Oral Cancer: Early Detection and the Crucial Role of Oral Surgeons

While overall cancer rates in the United States continue to decline, oral cancer is on the rise with the American Cancer Society estimating nearly 60,000 new cases in 2024 and more than 12,000 deaths.

“More people are getting oral or oropharyngeal cancer … and depending on the stage of cancer at diagnosis, the outcomes can be devastating,” says the Henry Ford Health staff.

Early detection of oral cancer -- which occurs most often on the tongue, tonsils and oropharynx (throat behind the mouth), gums, floor of mouth and other parts of the mouth -- is pivotal in survival rates.

“Oral and oropharyngeal cancers can affect your ability to eat and swallow. They can also restrict your speech,” said Samantha Tam, M.D., an otolaryngologist (ear, nose and throat specialist) at Henry Ford Health. “And depending on where the cancer is, there can also be dramatic changes to your physical appearance, especially if it presents at a later stage.”

It’s crucial that people at risk for oral cancer understand the importance of regular screenings and the role of oral surgeons in preventing and treating oral cancers.

“Historically the death rate associated with this cancer is particularly high not because it is hard to discover or diagnose, but due to the cancer being routinely discovered late in its development,” says the Oral Cancer Foundation.

Understanding Oral Cancer

Oral cancer encompasses a range of malignancies that can develop in various parts of the mouth and throat. These areas include:

• The tongue, at the base of the tongue, and under the tongue.
• The tissue lining of the mouth and gums.
• In the area of the throat at the back of the mouth (tonsils and oropharynx).
• Floor of the mouth and other parts of the mouth.
• Lips.
• Minor salivary glands (often found in the roof of the mouth).

Important statistics from the American Cancer Society show the importance of early detection as it improves survival rates:

• About 58,450 new cases of oral cavity or oropharyngeal cancer in 2024.
• About 12,230 deaths from oral cavity or oropharyngeal cancer in 2024.
• 5-Year survival rate between 2012 and 2018 when detected early:

o   Lip: 91 percent.

o   Tongue: 69 percent.

o   Floor of the Mouth: 53 percent.

o   Oropharynx: 52 percent.

• The average age of people diagnosed with oral cancer is 65.
• Just over 20 percent of cases occur in people younger than 55.
• Oral cancer is twice as common in men as in women.
• Oral cancer is slightly more common in white people than black people.
• Overall, the lifetime risk of developing oral cavity and oropharyngeal cancer is 1 in 59 for men and 1 in 139 for women.
• Since the mid-2000s rates have increased by about 1 percent per year, mostly because of a rise in cancers linked with human papillomavirus (HPV) infection.

Risk Factors and Causes

Understanding the risk factors can help individuals take preventive measures and seek timely screenings. Common causes of oral cancer include:

• Tobacco use (any form, including cigarette smoking).
• Oral tobacco products such as snuff, dip, spit, chew, or dissolvable tobacco.
• Chewing betel quid or gutka.
• Heavy alcohol consumption.
• Human papillomavirus (HPV) infection, particularly HPV 16.
• Sun exposure (for lip cancer).
• Age (risk increases after 40).
• Sex (oral cancers are twice as common in men than women).
• Excess body weight.
• Exposure to long periods of UV light.
• Poor nutrition.
• Genetic syndromes such as Fanconi anemia and dyskeratosis congenita.
  
  

It's important to note that combining tobacco and alcohol use significantly increases the risk of developing oral cancer.

“The risk of these cancers in people who drink and smoke heavily is about 30 times higher than the risk in people who don’t smoke or drink,” says the American Cancer Society.

The American Cancer Society also states that mouthwash use, irritation from dentures and poor oral health are “unproven or controversial risk factors.”

Signs and Symptoms

Being aware of potential oral cancer symptoms can lead to earlier detection. Common signs include:

• Persistent sores, irritations, lumps, or thick patches in the mouth, lip, or throat.
• White or red patches in the mouth.
• Difficulty in chewing, swallowing, or speaking.
• Numbness in the tongue, lip, or other areas of the mouth.
• Swelling of the jaw that affects your denture fit.
• Trouble moving the jaw or tongue.
• Persistent sore throat or feeling of something caught in the throat.
• Ear pain.
• Loosening of the teeth or pain around your teeth.
• Voice changes.
• Weight loss.
• A lump or mass in the neck or back of your throat.
  
  

If any of these symptoms persist for more than two weeks, it's crucial to seek professional evaluation.

Oral Surgeons Role in Oral Cancer Detection and Treatment

Oral surgeons play a vital role in the detection, diagnosis, and treatment of oral cancer. Their expertise is particularly valuable in the following areas:

• Perform comprehensive intraoral and extraoral evaluations.
• Use various imaging tools and advanced techniques to spot and evaluate any areas of concern more effectively.
• Customize diagnostic approaches for each patient on a case-by-case basis.

2. Biopsy Procedures

One of the most critical roles of oral surgeons is performing biopsies. When a suspicious lesion is identified, a biopsy is necessary to confirm or rule out cancer. Oral surgeons are specially trained to:

• Determine the most appropriate type of biopsy.
• Perform the biopsy with precision.
• Interpret the results accurately.
  
  

3. Diagnosis and Treatment Planning

If cancer is confirmed, oral surgeons work closely with other specialists to develop a comprehensive treatment plan. Their expertise is crucial in:

• Determining the stage and extent of the cancer.
• Recommending appropriate treatment options.
• Performing surgical interventions when necessary.
  
  

4. Surgical Interventions

In cases where surgery is required, oral surgeons are at the forefront of treatment. They can:

• Remove cancerous tissue while preserving healthy structures.
• Perform reconstructive procedures to restore function and appearance.
• Coordinate with other specialists for comprehensive care.
  
  

5. Follow-up Care and Monitoring

Even after treatment, oral surgeons play a crucial role in:

• Monitoring for recurrence.
• Managing any post-treatment complications.
• Conducting regular follow-up examinations.

Advancements in Oral Cancer Screening and Treatment

The field of oral cancer detection and treatment is continuously evolving. Some recent advancements include:

• AI-assisted screening: Artificial intelligence algorithms are being developed to assist in identifying suspicious lesions during routine dental examinations.
• Liquid biopsy: This non-invasive technique analyzes blood or saliva samples for cancer biomarkers, potentially allowing for earlier detection.
• Immunotherapy: New immunotherapy treatments are showing promise in treating advanced oral cancers by harnessing the body's immune system.
• Targeted therapies: These drugs specifically target cancer cells, potentially reducing side effects compared to traditional chemotherapy.
  
  

Early detection remains the most crucial factor in improving oral cancer outcomes. Regular dental check-ups, awareness of symptoms, and prompt action when abnormalities are detected can make a significant difference.

Oral surgeons play an indispensable role in this process, from advanced screening techniques to performing biopsies and coordinating comprehensive treatment plans.

By understanding the importance of early detection and the crucial role of oral health professionals, including oral surgeons, the impact of oral cancer can be reduced and survival rates increased.

Contact Northwest Oral and Maxillofacial Surgery today if you have concerns and/or questions about your oral health.