|
|---|
MOUTH CANCER
|
|
|---|
MOUTH CANCER
The mouth is an amazing machine for speech and eating, it actually starts the
process of digestion. Normally good mouth hygiene ensures healthy teeth, and
a lifetime of trouble free chewing (the muscles of the jaw are the strongest
of the body). Occasionally people develop a cancer in the mouth.
From a cancer doctor perspective, the mouth is anything forward of the last molar, up to the lips. This includes the part of the tongue we see in the mirror, the hard palate, and the inside of the cheeks. Anything behind the last molar is called "oropharynx" and is a different area which includes the tonsils and base of tongue.
Cells in the mouth are subjected to lots of injury from heat and abrasion, and
thus must divide frequently to replace those lost due to injury and old age. Normally,
cells
divide quickly as we develop in the womb and through infancy, and then the rate slows
down considerably, just to replace cells that die. The division of cells in the mouth
and
elsewhere is under very tight control, regulated by the genes within the cells. When
this control is lost, the cells may start to divide in a haphazard, uncontrolled manner,
and grow to form a swelling of abnormal cells, called a "tumor". A "benign" tumor only grows within it's local area, it does not spread to distant organs, and it is not
cancer. In contrast, a "malignant" tumor can spread to any area of the body, it is
cancer.
It is this ability to spread, or "metastasize", to vital organs which makes a
cancer so dangerous. Cancers of the mouth tend to grow to large sizes locally before
they spread, but any cancer can spread at any time.
How Common is Mouth Cancer?
Each year in the United States there are about 20,000 new cases of mouth cancer leading to 4,000 deaths annually from this disease. Men are affected twice as often as women. Overall,
mouth cancer represents about 3% of all new cancers each year, and it is more common
in blacks than whites, and in those of "lower socioeconomic status" (poor people).
The average patient is 60 years old.
What Causes, or Increases Risk for Mouth Cancer?
Like any cancer, the exact reason why one person gets mouth cancer and another
does not remains unknown. However, several"risk factors" have been shown to
be much more likely to be present in mouth cancer patients. These include:
1) Tobacco Usage-- This is the single strongest risk factor for developing cancers
of the head and neck, and especially mouth cancer. Any form of tobacco
taken
through the mouth, whether smoked or chewed, increases the risk over time. Even children who use chewing tobacco (often to emulate famous baseball
players) have gotten mouth cancer. The more tobacco that is used, for a
longer period of time, the higher the chance to get mouth cancer. Likewise, when
use is stopped, the risk declines almost to normal over a 5 to 10 year period.
2) Alcohol Usage-- Is the next strongest risk factor after tobacco. Occasional wine or beer may raise risk very slightly, if at all, but frequent use of strong
drinks like whiskey will increase cancer risk to the mouth, throat, esophagus (food pipe),
stomach and pancreas. Furthermore,combining alcohol with tobacco will have a "super additive" effect to greatly increase cancer risk for all of these areas.
This means that the risk is much more than twice as high as for using either tobacco or alcohol alone. Like tobacco, people who stop frequent drinking will gradually lower their cancer risk to nearly that of non-drinkers.
3) Poor Mouth Hygiene-- The more unclean the mouth is, the more is is subject to constant irritation from grime. Each teaspoon of saliva contains about 1
billion bacteria, which are making waste products which cling to teeth ("plaque").
This allows gum disease (pyorrhea) to develop, with subsequent tooth loss. Although plaque itself is not showto cause cancer, it helps other chemicals (like in smoke) to stick in the mouth, irritate it, and stimulate the cells to divide. The
more cells divide, the more chance one of them will become cancerous. That is why the
com- mon thread of many risk factors is irritation, leading to lots of cell division.
4) Ill-Fitting Dentures irritate the gum lining ("gingiva") and trap debris. This can lead to mouth cancers over time.
5) Betel-Nut Chewing in Indian populations is strongly associated with tooth loss and mouth cancer, again the common factor is prolonged irritation.
6) Infections such as syphilis and some viruses can lead to cancer over time, these cause mouth sores which heal poorly. The constant attempt to heal
leads to chronic cell division and thus more chance for cancer. Viruses can also
get into the mouth cells themselves and change the genes in them to form a cancer cell. This elaborate process is called "oncogene activation".
7) Lowered Immunity such as from AIDS or transplant anti-rejection drugs will increase the risk for many cancers, including those of the "aero-digestive
tract" (i.e. the area from the nose and mouth to the lungs and stomach). This
will be especially important in combination with the other risk factors noted
above.
8) History of Cancer of the aero-digestive tract can mean as much as 5% chance of a separate simultaneous cancer, and a 25% chance of developing another cancer in this area over time (especially if risks like smoking are continued).
The mouth is an amazing machine for speech and eating, it actually starts the
process of digestion. Normally good mouth hygiene ensures healthy teeth, and
a lifetime of trouble free chewing (the muscles of the jaw are the strongest
of the body). Occasionally people develop a cancer in the mouth.
From a cancer doctor perspective, the mouth is anything forward of the last molar, up to the lips. This includes the part of the tongue we see in the mirror, the hard palate, and the inside of the cheeks. Anything behind the last molar is called "oropharynx" and is a different area which includes the tonsils and base of tongue.
The treatment for cancers in these areas are different. It is critical to get prompt diagnosis and proper treatment for a mouth cancer problem, this can make the difference between mutilating surgery or an excellent cosmetic repair or even life and death. Understanding your options indealing with a mouth cancer problem will give you the peace-of-mind of knowing that you have done everything possible to ensure a successful outcome for yourself or a loved one.
The Cancer Group Institute's material explains, in plain English, the definition, types, risk factors, frequency, evaluation, historical and latest effective treatments for the various mouth cancers. We describe surgery, radiation, and chemotherapy, along with the their side-effects and results. While we don't promise a cure, we tell you everything you must know to help you make the right choices today for a mouth cancer problem.
