes the following:  lips, tongue, teeth, gums (gingiva), lining inside the lips and cheeks (labial mucosa and buccal mucosa), floor of the mouth, roof of the mouth (palate), area behind the wisdom teeth.  Most oral cancers are located on the sides of the tongue, floor of the mouth and lips.

Incidence and Survival Rates

Oral cancer represents approximately 2.3 % of all cancers in Canada.  In 2002, these cancers accounted for more than 3000 new cases and 1000 deaths.  The 5-year survival rate for oral cancer is low, just below 50%.  However, early detection results in the survival rate increasing sharply to 80%.

Key Risk Factors

• Smoking –especially if combined with heavy alcohol consumption
• Chewing tobacco or snuff
• Heavy alcohol consumption, particularly if combined with smoking
• Excessive sun exposure to the lips, often through working in outdoor jobs like construction
• Age –oral cancer is more common in people over 50
• Gender –more men than women develop oral cancer

Symptoms

• A sore on the lip or in the mouth that does not heal
• A lump on the lip or in the mouth or throat
• A white or red patch on the gums, tongue or lining of the mouth
• Unusual bleeding, pain or numbness in the mouth
• A sore throat that does not go away, or a feeling that something is caught in the throat
• Difficulty or pain chewing or swallowing
• Swelling of the jaw that causes dentures to fit poorly or become uncomfortable
• A change in the voice and/or pain in the ear

Diagnosis

A complete medical history is required before conducting an oral cancer assessment either as a routine exam or in cases where oral cancer may be suspected.  Any lesion that your dentist determines is unlikely to be cancerous should be observed for seven to 14 days to ensure that the healing process is ongoing.  When there is a high suspicion of cancer, an immediate biopsy will be needed to determine if the lesion is cancerous.  Your dentist may decide to remove the tissue in the office or refer you to a specialist.

Treatment

Treatment plans are developed to fit the specific needs of the patient and must consider the patient’s age and general health as well as the location, size, type and extent of the tumor and stage of the disease.

In most cases, treatment involves surgery, chemotherapy, radiation therapy or a combination of the two.  Some patients receive chemotherapy treatment with anticancer drugs.  Regular follow-up exams by the dentist and doctor are very important for anyone who has been treated for oral cancer in order to ensure that the cancer has not recurred.  Patients suffering from dry mouth due to radiation therapy should have dental exams three times per year.  Patients who continue to drink or smoke are strongly advised to quit.

Related Web Sites

Canadian Cancer Society

www.cancer.ca

Canadian Strategy for Cancer Control

www.cancercontrol.org

Cancer Care Ontario

www.cancercare.on.ca

Health Canada

www.hc-sc.gc.ca/pphb-dgspsp/dsol-smed/  (select cancer button)

National Cancer Institute of Canada (NCIC)

www.ncic.cancer.ca

MEDLINE plus

http://www.nlm.nih.gov/medlineplus/oralcancer.html

The Oral Cancer Foundation

www.oralcancerfoundation.org