Eliezer B. Blanes DMD, FPCOMS, AFPAHNSI
Chair, PDA committee on oral disease
Published in Manila Bulletin

In the modern world that we live in today advances in technology and science has brought comfort and efficiency in our lives. Transportation and communication has made the world a lot smaller. Even the stars become testament to what these advances has made us capable. The world of medicine underwent the same evolution, technological advances and knowledge has irradicated disease of old, our average lifespan has also increased, medicine for common cold, and fever can readily be bought at your corner drugstore. However with all the advances in science and medicine there still remain diseases that baffle us. One of these dreaded disease is that of Cancer.

On all malignancies that can affect the human body 3% befall the mouth. To separate it from other types they are called oral cavity cancer. In the United states cancer statistics, 1999-2005 incidence results shows that oral cavity cancer has a higher incidence (10.6) than cancer of the cervix and uteri (8.7), the same database of the US Dept of Health & Human services, Centers for Disease Control and Prevention, National Cancer Institute-august 2008 has also shown that it is commonly found in the oral cavity & pharaynx followed by the gums and other parts of the mouth then the tonsils.

Majority of oral cancer (90%) are malignant tumors of the soft tissues that cover the lips, mouth, oropharynx, tongue and jaws. The remaining 10% are cancers that may occur in the jaw bones or salivary glands. It has become 6th most common malignancy in the US among males and about 85%-90% is squamous cell carcinoma. Management of oral cavity cancer even with the advancement of our time has still remained the same with that decades ago. Surgery is still the mainstay treatment the sad part however is that majority of cases are diagnosed at a later stage of the disease and most often than not will end up with a debilitating condition resulting from an ablative surgical procedure.

The story of cancer isn’t always a tragedy, One of the greatest cancer story of our time is that of cervical cancer. Its incidence has drastically dropped since the 1980’s. All this however is not because of a miracle drug or a ground breaking surgical procedure. Cervical cancer’s secret is not in its management but in the preventive procedure and Increased public awareness. Incorporation of an annual screening has made it possible to notice pre-malignant conditions and prevent cancer from setting in and that in itself has caused the drop of the cervical cancer cases.

Oral squamous cell carcinoma, the most common oral cavity malignancy is similar with the squamous cell carcinoma of the cervix. Studies on HPV as a cause of some oral cavity cancer has even been explored owing to the success in the advancement of preventive management in cervical cancer. One of the newer equipment in oral cancer detection is tissue fluorescence which is also being used in cervical cancer detection.
Who is at risk, it can affect all races & sexes and most patients are over 40. Those who smoke and drink alcohol have a more than 10 times greater risk. However recent findings like the SEER program of the NCI Surveillance research program, have shown that nowadays an increasing occurrence of oral cancer is seen in patients that are no belonging to the risk groups. There is an increase of patients under 50 years old who have been diagnosed with oral cavity cancer. Oral cavity cancer’s 5 year survival rate drops from 80% to 20% as the cancer changes from a localized condition (carcinoma in situ) to causing distant metastasis.

Prevention and early detection, can however increase the chance of cure, a dentist can perform a thorough oral cancer examination as part of your yearly check up. He/she can also explain the risk factors such as smoking and excessive alcohol consumption.
The PDA committee on oral diseases recommends to see your dentist if you notice any of the following: reddish patches on the oral tissues, whitish patches that can’t be removed with brushing and rinsing, oral sores that bleed easily and/or fails to heal, a lump or “bukol” or unusual thickening of the oral tissues, chronic (long standing) sore throat, difficulty in chewing or swallowing.

Your dentist can examine these to make sure there is nothing to worry about, and if he or she discovers anything unusual they can refer you to the appropriate specialist.

The adage, “an ounce of prevention is better than a pound of cure” cannot be more true with oral cavity cancer. For if seen early enough in its stage or seen in its pre-malignant stage a definitive cure can be done and spare someone from a debilitating surgical procedure.
Prevention and early detection are the keys to early treatment and cure of oral cancer. So see your dentist for an oral cancer screening now.