Irish Dentists offer free oral examination for mouth cancer

Sceala Philosopher Location: Navan

Irish dentists are appealing for Irish people to get their mouth checked for signs of mouth cancer.

Understanding cancer
Cancer begins in cells, the building blocks that make up tissues. Tissues make up the organs of the body.
Normally, cells grow and divide to form new cells as the body needs them. When cells grow old, they die, and new cells take their place.
Sometimes this orderly process goes wrong. New cells form when the body does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue called a growth or tumor.
Tumors can be benign or malignant:
Benign tumors are not cancer:
Benign tumors are rarely life-threatening.
Generally, benign tumors can be removed, and they usually do not grow back.
Cells from benign tumors do not invade the tissues around them.
Cells from benign tumors do not spread to other parts of the body.

Malignant tumors are cancer:
Malignant tumors are generally more serious than benign tumors. They may be life-threatening.
Malignant tumors often can be removed, but sometimes they grow back.
Cells from malignant tumors can invade and damage nearby tissues and organs.
Cells from malignant tumors can spread to other parts of the body. The cells spread by breaking away from the original cancer (primary tumor) and entering the bloodstream or lymphatic system. They invade other organs, forming new tumors and damaging these organs. The spread of cancer is called metastasis.

Oral cancer
Oral cancer is part of a group of cancers called head and neck cancers. 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.
When oral cancer spreads (metastasizes), it usually travels through the lymphatic system. Cancer cells that enter the lymphatic system are carried along by lymph, a clear, watery fluid. The cancer cells often appear first in nearby lymph nodes in the neck.
Cancer cells can also spread to other parts of the neck, the lungs, and other parts of the body. When this happens, the new tumor has the same kind of abnormal cells as the primary tumor. For example, if oral cancer spreads to the lungs, the cancer cells in the lungs are actually oral cancer cells. The disease is metastatic oral cancer, not lung cancer. It is treated as oral cancer, not lung cancer. Doctors sometimes call the new tumor "distant" or metastatic disease
Irish Dentists offer free oral examination in campaign to combat mouth cancer.
Dentists to offer free oral exams in cancer drive
DENTISTS ACROSS the State will open their practices to the public for free oral examinations in the autumn as part of a national drive to raise awareness about mouth cancer, the new president of the Irish Dental Association (IDA) has announced.

Speaking at the IDA's annual conference in Cavan at the weekend, Dr Conor McAlister said mouth cancer was a growing issue that killed two people a week in the Republic – more than the number killed by cervical cancer and skin cancer – and yet it had a far lower profile.

"Mouth cancer is a highly lethal disease and is one of the most debilitating and disfiguring of all malignancies...Recently there has been an increase in the incidence among women and in younger men, particularly in respect of cancer of the tongue. Where previously the male-female incidence ratio was six to one, it is now less than three to one."

Claire Healy, director of teaching at the Dublin Dental University Hospital, said the survival rate for mouth cancer was about 50 per cent, but the prognosis was far better if this cancer was detected early.

"Unfortunately we have not seen improvements in survival rates. They are much lower than for breast or prostate cancer."

One of the key factors was patient delay in presenting for diagnosis, often because what are actually tumours or cancer may appear initially to be mouth ulcers or discoloration in the mouth.

Dentists, she said, were key to primary prevention as they had the opportunity to screen their patients, by examining their mouths and lips for persistent ulcers and lumps.

Paul Cashman, clinical lecturer at Eastman Dental Institute in the United States, gave a graphic address on the treatments for mouth cancer, in which he showed pictures of people who had to have parts of their jaws and even whole tongues removed and had to have faces rebuilt after cancerous tissues had been surgically removed from their mouths and skulls.

Dr McAlister said notwithstanding cutbacks to the medical card and PRSI dental schemes, people "must remember they are entitled to a free check up and should avail of that entitlement".

The conference also heard from Bruce Matis at Indiana University School of Dentistry, an expert on tooth whitening.

He expressed concern at over-the-counter products used to bleach teeth at home.

He said "teenagers across the US are going wild bleaching their teeth every night".

