Oral Cancer

Oral cancer (also known as mouth cancer) occurs when cells in the tissues of the mouth or throat divide without control or order, forming abnormal growths. Oral cancer can be deadly if not treated promptly.

What Is Oral Cancer?

Oral cancer usually begins in the tissues that make up the lips, tongue, or cheek lining, but it also can affect the gums, the floor or the roof of the mouth, or the salivary glands * . Long-term use of tobacco products, such as cigarettes, cigars, chewing tobacco, and pipes, is a substantial risk factor for oral cancer, as is heavy alcohol use. Risk is further increased if these two behaviors are combined. Other risk factors include human papillomavirus (HPV) * infection, exposure of the lips to the sun, and a prior history of oral cancer.

E-Cigarettes

Electronic cigarettes (also known as e-cigarettes or vapor cigarettes) are battery-operated devices that resemble traditional cigarettes. These cigarettes do not burn tobacco. Instead, they contain cartridges filled with nicotine and other chemicals. When the e-cigarette is used, the liquid chemicals in the cartridge are turned into a vapor or steam that is inhaled by the smoker.

E-cigarettes became readily available in the United States in 2006, and few studies have been done on the potential health risks they carry. Although e-cigarettes still give off some of the same chemicals as regular cigarettes, they do so at much lower levels, leading to the belief they are safer for smokers. Experts agree that more research is needed on the long-term effects of e-cigarettes.

In 2015 researchers at Portland State University reported that when operated at a high volume, e-cigarettes produced formaldehyde at levels 15 times higher than a regular cigarette. (Users of certain e-cigarettes have the option to increase the voltage on their devices to deliver a higher dose of nicotine.) The American Vaping Association, however, disputed these findings, stating that e-cigarette users would not operate their devices at the high voltage described in the study.

In 2016, the U.S. Food and Drug Administration (FDA) issued regulations deeming e-cigarette products as tobacco products, allowing tobacco regulations to apply to e-cigarette products. As of 2016, the FDA had not approved e-cigarettes as a way to quit smoking. People with cancer who want to quit smoking should use the approved methods for quitting smoking. As of 2015, no studies had been completed to determine if e-cigarettes cause oral cancer.

Many oral cancers begin as white or red patches in the mouth. The white patches are called leukoplakia (loo-ko-PLAY-kee-uh), and the red patches are known as erythroplakia (e-rith-row-PLAY-kee-uh). Other symptoms may include the following:

It is important that a person seek medical treatment if they experience any of these symptoms that last for more than two weeks.




Electronic cigarettes, also known as e-cigarettes, are battery-operated products that turn chemicals, including highly addictive nicotine, into an aerosol that is inhaled by the user.





Electronic cigarettes, also known as e-cigarettes, are battery-operated products that turn chemicals, including highly addictive nicotine, into an aerosol that is inhaled by the user. E-cigarette use can lead to hospitalization for illnesses such as pneumonia, congestive heart failure, disorientation, seizure, hypotension, and other health problems.
©scyther5/Shutterstock.com.
A MAJOR LEAGUE FIGHT AGAINST SPIT TOBACCO

For many years, baseball great Joe Garagiola (b. 1926) waged a one-man battle against the prevalent use of spit tobacco, also called chewing tobacco, snuff, or chew, by major league baseball players. A former user of spit tobacco, Garagiola was concerned about both the players’ health and the effect their behavior was having on young fans. He wanted to convey the message that just because spit tobacco is smokeless does not mean it is safe. To the contrary, it is a major cause of oral cancer.

In 1996, Garagiola collaborated with the group Oral Health America to found the National Spit Tobacco Education Program (NSTEP) and get other players involved with the cause. Bill Tuttle, who started using spit tobacco as an outfielder in the 1950s and 1960s, gave talks based on his own experiences with oral cancer. NSTEP recruited players Lenny Dykstra, Mike Piazza, Tino Martinez, Alex Rodriguez, and Paul Molitor to do antitobacco spots that were broadcast during games. Garagiola continues his involvement with NSTEP and served as one of their speakers.

The mission of the National Spit Tobacco Education Program, which celebrated its 20th anniversary in 2014, is to prevent people (especially young people) from starting to use spit tobacco and to help all users quit.




Oral cancer on the inside of a patient's cheek.





Oral cancer on the inside of a patient's cheek.
Clínica Clarós/Science Source.

How Is Oral Cancer Diagnosed and Treated?

Most dentists check for signs of oral cancer as part of a regular dental examination. Early detection is the key to treating it successfully. Otherwise, it can spread throughout the mouth, throat, neck, and even to distant parts of the body through the lymphatic system * . If oral cancer is not discovered until late in its development, only around 57 percent of sufferers are still alive five years after being diagnosed. When dentists or doctors find a suspicious-looking area in the mouth, they may order a biopsy. During this procedure, a surgeon removes part or all of the suspect tissue. Examination under a microscope determines whether cancer cells are present. Once oral cancer is diagnosed, doctors then need to find out whether the cancer has spread.

The first course of treatment is to remove the tumor and any cancerous tissue in the mouth. If there is evidence that the cancer has spread, the surgeon may remove lymph nodes * in the neck as well as part or all of the tongue, cheek, or jaw.

Doctors may also order radiation * therapy, either before the surgery to shrink the tumors, or afterward to destroy any remaining cancer cells. In some cases, surgeons may place tiny “seeds” containing radioactive material directly into or near the tumor. Generally, this implant is left in place for several days, and the patient stays in the hospital.

