Symptoms of oral cancer can be overlooked

Christine Maddox

According to the National Institute of Dental and Craniofacial Research, 10.5 out of 100,000 adults will develop oral cancer. Yet people might not recognize the symptoms until the cancer is discovered on a routine visit to their dentist or healthcare provider.

Many people experience symptoms they blame on other conditions. Those include bleeding, a sore or lump on the tongue or inside the mouth, tongue and mouth pain, difficulty swallowing or speaking, and a lump in the neck. Oral cancer sometimes is not obvious to the patient or medical provider. Oral cancer rates are higher in men overall, and higher for Hispanic and black men. Also, oral cancer rates increase with age, peaking between 60 and 70.

Symptoms of oral cancer can present as a white or red sore on the tongue, or an area or erosion on gingiva (gum tissue) or buccal (inner cheek) tissue or any tissue inside the mouth that does not heal. Symptoms also include swelling in the jaw, unusual mouth bleeding or an obvious lump, painful dentures, difficulty swallowing, chewing or moving the tongue; coughing up blood, or persistent pain in your throat or ears. Also masses or lumps under your chin or in the neck can be present. Any of the above symptoms need to be checked by a healthcare provider familiar with you and your medical history. Dentists look at your mouth closely and can detect something very small that may need to be addressed.

When a provider identifies an area of concern, treatment varies. If the area has not been treated, the provider may offer an oral rinse or gel to see if the area improves. If it does not respond to treatment after 2 to 3 weeks, a biopsy may be needed. A biopsy is when a small piece of the area is removed and sent to a lab where a pathologist evaluates the tissue under a microscope to find abnormalities. This can take 4 to 5 days up to 2 to 3 weeks depending on what is found. A biopsy is the only way to tell if there is cancer within tissue. Many providers can perform this biopsy in the office with minimal or no recuperation time. If cancer is found, depending upon the type and extent, you will need further treatment and evaluation.

Smokers can reduce their cancer risk by stopping. Ten years after quitting, an ex-smoker’s risk level returns to the non-smoking population. This includes not only cigarettes, but pipes and cigars. Also, do not use smokeless tobacco products such as chew and snuff. The cancer risk for those who use E-cigarettes is unknown. However, little is known about the carcinogenic effects of the components used in the flavoring, propylene glycol and glycerol, when they are heated and aerosolized. E-cigarettes are not approved by the U.S. FDA for smoking cessation and the FDA has not endorsed their safety.

Finally, if you are younger than 26, talk to your provider about the HPV vaccine. This vaccine is used to prevent cervical and other genital cancers, and HPV can be present in some head and neck cancers.

Being aware of and reducing your risks for oral cancer and routine check-ups with your provider can keep you healthy and living longer.

Christine Maddox, FNP-C CORLN, is a nurse practitioner specializing in otolaryngology/ENT with Franciscan Physician Network.

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