He said if a person over-bleached their teeth they would eventually go grey, and this was irreversible.

Dr McAlister said he would like to see tooth-whitening "clinics" regulated.

"If done correctly teeth whitening can be very effective," he said.

"If done incorrectly there can be extreme tooth sensitivity. We would prefer this whole area was regulated."

CASE STUDY: 'THEY TOOK BONE FROM MY LEG TO REBUILD MY FACE'

FIVE YEARS ago Lia Mills, from south Dublin, had what she thought was a mouth ulcer that "wouldn't go away". After about eight months she went to her GP, who was immediately unhappy with the persistent sore.

"I was sent straight to St James's Hospital, where they did a biopsy, and by the time they came back with a diagnosis, they said it was a stage four tumour.

"I assumed there were about 10 stages when I asked how many there were. They said there were four. I said, 'Oh flip, I'm in trouble now'." She concedes that by this stage the ulcer was "very big". She was "desperate to have the cancer out", fearing it might spread to her eyes. She also feared losing all or part of her mouth. "I began to think of all the things you do with your mouth, that you never think about – speaking, tasting, inhaling, kissing, even smelling. The mouth is so important, so sensitive."

She had part of her lower jaw, seven teeth, all the lymph nodes and some nerves in her neck removed. "They took bone from my leg to rebuild my face, along with some titanium too. I am the Bionic Woman," she laughs.

"There were various complications which delayed radiotherapy, though I then had radiotherapy for two months."

This got rid of the cancer, and she is now well. "One half of my face is very concave, and I have very little sensation in part of my face. I am quite a messy eater now as I can't open my mouth very wide. People can be very curious. Kids especially are, but that's okay. I am used to how I look and don't even think about it any more."

She wants people to be more aware of mouth cancer and to see their dentist immediately if they have lumps or sores in the mouths or on their lips that won't go away.
irishtimes.com/newspaper/ireland/2011/0516/1224297037734.html

What is mouth cancer
Oral cancer
From Wikipedia, the free encyclopedia

This article has multiple issues. Please help improve it or discuss these issues on the talk page.

It needs additional references or sources for verification. Tagged since May 2009.
Its factual accuracy is disputed. Tagged since May 2009.
It may require general cleanup to meet Wikipedia's quality standards. Tagged since May 2009.

This article needs attention from an expert on the subject. See the talk page for details. WikiProject Medicine or the Medicine Portal may be able to help recruit an expert. (May 2009)
Oral cancer
Classification and external resources
ICD-10 C00.-C08.
ICD-9 140-146
DiseasesDB 9288

Oral cancer is a subtype of head and neck cancer, is any cancerous tissue growth located in the oral cavity. It may arise as a primary lesion originating in any of the oral tissues, by metastasis from a distant site of origin, or by extension from a neighboring anatomic structure, such as the nasal cavity or the Oral cancers may originate in any of the tissues of the mouth, and may be of varied histologic types: teratoma, adenocarcinoma derived from a major or minor salivary gland, lymphoma from tonsillar or other lymphoid tissue, or melanoma from the pigment producing cells of the oral mucosa. There are several types of oral cancers, but around 90% are squamous cell carcinomas, originating in the tissues that line the mouth and lips. Oral or mouth cancer most commonly involves the tongue. It may also occur on the floor of the mouth, cheek lining, gingiva (gums), lips, or palate (roof of the mouth). Most oral cancers look very similar under the microscope and are called squamous cell carcinoma. These are malignant and tend to spread rapidly.
Contents

1 Signs and symptoms
2 Causes
2.1 Tobacco
2.2 Alcohol
2.3 Human papillomavirus
3 Diagnosis
4 Management
5 Prognosis
6 Epidemiology
7 See also
8 References
9 External links
10 Further reading

Signs and symptoms

Skin lesion, lump, or ulcer:

On the tongue, lip, or other mouth areas
Usually small
Most often pale colored, may be dark or discolored
Early sign may be a white patch (leukoplakia) or a red patch (erythroplakia) on the soft tissues of the mouth
Usually painless initially
May develop a burning sensation or pain when the tumor is advanced

Additional symptoms that may be associated with this disease:

Tongue problems
Swallowing difficulty
Mouth sores that do not resolve in 14 days
Pain and paraesthesia are late symptoms.

