DOWN IN THE MOUTH

Oral cancer is not a pretty sight. But even so, it’s often missed in its beginning stages. Caught early, the cure rate is as high as 80 percent. When it's detected at a later stage, the chance for a cure drops to less than 18 percent. An estimated 8,100 people will die of the disease this year and there will be approximately 29,800 new cases diagnosed.

The problem is that few people run to a physician or dentist for a diagnosis. The lesions initially look and feel like any innocuous sore that might crop up in your mouth. Arnold Rosenheck, DMD, associate dean at UMDNJ-New Jersey Dental School (NJDS), calls it one of the “silent killers.”

Cigarette, cigar and pipe smokers and those who chew tobacco are at highest risk. In fact, 90 percent of those with oral and pharyngeal cancers are tobacco users. Consuming more than six drinks a day also vastly increases the risk of contracting the disease, with the combination of tobacco use and alcohol being particularly deadly. According to Rosenheck, these two factors can raise the risk of oral cancer up to 100 times.

But there are also certain caustic substances, such as betel nuts and some spices, that can do damage to the mouth and throat, sometimes leading to malignancies. In addition, dietary deficiencies of vitamins A,E,C, and iron; a family history; cancers of the esophagus, larynx and lung; a compromised immune system or viral infection, particularly with a herpes virus or HPV (human papilloma virus), an adeno virus or candida; or chronic oral irritation can all drive up the risk. Long hours in the sun Ñmost often in those with outdoor jobs - is strongly linked with lip cancer.

June 2 and 3 marked the first free oral health screening offered by a new consortium dedicated to catching oral cancer early in those who do not regularly get medical and dental check-ups. The consortium is composed of NJDS, NYU Dental School, Columbia Dental School, the Dental School at Stony Brook - SUNY and The Health and Hospitals Corporation of New York.

In response to advertising in local papers and The New York Times, more than 1,200 people showed up for oral cancer screenings, and 150 brush biopsies were done on suspicious-looking lesions, says Rosenheck, the consortium’s coordinator at the dental school. At NJDS, 220 patients were examined and 45 brush biopsies performed. He says the consortium will meet again shortly to make plans for a second event.

If cancers are identified, the individuals will be called back in and treatment will be recommended. Surgery and radiation are the primary approaches, with chemotherapy added for advanced disease.

For those concerned about the disease -particularly smokers-the primary signs are a mouth sore that doesn't heal in two to three weeks; an unusual lump; easy bleeding of the throat or mouth; pain; difficulties in chewing, swallowing or talking; voice changes; numbness around the jaw and face; and loosening of teeth.

Rosenheck says that along with providing check-ups for individuals who do not get regular medical care, the consortium is also dedicated to alerting healthcare workers to the need of spending the requisite five minutes checking patients for potential oral cancers. He advises making this a part of every routine annual health check-up.