Preventing oral cancer

Oral cancer may not be as common and “popular” as the other more known cancers, but it is certainly as debilitating and deadly as the top two cancers in the Philippines.

Oral cancer ranks 19th among the most common cancers in the country. However, compared with other cancers, it has one of the lowest five- and 10-year survival rates of 27% and 17%, respectively. Oral cancer is more common in men and in older people, and more deadly in men compared to women; its incidence varies strongly by socio-economic circumstances, according to the World Health Organization (WHO).

As the country observes National Cancer Awareness Month and Oral Health Month this February, there is a need to increase awareness on oral cancer prevention, early detection, and prompt treatment.

Oral cancer is a malignancy that can develop in the lip, tongue, throat, and mouth. The US Centers for Disease Control and Prevention (CDC) lists the following warning signs of oral cancer: sore in the mouth that does not heal (most common symptom); white or red patch on the gums, tongue, tonsil, or lining of the mouth that will not go away; lump or thickening in the cheek; and sore throat or a feeling that something is caught in the throat.

Other symptoms are difficulty chewing or swallowing; difficulty moving the jaw or tongue; numbness of the tongue or other area of the mouth; swelling of the jaw that causes dentures to fit poorly or become uncomfortable; and loosening of the teeth or pain around the teeth or jaw. Moreover, voice changes, a lump or mass in the neck, and weight loss can be added into the list.

The WHO said that tobacco, alcohol, and areca (betel) nut use are among the leading causes of oral cancer. Among young people in some countries, human papillomavirus infections are responsible for a growing percentage of oral cancers.

Oral cancer is diagnosed either by a physician or dentist by performing a physical exam. This includes checking the lymph nodes in the neck and under the lower jaw, cheeks, lips, and gums; pulling the tongue forward; and checking the palate, back of the throat, and floor of the mouth. If a suspicious area is found, your doctor or dentist may remove a sample of cells for biopsy.

The American Cancer Society said that treatment for oral cavity cancer is based largely on the stage (extent) of the cancer, but other factors can also be important.

Treatment may involve one or a combination of the following: surgery, radiation therapy, chemotherapy, targeted drug therapy, and immunotherapy, according to the Mayo Clinic.

Chemotherapy may increase the effectiveness of radiation therapy, which is why the two are often combined. Targeted drugs, meanwhile, treat oral cancer by altering specific aspects of cancer cells that fuel their growth. Targeted drugs can also be used alone or in combination with chemotherapy or radiation therapy. Immunotherapy uses the patient’s immune system to fight cancer. It is generally reserved for people with advanced oral cancer that is not responding to standard treatments. Having said these options, it is important to consult a physician for an explanation of the benefits and risks of any of the treatment goals and plans.

Not all cases of oral cancer can be prevented, but one can significantly lower his or her risk by taking steps to avoid certain risk factors, added the American Cancer Society.

Smoking while drinking greatly increases the cancer-causing effect of tobacco. If at all, there is also a need to limit your exposure to ultraviolet (UV) light. If one is out in the sun, wearing a wide-brimmed hat and use sunscreen and lip balm with a sun protection factor (SPF) of at least 30 could help.

It is also important to maintain a healthy weight and eat a healthy diet with lots of fruits, vegetables, and whole grains. One also needs to avoid red and processed meats, sugary drinks, and highly processed foods.

Getting regular dental checkups is also a must. A dentist may find and remove pre-cancer growths in one’s mouth (leukoplakia or erythroplakia) that sometimes turn into cancer. If one wears dentures, make sure they fit properly. Avoiding sources of oral irritation, such as dentures that don’t fit properly, may help lower one’s risk for oral cancer.

The CDC said that delay in diagnosis may be partly due to the public’s overall lack of knowledge of the signs and symptoms of oral cancer and to the need for an increase in annual screening exams for oral cancer, particularly for those at higher risk. Pursuing a healthy lifestyle and good oral health can also help save lives.

Teodoro B. Padilla is the executive director of Pharmaceutical and Healthcare Association of the Philippines (PHAP).  PHAP represents the biopharmaceutical medicines and vaccines industry in the country. Its members are in the forefront of research and development efforts for COVID-19 and other diseases that affect Filipinos.