Causes

Oncogenes are activated as a result of mutation of the DNA. The exact cause is often unknown. Regardless of the cause, treatment is the same: surgery, radiation with or without chemotherapy. Risk factors that predispose a person to oral cancer have been identified in epidemiological studies. India being member of International Cancer Genome Consortium is leading efforts to map oral cancer's complete genome.

In many Asian cultures chewing betel, paan and Areca is known to be a strong risk factor for developing oral cancer. In India where such practices are common, oral cancer represents up to 40% of all cancers, compared to just 4% in the UK.

Some oral cancers begin as leukoplakia a white patch (lesion), red patches, (erythroplakia) or non healing sores that have existed for more than 14 days. In the US oral cancer accounts for about 8 percent of all malignant growths. Men are affected twice as often as women, particularly men older than 40/60. In Indian subcontinent Oral submucous fibrosis is very common. This condition is characterized by limited opening of mouth and burning sensation on eating of spicy food. This is a progressive lesion in which the opening of the mouth becomes progressively limited, and later on even normal eating becomes difficult. It occurs almost exclusively in India and Indian communities living abroad.
Tobacco

Smoking and other tobacco use are associated with about 75 percent of oral cancer cases, caused by irritation of the mucous membranes of the mouth from smoke and heat of cigarettes, cigars, and pipes. Tobacco contains over 60 known carcinogens, and the combustion of it, and by products from this process, is the primary mode of involvement. Use of chewing tobacco or snuff causes irritation from direct contact with the mucous membranes.
Alcohol

Alcohol use is another high-risk activity associated with oral cancer. There is known to be a very strong synergistic effect on oral cancer risk when a person is both a heavy smoker and drinker. The risk is greatly increased compared to a heavy smoker, or a heavy drinker alone. Recent studies in Australia, Brazil and Germany point to alcohol-containing mouthwashes as also being etiologic agents in the oral cancer risk family. Constant exposure to these alcohol containing rinses, even in the absence of smoking and drinking, lead to significant increases in the development of oral cancer. A 2008 study suggests that acetaldehyde (a break-down product of alcohol) is implicated in oral cancer.
Human papillomavirus
Main article: HPV-positive oropharyngeal cancer

Infection with human papillomavirus (HPV), particularly type 16 (there are over 120 types), is a known risk factor and independent causative factor for oral cancer. (Gilsion et al. Johns Hopkins) A fast growing segment of those diagnosed does not present with the historic stereotypical demographics. Historically that has been people over 50, blacks over whites 2 to 1, males over females 3 to 1, and 75% of the time people who have used tobacco products or are heavy users of alcohol. This new and rapidly growing sub population between 20 and 50 years old is predominantly non smoking, white, and males slightly outnumber females. Recent research from Johns Hopkins indicates that HPV is the primary risk factor in this new population of oral cancer victims. HPV16 (along with HPV18) is the same virus responsible for the vast majority of all cervical cancers and is the most common sexually transmitted infection in the US. Oral cancer in this group tends to favor the tonsil and tonsillar pillars, base of the tongue, and the oropharnyx. Recent data suggest that individuals that come to the disease from this particular etiology have some slight survival advantage.
Diagnosis

An examination of the mouth by the health care provider or dentist shows a visible and/or palpable (can be felt) lesion of the lip, tongue, or other mouth area. As the tumor enlarges, it may become an ulcer and bleed. Speech/talking difficulties, chewing problems, or swallowing difficulties may develop. A feeding tube is often necessary to maintain adequate nutrition. This can sometimes become permanent as eating difficulties can include the inability to swallow even a sip of water.

