ORAL CANCER

1. 6/6/2012 Oral Cancer 1 ORAL CANCER By Delene Coletti Biology 316 – The Biology of Cancer Biology 316 – The Biology of Cancer

2. 6/6/2012 Oral Cancer 2 What is Oral Cancer? Cancer that occurs in the . . . Mouth Lip Tongue Floor of the mouth Sulcus Hard palate Tonsils 90% squamous cell

3. 6/6/2012 Oral Cancer 3 STATISTICS FOR U.S. 30,000 diagnosed each year 50% survival rate over 5 years 8,000 deaths per year 1 person per hour per day Higher death rate than many other cancers Late detection Metastasis High risk of developing a 2nd primary cancer 20X more likely in next 5-10 years Higher death rate than cervical, Hodgkin's, brain. Liver, testes, kidney or skin cancers. High death rate due to delayed detection or metastasis has spread deep into the local structures or to the neck or lymph nodes. Higher death rate than cervical, Hodgkin's, brain. Liver, testes, kidney or skin cancers. High death rate due to delayed detection or metastasis has spread deep into the local structures or to the neck or lymph nodes.

4. 6/6/2012 Oral Cancer 4 Who is at risk? Adults over 40 years old Lag time 2 men for every one woman Used to be 6 men for every woman Increased # of women smokers 2x more in black population than caucasian Survival rate over 5 years Blacks 33% Caucasians 55%. Stats do not consider SES, education, availability of health care & increased use of carcinogens by different Ethnic populations. Stats do not consider SES, education, availability of health care & increased use of carcinogens by different Ethnic populations.

5. 6/6/2012 Oral Cancer 5 Risk Factors Tobacco is the main culprit Mainly chewing tobacco Cumulative damage 75% of those diagnosed are tobacco users. Alcohol 2nd largest risk factor Combination of alcohol and tobacco use 15x greater risk for oral cancer Excessive sun exposure Lip cancer Alcohol – dehydrating effects on the cell walls enhance the ability to tobacco carcinogens to permeate the mouth tissues. It also interrupts the body’s natural ability to use anti-oxidants from nutrition to prevent cancers. Sun Exposure decline in last few decades due to more awareness of sun’s damage and increased use of sunscreens. Alcohol – dehydrating effects on the cell walls enhance the ability to tobacco carcinogens to permeate the mouth tissues. It also interrupts the body’s natural ability to use anti-oxidants from nutrition to prevent cancers. Sun Exposure decline in last few decades due to more awareness of sun’s damage and increased use of sunscreens.

6. 6/6/2012 Oral Cancer 6 Risk Factors X-rays Cumulative exposure Other biological factors Viruses and fungus HPV 16 Main agent in cervical cancer Now has been linked to oral cancer

7. 6/6/2012 Oral Cancer 7 Symptoms Oral sores that last more than 2 weeks Found on cheek, tongue, floor of mouth, or lip Types of oral cancer sores Leukoplakia Erythroplakia Dysplasia Lump or mass Difficulty swallowing, speaking or chewing Numbness in oral or facial region Leukoplakia White patches on cheek or tongue. Mostly benign 5% is cancerous Erythroplakia Raised red legions that bleed easily More serious than Leukoplakia because half of all lesions are already cancer at time of biopsy Dysplasia When cells are found, they could also be from smoke, chew tobacco, or irritation from poorly fitted dentures.Leukoplakia White patches on cheek or tongue. Mostly benign 5% is cancerous Erythroplakia Raised red legions that bleed easily More serious than Leukoplakia because half of all lesions are already cancer at time of biopsy Dysplasia When cells are found, they could also be from smoke, chew tobacco, or irritation from poorly fitted dentures.

8. 6/6/2012 Oral Cancer 8 Self-Diagnosis Self-diagnosis is critical Seven steps Head and Neck Face Neck Lips Cheek Roof of mouth Floor of mouth and tongue Self-diagnosis One of the major dangers is not catching it early. See a professional if you have canker sores that last more than 2 weeks or any of the other symptoms Self-diagnosis One of the major dangers is not catching it early. See a professional if you have canker sores that last more than 2 weeks or any of the other symptoms

9. 6/6/2012 Oral Cancer 9 Clinical Diagnosis Semi-annual dental check-up Trained dentist/hygienist does an oral cancer screening Biopsy Normally performed by oral surgeon Lab pathologist determines abnormal stage Semi-annual dental check-up Dentists or hygienists know what to look for and can feel tissue changes while still in an early stage Semi-annual dental check-up Dentists or hygienists know what to look for and can feel tissue changes while still in an early stage

10. 6/6/2012 Oral Cancer 10 Treatments Multidisciplinary treatment is ideal Surgery Most common with radiation General health of mouth is analyzed and affects treatment Chemotherapy Sometimes added to decrease possibility of distant micro-metastasis Loss of taste and smell Removal of portion of mandible Severe cases Facial reconstruction is needed Later assistance needed with speech and chewing Multidisciplinary Surgeons, radiation & chemo oncologists, dentists, nutritionists, restorative specialists—prosthodontists. Surgery Perio or cavitied teeth may be extracted prior to radiation. If not, the radiation can damage tissue and expose underlying boneMultidisciplinary Surgeons, radiation & chemo oncologists, dentists, nutritionists, restorative specialists—prosthodontists. Surgery Perio or cavitied teeth may be extracted prior to radiation. If not, the radiation can damage tissue and expose underlying bone

11. 6/6/2012 Oral Cancer 11 Oral Cancer Photos

12. 6/6/2012 Oral Cancer 12 Photos continued… Maxillary/Mandible reconstruction

13. 6/6/2012 Oral Cancer 13 Prevention Tips Regular self-examination Once a month Limit alcohol consumption Quit chewing tobacco Sunflower seeds Mint “tobacco-less” chew Nicotine patch or gum Find new stress coping techniques

14. 6/6/2012 Oral Cancer 14 New outfit for presentation: $120 Teeth whitening treatment: $300 A perfect score on this presentation: PRICELESS