Thursday, April 7, 2011

Health Care and Oral Cancer

Oral cancer can be a killer, and it is extremely painful. Tobacco users have been aware for decades of the possibility of contracting this disease. However, cancer in the mouth has been a scourge of those who spin the health care roulette wheel and hope to not lose. Oral Cancer affects Americans not only physically, but also financially and in many other ways.
Oral cancer is part of a group of cancers called head and neck cancers, according to MedicineNet. Oral cancer can develop in any part of the oral cavity or oropharynx. Most oral cancers begin in the tongue and in the floor of the mouth. Almost all oral cancers begin in the flat cells (squamous cells) that cover the surfaces of the mouth, tongue, and lips. These cancers are called squamous cell carcinomas.
Oral cancer is a silent killer in that it may not produce pain or other symptoms in the early stages. By the time a person realizes that there is a problem, the cancer has had an opportunity to spread to other areas of the body, according to the Consequently, the death rate for oral cancer is high -- higher than that of cervical cancer, skin cancer, Hodgkin's lymphoma, and testicular cancer. Roughly one person dies every hour of every day as the result of oral or pharyngeal cancer. Last year, approximately 37,000 Americans were diagnosed with oral cancer, and worldwide, more than 640,000 new cases were detected, according to the Oral Cancer Foundation. Regular dental examinations can improve the odds because early detection may lead to early cancer diagnosis and treatment. Even before a person notices any warning signs, a dentist may detect tissue changes or the actual cancer while it is still very small and more easily treated.

Doctors cannot always explain why one person develops oral cancer and another does not. However, we do know that this disease is not contagious, according to MedicineNet. You cannot "catch" oral cancer from another person. Research has shown that people with certain risk factors are more likely than others to develop oral cancer. A risk factor is anything that increases your chance of developing a disease. The following are risk factors for oral cancer:

•Tobacco: Tobacco use accounts for most oral cancers. Smoking cigarettes, cigars, or pipes; using chewing tobacco; and dipping snuff are all linked to oral cancer. The use of other tobacco products (such as bidis and kreteks) may also increase the risk of oral cancer. Heavy smokers who use tobacco for a long time are most at risk. The risk is even higher for tobacco users who drink alcohol heavily. In fact, three out of four oral cancers occur in people who use alcohol, tobacco, or both alcohol and tobacco.

•Alcohol: People who drink alcohol are more likely to develop oral cancer than people who don't drink. The risk increases with the amount of alcohol that a person consumes. The risk increases even more if the person both drinks alcohol and uses tobacco.

•Sun: Cancer of the lip can be caused by exposure to the sun. Using a lotion or lip balm that has a sunscreen can reduce the risk. Wearing a hat with a brim can also block the sun's harmful rays. The risk of cancer of the lip increases if the person also smokes.

•A personal history of head and neck cancer: People who have had head and neck cancer are at increased risk of developing another primary head and neck cancer. Smoking increases this risk.

According to the Oral Cancer Foundation, while some think this is a rare cancer, mouth cancer will be newly diagnosed in about 100 new individuals each day in the US alone, and a person dies from oral cancer every hour of every day. If you add the sub category of laryngeal throat cancers, the rates of occurrence (about 10,000 additional new cases per year) and death are significantly higher. When found at early stages of development, oral cancers have an 80 to 90 % survival rate. Unfortunately at this time, the majority are found as late stage cancers, and this accounts for the very high death rate of about 45% at five years from diagnosis, and high treatment related morbidity in survivors. Late stage diagnosis is not occurring because most of these cancers are hard to discover, it is because of a lack of public awareness coupled with the lack of a national program for opportunistic screenings which would yield early discovery by medical and dental professionals.
In the past, oral cancer patients were predominantly age 40 or older at the time they were diagnosed. Most patients are still older, but a growing number of patients are young people. In the latter group, the primary causes are smoking, the use of "smokeless" tobacco, and the human papilloma virus. Gender and race also play a role. Oral cancer has traditionally affected men by a six to one ratio over women, but in recent years, the gap between the sexes has closed to a ratio of two to one. This change may be the result of an increase in unhealthy lifestyle choices that women are making, such as smoking. Race plays a role in the development of oral cancer in that it occurs twice as often in African-Americans as in Caucasians, according to the OakRidger.

After a definitive diagnosis has been made and the cancer has been staged, treatment may begin. Treatment of oral cancers is ideally a multidisciplinary approach involving the efforts of surgeons, radiation oncologists, chemotherapy oncologists, dental practitioners, nutritionists, and rehabilitation and restorative specialists. The actual curative treatment modalities are usually surgery and radiation, with chemotherapy added to decrease the possibility of metastasis, to sensitize the malignant cells to radiation, or for those patients who have confirmed distant metastasis of the disease, according to the Oral Cancer Foundation. Prior to the commencement of curative treatment, it is likely that other oral health needs will be addressed. The purpose is to decrease the likelihood of developing post therapeutic complications. Teeth with poor prognosis from periodontal problems, caries, etc. may be extracted. This avoidance of post radiotherapy surgery is important as it can sometimes induce osteonecrosis, a condition which can develop when tissue damaged by radiation exposes the underlying bone. The bone, which has lost its ability to efficiently repair itself due to reduced blood supply, again from radiation exposure, yields a chronic and difficult to treat situation. A thorough prophylaxis, or cleaning will likely be done as well.

Prevention is always best, and making healthy lifestyle choices, such as steering clear of tobacco, may help. Regular dental examinations also are advisable. Anyone who develops a sore or discolored area in the mouth should see their dentist or family doctor if the place does not heal within two weeks. People also should seek medical help if they experience difficulty in swallowing, speaking, or chewing; persistent hoarseness; frequent ear aches; or numbness in the oral or facial region according to Dr. Joshua Campbell, D.D.S., an oral-maxillofacial surgeon on the staff of Methodist Medical Center of Oak Ridge.

Follow-up care after treatment for oral cancer is important, according to MedicineNet. Even when the cancer seems to have been completely removed or destroyed, the disease sometimes returns because undetected cancer cells remained in the body after treatment. The doctor monitors your recovery and checks for recurrence of cancer. Checkups help ensure that any changes in your health are noted. Your doctor will probably encourage you to inspect your mouth regularly and continue to have exams when you visit your dentist. It is important to report any changes in your mouth right away. Checkups include exams of the mouth, throat, and neck. From time to time, your doctor may do a complete physical exam, order blood tests, and take x-rays. People who have had oral cancer have a chance of developing a new cancer in the mouth, throat, or other areas of the head and neck. This is especially true for those who use tobacco or who drink alcohol heavily. Doctors strongly urge their patients to stop using tobacco and drinking to cut down the risk of a new cancer and other health problems.

Living with a serious disease such as oral cancer is not easy. You may worry about caring for your family, keeping your job, or continuing daily activities, according to MedicineNet. You may have concerns about treatments and managing side effects, hospital stays, and medical bills. Doctors, nurses, and other members of the health care team can answer your questions about treatment, working, or other activities. Meeting with a social worker, counselor, or member of the clergy can be helpful if you want to talk about your feelings or discuss your concerns. Often, a social worker can suggest resources for financial aid, transportation, home care, or emotional support. Support groups also can help. In these groups, patients or their family members meet with other patients or their families to share what they have learned about coping with the disease and the effects of treatment. Groups may offer support in person, over the telephone, or on the Internet. You may want to talk with a member of your health care team about finding a support group. Much more info can be found at this site: .

Until next time.

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