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Oral Cancer

Although this topic is scary, this article may just save your life

By Dr. Sol Silverman, Jr.


Treatment of Pre-Cancerous Conditions

Pre-cancerous lesions must be assessed by biopsy (tissue sampling for disease). If pre-cancerous changes disappear by removing irritants, e.g. tobacco, alcohol, biting, or other chemical or physical irritants, there is no need to biopsy. Follow up is necessary together with determining a frequency for continued monitoring and evaluation. This will, of course, depend upon the findings at the time of biopsy. The ultimate treatment of pre-cancerous lesions is surgical removal however the use of lasers has been very helpful. Diets, vitamins and other drug or chemical approaches have not been useful.

If there is some reason to delay biopsy, other techniques are available to help evaluate a suspicious lesion. While these non-invasive “adjunctive” techniques are helpful in shedding light on a suspicious lesion, they do not substitute for biopsy confirmation. These FDA-approved devices include the use of light reflections, tissue staining (tolonium chloride), cytology (brush biopsy), and fluorescence. These adjunctive techniques do not require anesthesia and are helpful in accelerating the need for further testing or referral. These techniques are available to general dental practitioners, however biopsy remains the gold standard.

The American Cancer Society recommends a cancer related check up annually for all individuals aged 40 and older and every three years for those between 20 and 29.

When Cancer is Diagnosed

Once the diagnosis is definitive, the extent of disease has to be determined so that a treatment plan and prognosis can be formed. Staging is the term used to describe the level a cancer has reached. Involved in staging are clinical, microscopic findings and imaging with techniques such as magnetic resonance imaging (MRI). Depending upon the stage, your health care professional will formulate a treatment plan that will most likely include considerations for surgery and/or radiation and/or chemotherapy. With all treatments, the teeth and membranes of the mouth must be protected from further incidence of decay, gum disease and other infections, dryness of the mouth, and other more subtle changes.

A treatment team is usually comprised of surgeons, radiation and medical oncologists (cancer specialists), dentists, dental hygienists, nurses, and other professional specialists.

In summary, as a health care professional, I hope you understand the importance of knowing all you can about one of the principal killers in developed nations today. Obviously, risk factors can and must be minimized wherever possible and proper periodic oral cancer screening exams should be a priority. Keep in mind, the more you know about this class of diseases, the more empowered you'll be toward paving your road to victory.

Hard Facts About Oral Cancer

Aside from a genetic predisposition, the use of tobacco in any form and/or excessive use of alcohol increase risk for many diseases, including oral and pharyngeal cancer. Let's take a look:

  1. Chronic exposure to the sun is, without a doubt, associated with development of lip cancers
  2. Moderate to heavy drinkers are at three to nine times greater risk than non-drinkers — obviously hard alcohol creates a much greater risk than beer or wine because of the higher alcohol content.
  3. Tobacco smokers are at five to nine times greater risk than non-users
  4. Snuff and chewing tobacco users are at roughly four times greater risk than non-users

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