Ruadhán Jones
Diagnoses of mouth and neck cancer to increase 30% in 25 years, writes Ruadhán Jones
Here’s something that may have slipped by you – September 16 was Mouth Cancer Awareness day. I don’t think you would be alone, of course, and a possible explanation for this is that mouth and neck cancers are not as common or as well-known as other areas, such as lung, prostate and breast cancer.
However, there are still more than 700 cases of mouth cancer diagnosed every year and this figure has continued to rise over the last few years. As with other forms of cancer, those numbers are likely to rise as our population ages. Projections from the National Cancer Registry Ireland suggest that cases could rise as much as 30% over the next 25 years.
In a statement for the campaign, Dr Eleanor O Sullivan of Cork University Dental School said that, “while this cancer receives little publicity, it is more lethal than breast cancer, cervical cancer or malignant melanoma. Those over the age of 55 who smoke and/or drink are most at risk. We can turn the tide on this disease by avoiding known risk factors (smoking, alcohol, HPV), knowing the warning signs and encouraging people to be mouth aware and to seek help from their dentist or GP if they have any ulcers or other lesions that do not heal in 3 weeks. Survival and quality of life is greatly improved when these cancers are diagnosed early and treated quickly.”
While mouth and neck cancers can occur at any age, the majority of mouth cancers are diagnosed in the over 55’s, regardless of whether or not they still have their own natural teeth or may be wearing dentures.
This year, the Mouth Cancer Awareness campaign is advising the older population and their carers to be particularly mindful of the early signs of mouth cancer and to seek advice and treatment from their dentist or doctor.
But what signs and symptoms should you look out for? And what are the likely treatments you will need to undergo? Here is the main advice the campaign has produced.
Signs and symptoms
If detected early, treatment for mouth cancer can be more straightforward and have an excellent outcome. Unfortunately for those who are diagnosed at a late stage, the outcomes can be poor and affected individuals can be left with life altering changes to their appearance and their ability to speak, eat and swallow.
There a number of signs of mouth cancer, though they vary slightly depending on the area of the mouth, throat, or nose affected. The website, mouthcancer.ie provides a quite extensive list of potential signs and symptoms.
- A sore or ulcer in the mouth that doesn’t heal
- An ongoing sore throat, hoarse voice or difficulty speaking
- Problems chewing or swallowing
- White or red patches in the mouth
- A swelling or a lump anywhere in the mouth or neck
- Nose bleeds or a persistent blocked nose
- Problems with hearing or ringing in the ears
- Pain in the face or jaw
- Numbness
- A thickening or hardness of the cheek or tongue
- Unexplained loose teeth
You can check yourself for any of these symptoms by using a torch to check inside your mouth, tongue, lips and throat. You can also check your neck and jaw by gently feeling for any changes.
It’s important to maintain an awareness of how your mouth looks and feels. Checking it regularly, while brushing your teeth for example, and maintaining good dental hygiene can help you to identify mouth cancers quickly.
Dental check-ups
As well as maintaining your own good dental hygiene, regular dental check-ups are important. Dentists have a vital role to play in the prevention of mouth cancers by advising on risk factors. When you attend your dentist, a mouth cancer examination should be part of your routine dental check-up. The examination is quick and painless.
A dentist or doctor will examine your mouth, head and neck. If they are concerned, they will refer you to an appropriate specialist who will carry out some further tests. These may include one or more of the following tests:
- X-rays, MRI scans, Ultrasound
- Endoscopy
- Biopsy
Susan Richmond, a mouth cancer patient from Cork, said she regretted not visiting the dentist more regularly and encouraged people to do so.
“Like a lot of people, I didn’t like the dentist,” she said. “I only went if I really had to. I just wish that I had taken that step earlier and perhaps, I wouldn’t look and sound as I do today. Be aware of your own mouth. You look at your face daily, you clean your teeth daily. Note any changes in your mouth…and if you do find anything you’re not sure about, go to your dentist. I’m proof this can be beaten, life can go on.”
Dr Denise McCarthy of Dublin Dental University Hospital had a similar message: “Early detection and diagnosis of mouth cancer is improved by attending your dentist every year for an examination of your mouth, even if you have no remaining natural teeth. Early detection and treatment of cancer will greatly improve treatment outcome, long-term survival and quality of life.”
Mouth cancer treatment
The treatment for mouth cancer will vary depending on the location and type of cancer and your general health. Your doctors will develop a treatment plan to suit your case which may include one or more of the following treatments:
- Surgery – to remove the cancer
- Radiotherapy – to kill cancer cells using x-rays
- Chemotherapy – to kill the cancer cells with drugs
However, doctors and dentists encourage what are called preventative measures, which mainly involve avoiding factors which increase the risk of contracting cancer. Cancer is caused by a change in genes that control the way cells function. These genetic changes can be caused by external factors and can sometimes run in families.
“Our message on MCAD 2020 is one of hope and self-awareness,” said Dr McCarthy. “Prevention of mouth cancer is helped by having a healthy lifestyle, controlling mouth cancer risk factors by quitting smoking and alcohol consumption and getting the HPV vaccination.”
The most common risk factors are smoking, drinking alcohol, UV exposure from the sun and poor diet. A number of simple steps can be taken to reduce or eliminate these risk factors:
- Do not smoke. If you do smoke, plan to quit
- Limit your alcohol consumption
- Always use a lip balm and face cream with sun protection (SPF 30+)
- Eat a healthy diet high in fruit and vegetables
Ultimately, the best way to avoid and/or diagnose mouth cancers are to maintain a healthy lifestyle and to regularly visit your dentist for a check-up.
For more information, check the website www.mouthcancer.ie. You can also talk to a specialist cancer nurse on the National Cancer Helpline on freephone 1800 200 700. The opening hours are 9.00am-7.00pm Monday to Thursday and 9.00am-5.00pm on Fridays.