HEALTH

What you should know about oral cancer

11 April, 2023 . 0

Aussie music legend John Farnham’s battle with oral cancer has put the spotlight on the aggressive disease.

Oral cancer is the sixth most-common type of cancer worldwide but it has taken Australian music icon John Farnham’s case to really heighten public awareness of the disease.

Farnham’s diagnosis and subsequent 11.5-hour surgery to remove a cancerous growth from his mouth prompted an outpouring of support for the 73-year-old last August, and a timely reminder from medical professionals of the importance of oral health screening.

What is oral cancer and why is it often overlooked?

Oral – or mouth – cancer includes cancer of the lips, cheeks, gums, back of the throat and salivary glands but is most common on the sides of the tongue and the floor of the mouth.

More than 900 cases are recorded – about 6.5 per cent of all cancers diagnosed – in Australia each year and the average age at diagnosis is 67 years old.

An aggressive disease, it has a survival rate of only 50 per cent over five years.

In an interview with The House of Wellness radio for Oral Cancer Awareness Month in April, Sydney dentist Dr Celso Cardona says oral cancer often has no symptoms until it is more advanced.

“I think the main reason for that is unfortunately oral cancer is (initially) painless,” Dr Cardona says.

“The No.1 trigger for people to visit a medical health professional or a dentist is pain, and cancer doesn’t have that a lot of the time in the mouth.”

Listen to The House of Wellness radio interview here:

What are some of the symptoms of oral cancer?

Dr Cardona says the most common symptom of oral cancer is a mouth ulcer that doesn’t heal, either inside the mouth or on the lip.

“There are other signs – like difficulty swallowing, difficulty chewing, loose teeth, any lumps inside the mouth and patches, as well, but most of those things are not easily noticed by the untrained eye,” he says.

“The mouth is quite complex, we can look at it quite in depth and we are trained to see small, small changes inside the mouth that the untrained person would not notice, unfortunately.”

Other symptoms include changes to your speech, bleeding or numbness in the mouth, a lump in your neck or unexplained weight loss.

Dentists often first to notice signs of oral cancer and they or your doctor can conduct an examination, which may warrant further tests such as an endoscopy, biopsy or scan for diagnosis.

What are the risk factors for oral cancer?

Smoking or drinking more than the recommended amount of alcohol
Sun exposure, especially to the lips
Poor diet, poor mouth hygiene or gum disease
Viruses such as human papillomavirus (HPV virus) or Epstein-Barr virus (EBV), which causes glandular fever
Having a close relative who has had mouth cancer
Chewing betel nuts
Men are three times more likely than women to develop oral cancer
Being over 40 years old

What is the link between oral cancer and HPV?

The human papilloma virus is a sexually transmitted infection, which in most cases the immune system clears from the body.

Persistent HPV infection can cause mouth and throat cancers, and is responsible for 60 per cent of oropharyngeal cancers (back of the throat, including the base of the tongue and tonsils).

Fortunately the HPV vaccine is offered to all Australian children aged around 12 to 13 via the Secondary School Immunisaton Program.

“Mouth cancers were traditionally the cancers of older males,” Dr Cardona says.

“We see younger people with oral cancers now, especially younger females, so there is a probable link, which we don’t understand fully.”

What can we do to prevent mouth cancer?

“If you have your nutrition in balance, your exercise, your sleep – all those things are quite important in the prevention of any type of cancer,” Dr Cardona says.

“Oral cancer is no different.”

About 59 per cent of oral cancers in Australia are caused by smoking, while some 31 per cent are caused by excess alcohol consumption.

“If you drink and smoke together your risk increases exponentially,” Dr Cardona says.

“Also early detection is paramount when it comes to oral cancers because the first lesion, the first detection may be something small, maybe a millimetre in width.”

He says many patients, particularly older, are under the false impression that if they do not have teeth they do not need to go to the dentist anymore.

“It’s very important to continue check-ups even if you have no teeth because oral cancer still develops in a patient that doesn’t have any,” Dr Cardona says.

“Now in terms of timing, any ulcers that don’t heal in your mouth after two weeks, they need to be considered suspicious.”

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Written by Dan Imhoff.