The Changing Face of Oral Cancer : A Healthy Smile, A Healthy You
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The Changing Face of Oral Cancer

by Dr. Scot Ioset, DDS on 07/12/11

     When I graduated from the University of Michigan School of Dentistry in 1984, we had been taught that the vast majority of oral cancers occurred in older men who where tobacco users and heavy drinkers.  A quick review of several "health" internet sites shows that they repeat the old mantra for oral cancer causation. Well that was true right up to Y2K, but since then an alarming increase of squamous cell carcinoma of the mouth and throat has been noted in young people, some as early as their mid-teens and with a 2 to 1 prevalence in women over men. What is going on?!?
     This pandemic has been attributed to the rising rates of infection of the human papilloma virus  (HPV), transmitted primarily via sexual contact.  When this contact occurs orally, the mouth becomes susceptible to HPV infection and HPV- induced cancers. More cancers are now seen on the soft palate, whereas before the floor of the mouth and the lateral borders of the tongue were more common sites.
     The numbers on the morbidity of oral cancer is not good.  1 in 4 people with oral cancers die from it.  If it is detected late in advanced stages, the 5 year survival rate is a dismal 25 to 30%.  However, early detection of oral cancer leads to 5 year survival rate approaching 90% or better.
     If you are my patient, you have always been given an oral cancer screening every 6 months. As of July 1, 2011,  I have added a new technology to our screening procedure--the Velscope.  Its blue light causes healthy tissue to fluoresce green when viewed through the green filter of the device. Unhealthy, precancerous and cancerous tissue appears dark to black.
     One great success in medicine has been the reduction of deaths in women from cervical cancer. The primary cause of cervical cancer? HPV. Pap smears have become routine in screening cervical tissues to identify early cellular changes in the cervical mucosa. As a result, cervical cancer has fallen from #2 to #14 as causes of cancer deaths in women.
     Our office has a similar device for screening questionable lesions in the mouth--the Oral CDX.  It utilizes a brush to scrub cells off of the lesion, which are then placed on a microscope slide, fixed with alcohol, then sent to the CDX laboratory for a very careful evaluation of the cells. Based on the findings, we can refer for care to a specialist for treatment if required.
     The Velscope, coupled with the Oral CDX provides state of the art care to our patients. The cost of a Velscope screening may be covered by your insurance, and our fee is $10.  We want it available to all of our patients and do not want cost to be an issue.
     What are the signs of oral and pharyngeal cancer?
1.White or red sores or ulcers that fail to heal after ten days. These can occur anywhere in the mouth, lips and pharynx.
2. Persistent throat and/or unilateral ear pain lasting more than two weeks.
3. Hoarseness lasting more than a few days and does not get better.
4.Lump in the neck. If you experience any of these symptoms, contact our office or your physician to have them evaluated.
     Finally, prevention is the best medicine. Avoid all tobacco, limit alcohol consumption, avoid chronic use of alcohol-containing mouthwash, use 50 SPF sunscreen on lips and face, and practice safe sex at all times. Dr. Oz has done an excellent 5 part series that can be viewed on YouTube




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