Chemotherapy is another possible treatment for oral cancer, especially when it has spread beyond the mouth. It involves taking anticancer drugs by injection or in pill form.

ORAL CANCER AND TOBACCO

The Centers for Disease Control and Prevention (CDC) has compiled statistics about tobacco use in the United States. Tobacco use is one of the major causes of oral cancer.

All forms of tobacco use have been linked to oral cancer. Scientists believe that certain chemicals in tobacco damage a person's DNA; of the over 7,000 chemicals found in tobacco smoke, over 70 of them have been found to cause cancer.

Life after Oral Cancer

People who are treated for large or widely spread oral tumors often experience permanent changes that are challenging to deal with, both emotionally and physically. If a person loses part of his or her jaw, tongue, cheek, or palate (the roof of the mouth), reconstructive and plastic surgery may be necessary. Some people need to be fitted with an artificial dental or facial part called a prosthesis * . Both of these procedures can change a person's appearance permanently. Some treatments for oral cancer can lead to difficulty chewing and swallowing, and loss of the sense of taste is also possible.

Many patients have trouble speaking after losing part of their mouth or tongue. Speech therapists work with them both during and after their hospital stay to help them get back to speaking as normally as possible. Persons who have had oral cancer should receive regular checkups to make sure the cancer has not recurred. This is especially important for those who continue to use tobacco or alcohol products after treatment.

How Is Oral Cancer Prevented?

People can prevent oral cancer by not using spit tobacco or smoking cigarettes, cigars, or pipes, or by quitting if they already do. Alcohol use should be moderated, especially if the person is also a smoker. Sexually active persons should take precautions to avoid getting HPV.

See also Cancer: Overview • Tobacco-Related Diseases: Overview

Resources

Books and Articles

Kirita, Tadaaki and Ken Omura. Oral Cancer: Diagnosis and Therapy. New York: Springer, 2015.

National Cancer Institute. What You Need to Know About Oral Cancer. http://www.cancer.gov/publications/patient-education/wyntk-oral.pdf (accessed November 22, 2015).

Raloff, Janet. “Health Risks of E-Cigarettes Emerge.” Science News 185, 13 (June 13, 2014): 9. https://www.sciencenews.org/article/health-risks-e-cigarettes-emerge (accessed November 22, 2015).

Seaman, Andrew M. “Smokeless Tobacco Users Exposed to More Nicotine, Cancer-Causing Chemical.” Reuters. November 20, 2015. http://www.reuters.com/article/2015/11/20/us-health-tobacco-smokeless-idUSKCN0T92YE20151120#7wsOS4ZX0BK0Fw2q.97 (accessed November 22, 2015).

Websites

American Cancer Society. “Tobacco and Cancer.” http://www.cancer.org/cancer/cancercauses/tobaccocancer/ (accessed November 22, 2015).

Cancer.net . “Health Risks of E-Cigarettes, Smokeless Tobacco, and Waterpipes.” http://www.cancer.net/navigating-cancer-care/prevention-and-healthy-living/tobacco-use/health-risks-e-cigarettes-smokeless-tobacco-and-waterpipes (accessed October 23, 2015).

MedlinePlus. “Oral Cancer.” U.S. National Library of Medicine, National Institutes of Health. https://www.nlm.nih.gov/medlineplus/oralcancer.html (accessed November 22, 2015).

Merck Manual: Consumer Version. “Mouth and Throat Cancer (Oral Cancer; Oropharyngeal Cancer).” http://www.merckmanuals.com/home/ear-nose-and-throat-disorders/mouth-nose-and-throat-cancers/mouth-and-throat-cancer (accessed November 22, 2015).

Organizations

American Cancer Society. 250 Williams St. NW, Atlanta, GA 30303. Toll-free: 800-227-2345. Website: http://www.cancer.org (accessed August 11, 2015).

National Cancer Institute. BG 9609 MSC 9760, 9609 Medical Center Dr., Bethesda, MD 20892. Toll-free: 800-422-6237. Website: http://www.cancer.gov (accessed October 23, 2015).

The Oral Cancer Foundation. 3419 Via Lido, #205, Newport Beach, CA 92663. Telephone: 949-723-4400. Website: http://www.oralcancerfoundation.org (accessed October 23, 2015).

Oral Health America. 180 N Michigan Ave., Suite 1150, Chicago, IL 60601. Telephone: 312-836-9900. Website: https://oralhealthamerica.org (accessed November 22, 2015).

* salivary glands (SAL-i-var-ee) are the three pairs of glands that produce the liquid called saliva, which aids in the digestion of food.

* human papillomavirus (HPV) is a sexually transmitted disease that affects both men and women. HPV often goes away without causing any damage, but it can lead to medical issues such as genital warts or cancer.

* lymphatic system (lim-FAH tik) is the system that contains lymph nodes and a network of channels that carry fluid and cells of the immune system through the body.

* lymph nodes (LIMF) are small, bean-shaped masses of tissue containing immune system cells that fight harmful microorganisms. Lymph nodes may swell during infections.

* radiation is energy that is transmitted in the form of rays, waves, or particles. Only high-energy radiation, such as that found in x-rays and the sun's ultraviolet rays, has been proven to cause human cancer.

* prosthesis (pros-THEE-sis) is an artificial substitute for a missing body part. It can be used for appearance only or to replace the function of the missing part (as with a prosthetic leg).

Disclaimer:   This information is not a tool for self-diagnosis or a substitute for professional care.

(MLA 8th Edition)