Oral Cancer in Epidemic Stages

Rise in Human Papillomavirus (HPV) Related Oropharyngeal Cancers (Oral Cancer).

With an increase in the HPV-OPC’s (Oropharyngeal Cancer), proper and timely diagnosis and treatment are mandatory and education of the patients is even more necessary. The above is a form of oral cancer also known as mouth cancer or also neck cancer.  Health care professionals of all kinds, dentists, oral surgeons, dental hygienists, nurses, all types of physicians, especially ENT physicians, and other health care providers must provide a more thorough initial screening method. Any swelling or tenderness of lymph nodes, especially in the neck region, is suspicious.

The human papilloma virus (HPV) is becoming more prevalent in today’s society in the form of throat cancer, especially of the squamous cell carcinoma type. This HPV infection is rapidly increasing to nearly to 80% of all oral cancers, and this cancer is usually caused by the HPV. In the past, tobacco was the probable cause of oral cancer. Genetics, as well as excessive use of alcohol, were also culprits. The previous holds true but the HPV has become the leading cause of oral cancer or mouth cancer. Some statistics say that approximately 8% of the general population have the HPV virus now. Where is the HPV usually found? The answer is in the throat, cervix, or anus. The fact that the incidence of oral cancer is on the rise, requires all health care providers to be more diligent in their diagnosis and for the general public to educate themselves on the probable cause, which is stated in the next paragraph.

Unprotected oral sex is the primary cause of the increase in the spread of HPV, and since HPV is also the primary cause of throat cancer or oral cancer, we must begin to educate the general public of this. Many patients are completely unaware that this virus can transmit the infection through unprotected oral sex. One of our previous president’s did not help the cause as he convinced many that oral sex was not really sex.

Education is the answer. Parents should educate their children. Physicians, dentists, nurses, dental hygienists, and all health-care professionals should be involved. Cancer of the throat in middle-aged men will soon surpass cervical cancer in women. That is an astounding statistic. Teens and young adults must be educated that oral sex is not safe sex. The spread of the HPV is becoming rampant. It is the cause of genital warts. Consideration should be given to both boys and girls being vaccinated to prevent either cervical cancer for the girls and cancer and genital warts of the penis for the boys. The name of the vaccine is Gardasil. Although there are a few hundred strains of HPV, the one we need to guard against primarily is called HPV-16.

This is a very sensitive topic to discuss with your patient, but one that needs a conversation. Special lights such as the DentalEZ brand are readily available to help in the diagnosis of oral cancer. Careful observations should be made in the back of the throat, behind the tonsils, and at the back of the tongue. Saliva can be tested for the presence of HPV. Squamous cell carcinoma is now often found in the mouth and is considered to be a form of mouth cancer. Lymph nodes should be palpated or carefully examined for tenderness or enlargement.

The health care practitioner must not only educate the patient but also encourage them. Education and information are truly lacking and need to be improved. Early diagnosis may allow treatment by simply enhancing the immune system. If the enhanced immune system cannot eliminate the HPV, then the patient maintains the HPV infection which makes them more prone to  oral cancer. Reduction in the virus or elimination will lessen the statistics on the human papilloma virus caused oral cancer.

Unfortunately, the HPV virus is more common than one thinks. It is carried unknowingly on some for their entire life with no symptoms. However, the Center for Disease Control (CDC) states that approximately half of men and women who are sexually active will contract this infection genitally at some point. This is an alarming statistic.

So….what should you do?

• Practice safe sex, especially oral sex.
• Do not be promiscuous. Limit partners.
• Lessen the intake of alcohol.
• Eat lots of fruits and vegetables, raw or not over-cooked.
• Do not smoke.
• Avoid second-hand smoke.
• Avoid smokeless tobacco, as well as the Asian betel nut.
• Brush twice per day and floss once.
• Self check your mouth.
• Visit your dentist twice per year.
• Avoid sunburns.

The HPV infection can be limited by the human papillomavirus vaccine (Gardasil) which highly limits throat cancers, mouth cancers, cervical cancer, genital warts, and human  HPV. The risk of having oral, mouth, throat, or neck cancer is just too high. The tumor created by the HPV infection is certainly abnormal, especially when it is shown to produce cancer cells. As mentioned above, this oral cancer is prevalent in the mouth, throat and neck. It is strongly recommended that teenagers should consider having this vaccination around twelve or thirteen years of age.

Today’s Dentist

Life Member of American Dental Society, Emeritus Fellow of Academy of General Dentistry, American Association of Implant Dentists.