Five Minutes to Save a Life
As we approach Ireland’s National Mouth Cancer Awareness Day on Wednesday, September 17th, I’m going to outline what the disease involves and some of the problems that can arise from mouth cancer. You can find more information on this in my previous blogs, but this is a summary of the important stuff.
Swords Orthodontics is in the middle of a busy street where there are about a dozen people trained and equipped to detect and intercept one of Ireland’s most dreadful diseases, and even though this disease is on the increase few people are aware of it - and how easy it is to get checked out for it when they’re least likely to know it’s there and they’re most likely to have successful treatment for it.
What is mouth cancer?
Cancer is a general term for diseases where some of the body’s tissue loses the regulation of its growth and it grows uncontrollably. It can invade the local area and damage tissues nearby or be spread through blood vessels to other parts of the body. If it involves some area of the body that is vital to life, then it becomes life-threatening.
Mouth cancer is a general term given to any form of cancer (there are a few different ones) that presents in the mouth.
Although it's not a widely discussed illness, the mouth is a relatively common area for cancer to occur. If you go to the cinema or watch TV, you might see an advert to get screened for cervical cancer, you’ll also often hear about screening for breast cancer and prostate cancer (particularly in Movember). The public awareness for mouth cancer is a lot less, so this is an article to improve that.
How common is mouth cancer?
I mentioned cervical cancer - this accounts for about 2% of all cancers in women (which means about 1 in 50 of all cancers diagnosed in women will be cervical cancer). Mouth cancer also accounts for about 2% of all cancers in women (so about 1 in 50 of all cancers diagnosed will be mouth cancer), but it also accounts for the same percentage in men, and when you add the two together, it's one of the 20 most common areas for cancer to occur.
It's more common than brain cancer, myeloma or liver cancer. In fact, it's more common than cervical cancer and thyroid cancer combined.
(These figures are for the UK from UK Cancer Research, I don't have Irish figures handy as I'm writing, but you can expect them to be roughly similar. However, on a worldwide basis, Mouth Cancer is the sixth most common cancer because it is very common in some large population countries like India and Pakistan.)
It’s also on the increase – we see far fewer new cases of stomach, throat and lung cancer compared to 15 years ago, but many more mouth cancers.
How serious is mouth cancer?
Ultimately, any life threatening disease should be considered serious, but mouth cancer has a few special characteristics.
- The mouth is part of the face, and the face is the most obvious source of our identity. Therefore any disease that threatens the appearance of the face has an extra significance. When I was studying dentistry we had a lecture on anaesthetics and the anaesthetist mentioned a well-known actor that had lung cancer, and was treated with an operation to remove one of his lungs “he’d only one lung, and went up and collected his Oscar no bother”. In other words, there are areas of the body where you can experience significant disease, and then significant surgical alteration and it will be practically invisible, but the mouth is not one of them. Advanced mouth cancer is disfiguring to the face, and even if the cancer doesn’t advance far, if advanced surgical treatment is required that can also have a radical effect on the patient’s appearance. And both the disease and the treatment can have a significant effect on the function of the mouth – that could involve eating and speaking.
- Mouth cancer can often be painless, sometimes a patient doesn’t notice it’s there until they notice a swelling in their mouth, or a break in the lining of the mouth, or they can’t move their tongue normally.
But unlike many other cancers that happen deep within the body, mouth cancer happens in an area which can easily be examined without using complicated equipment – often a good light and a small mirror are all you need.
Reducing the risk
There are some risk factors that you have no control over – age, sex, ethnic background. There are some that you do, and according to UK Cancer Research, about 9 out of 10 cancers have a link to lifestyle or environment:
- Smoking - you guessed it, the more you smoke, the more likely you are to have this illness
- Alcohol - yep, that too, the more you drink the more likely you are to have mouth cancer
- Smoking and Alcohol - well, that seems obvious, but actually when scientists looked into this, it turns out that combining tobacco and alcohol has a multiplying effect on the appearance of mouth cancer, well beyond what you'd expect from just adding up the risks. They seem to boost the danger of each other
- Tobacco - well, you'd think that comes under smoking but some people chew it too and that increases their risk of the disease
- Sunshine - we need a bit of it for general health, but it can increase the chances of some cancers, particularly on the lip so if you have an outdoor lifestyle a bit of sunblock is a good idea
- Poor Diet - the more fresh fruit and vegetables you eat, the lower your risk
- Viruses - there is a particular virus, part of the same virus family that causes warts, that can increase the risk of mouth cancers
- Immune system disorders - either due to diseases or medicines that alter the immune system (which you might have to take after a transplant for instance) make the disease more likely
- Chewing betel quid, areca nut, paan - these are things like chewing tobacco that are more common in some Asian countries, but would be pretty rare in Europe in the wider community. They are believed to contribute to the colossal incidence of mouth cancer in some countries where they are used
- Also, anyone who has had a previous history of mouth cancer is much more likely than the general public to have a new mouth cancer appear. Not exactly a lifestyle choice, but something you can be aware of and make decisions about.
Signs to look out for
Even if you sorted out all of these things, you don't become immortal! You may still have a chance of mouth cancer occurring so the next stage is to look out for the disease. Since the mouth is reasonably easy to look at, this should be easier than spotting most other cancers.
- Sores or ulcerations (breaks in the lining of the mouth) that don't heal up in 2-3 weeks
- Lumps or swellings in the mouth or neck
- Red areas, white areas, speckled areas on the lining of the mouth or cheeks
- Difficulties swallowing, chewing, moving the tongue, speaking (including hoarseness)
- Numbness or altered sensation in the mouth
The best person to look for mouth cancer, particularly in the early stages, is a dentist.
A dentist has:
- A big light specially designed for looking in your mouth
- Small mirrors for looking around your mouth
- Plenty of knowledge about what healthy mouths are normally supposed to look like
- Plenty of knowledge about what mouth cancer looks like
- Plenty of knowledge about things that aren't mouth cancer but might still look abnormal
- The phone number and address of specialists to discuss any problems with
So if there was ever a reason to have a regular visit to the dentist, this is it – even if you have no teeth!
And here's the only statistic in this article you need to remember
Early detection and treatment of the disease means you are more likely to survive it. In some cases this could be 500% more likely.
Sadly most people don't present until late in the disease process and their survival rates are poor, and their treatments are much tougher. According to some studies, the overall likelihood of surviving this disease hasn't improved in 20 years - not because treatments haven't got better, but because more people are suffering from it, but still presenting too late.
Irish National Mouth Cancer Awareness Day
Five minutes to save a life
For one day a year, many dentists across Ireland will offer free mouth cancer screening to people - even if they aren't a patient at that dentist's practice. This year it’s Wednesday, September 17th. If you want to find out more about it, and if a dentist in your area is participating go to:
Phone your dentist now and arrange an appointment – if it saves your life, then it’s 5 minutes well spent.
Our practice, Swords Orthodontics will be participating again in this national campaign. Give us a call on 01 810 7622 to arrange a screening appointment.