Oral Cancer — A "Lifestyle" Disease
As we grow older, our risk of developing any type of cancer increases, but certain lifestyle choices significantly raise the risk of developing a precancer or oral cancer. Tobacco and alcohol use are the biggest culprits, and are responsible for 90 percent of oral-cavity and throat cancers in people aged 40 or older. Younger people as well as non-smokers and non-drinkers are not immune to oral cancer; they're just less statistically likely to develop it.
When identified early at the precancer – or potentially malignant – stage, oral cancer is one of the easier cancers to prevent. Regrettably, too many precancers are never identified until they have grown into malignant tumors. After diagnosis of oral cancer, the five-year survival rates are grim. Of the approximately 40,000 Americans diagnosed with oral cancer each year, 60 percent of them have advanced-stage disease.
Why are the statistics so dire? It can take months or even years for noticeable symptoms of oral cancer – pain, swelling, and difficulty chewing or swallowing – to develop; by which time the disease is well advanced. This delay likely means a larger tumor, invasion of nearby tissues and bone, spread to lymph nodes in the neck or even metastasis to other parts of the body.
At the NYU Oral Cancer Center, our goal is not only to treat oral cancer but to detect precancerous changes and prevent those from developing into malignancies. Our oral biology experts offer preventive services and risk factor management, such as tobacco cessation.
Prevention of Oral Cancer
Prevention is a combination of the simple act of observing plus healthy lifestyle choices.
Once a month, open your mouth wide and take a quick look in the mirror. Look at the roof and floor of the mouth, inside the cheeks, all around the tongue, the gums and inside surface of the lips. The early signs of precancer are white, red or mixed white/red patches that cannot be wiped off the surface. Click here for the Precancer section for more information and photos.
At each six-monthly dental check up, the dentist should perform an inspection not only of the teeth and gums but also of the soft tissues in and around the mouth. This includes the inside and outside of the lips, the cheeks, the sides and undersurface of the tongue, the floor and roof of the mouth, the gums, and the back of the mouth/top of the throat (oropharynx). Make sure your dentist performs this examination as part of a routine dental visit. Any suspicious tissue should be examined by an oral cancer specialist. This early detection of tissue changes is the best means of preventing oral cancer.
Education, counseling and dependency treatment can prevent oral cancer in the typical high-risk individual, who is male, over 40 years of age and uses tobacco and/or alcohol heavily. Although often requiring dramatic changes to lifestyle and habits, the benefit of a healthy lifestyle is a decreased likelihood of developing the disease as well as improved general health. There is evidence suggesting that a healthy diet high in fruits and vegetables is associated with a reduced risk of oral cancer and may be protective.
Smoking cessation programs have reduced the number of smokers and consequently reduced the number of oral cancers seen in males aged 40 or older. After quitting smoking, many precancerous lesions improve and in some cases may even disappear. Today, the fastest growing segment of the oral cancer population is non-smokers under the age of 50. Patients diagnosed with a precancerous lesion or oral cancer will be offered smoking cessation counsel and guidance on limiting alcohol consumption.
Lip cancer, which is also a lifestyle cancer primarily due to prolonged sun exposure, shows a decline in numbers over the last decade. Once again public education campaigns – touting the damaging effects of excessive sun and UV light and advocating sunscreen protection – are most likely responsible for these reduced numbers.