There are a variety of screening devices that may assist dentists in detecting oral cancer, including the Velscope, Vizilite Plus and the identafi 3000. While a dentist, physician or other health professional may suspect a particular lesion is malignant, there is no way to tell by looking alone - since benign and malignant lesions may look identical to the eye. A non-invasive brush biopsy (BrushTest) can be performed to rule out the presence of dysplasia (pre-cancer) and cancer on areas of the mouth that exhibit an unexplained color variation or lesion. The only definitive method for determining if cancerous or precancerous cells are present is through biopsy and microscopic evaluation of the cells in the removed sample. A tissue biopsy, whether of the tongue or other oral tissues and microscopic examination of the lesion confirm the diagnosis of oral cancer or precancer.
Management

Surgical excision (removal) of the tumor is usually recommended if the tumor is small enough, and if surgery is likely to result in a functionally satisfactory result. Radiation therapy with or without chemo is often used in conjunction with surgery, or as the definitive radical treatment, especially if the tumour is inoperable. Surgeries for oral cancers include

Maxillectomy (can be done with or without Orbital exenteration)
Mandibulectomy (removal of the mandible or lower jaw or part of it)
Glossectomy (tongue removal, can be total, hemi or partial)
Radical neck dissection
Moh's procedure or CCPDMA
Combinational e.g. glossectomy and laryngectomy done together.
Feeding tube to sustain nutrition.

Owing to the vital nature of the structures in the head and neck area, surgery for larger cancers is technically demanding. Reconstructive surgery may be required to give an acceptable cosmetic and functional result. Bone grafts and surgical flaps such as the radial forearm flap are used to help rebuild the structures removed during excision of the cancer. An oral prothesis may also be required. Most oral cancer patients depend on a feeding tube for their hydration and nutrition. Some will also get a port for the chemo to be delivered. Many oral cancer patients are disfigured and suffer from many long term after effects. The after effects often include fatigue, speech problems, trouble maintaining weight, thyroid issues, swallowing difficulties, inability to swallow, memory loss, weakness, dizziness, high frequency hearing loss and sinus damage.

Survival rates for oral cancer depend on the precise site, and the stage of the cancer at diagnosis. Overall, survival is around 50% at five years when all stages of initial diagnosis are considered. Survival rates for stage 1 cancers are 90%, hence the emphasis on early detection to increase survival outcome for patients.

Following treatment, rehabilitation may be necessary to improve movement, chewing, swallowing, and speech. speech and language pathologists may be involved at this stage.

Chemotherapy is useful in oral cancers when used in combination with other treatment modalities such as radiation therapy. It is not used alone as a monotherapy. When cure is unlikely it can also be used to extend life and can be considered palliative but not curative care. Biological agents, such as Cetuximab have recently been shown to be effective in the treatment of squamous cell head and neck cancers, and are likely to have an increasing role in the future management of this condition when used in conjunction with other treatments.

Treatment of oral cancer will usually be by a multidisciplinary team, with treatment professionals from the realms of radiation, surgery, chemotherapy, nutrition, dental professionals, and even psychology all possibly involved with diagnosis, treatment, rehabilitation, and patient care.

The Oral Cancer Foundation is a website devoted to in depth medical information about all oral cancers including treatment, side effects and even lists of the nation's best cancer treatment centers. The Oral Cancer Foundation has a forum where patients and their caregivers assist each other. It is monitored by the founder and administrators who ensure accurate up to date information is exchanged. This website has the most comprehensive amount of information devoted to oral cancer.
Prognosis

Postoperative disfigurement of the face, head and neck
Complications of radiation therapy, including dry mouth and difficulty swallowing
Other metastasis (spread) of the cancer
Significant weight loss

Epidemiology
Age-standardized death from oro-pharyngeal per 100,000 inhabitants in 2004.

In 2008, in the United States alone, about 34,000 individuals were diagnosed with oral cancer. 66% of the time these will be found as late stage three and four disease. Low public awareness of the disease is a significant factor, but these cancers could be found at early highly survivable stages through a simple, painless, 5 minute examination by a trained medical or dental professional.

Don't forget your free oral examination for mouth cancer. Book it with your local Irish dentist.

Register

The Irish Community have posted
3 REPLIES TO THIS TOPIC
for logged in members to view.

Irish Forums Message Discussion :: Irish Dentists offer free oral examination for mouth cancer

Irish Dentists offer free oral examination for mouth cancer