January 14, 2021 BY
ANN GILLENWATER, M.D.
As director of MD Anderson’s Oral Cancer
Prevention Clinic, I see many patients each year with both oral cancers and pre-cancerous
conditions. Squamous cell carcinoma accounts for about 95% of oral cancers,
which, unlike oropharyngeal cancers,
are not related to the human papillomavirus (HPV).
One thing I’ve noticed is how many patients express the
same reasons for not having their oral lesions looked
at sooner. None of them are based in fact, but all of them are based on
misinformation.
Here are four myths I hear the most often, and why you
shouldn’t believe them, either.
Myth #1: It doesn’t hurt, so I don’t
need to worry about it.
Fact: Most people who find white
splotches in their mouths will never develop oral cancer. But it’s still a good
idea to have them checked out. One of the most common symptoms of oral cancer
is something called “leukoplakia,” or white spots in the mouth. Leukoplakia is
a pre-cancerous lesion indicating an increased risk of developing oral cancer
one day.
When I first meet some patients, they’ll say, “Well,
I’ve had this spot on my tongue or cheek or gums for a while now, but it didn’t
hurt, so I figured it was harmless.”
Actually, the opposite is often true. If a sore in your
mouth hurts, it’s usually because you bit, scraped or burned yourself somehow,
or you have a little viral infection. Normally, these types of things clear up
on their own in a couple of weeks.
But if a sore doesn’t hurt — and
doesn’t heal within a few weeks — that’s when you need to
worry. Because cancer is not usually painful at early stages. And it doesn’t
heal spontaneously.
Myth #2: I don’t smoke or use tobacco,
so I can’t get oral cancer.
Fact: More than half of my patients
have no history of tobacco use of any
kind.
Just as anyone with lungs can get lung
cancer, anyone with a mouth can develop oral cancer. And while
it’s true that tobacco use significantly increases the odds that you will
develop oral cancer, it’s not the only possible cause.
In fact, many doctors who treat oral cancers have
started noticing a curious phenomenon: there seem to be two peaks in the
occurrence of oral cancers among women with no history of smoking. One is
of tongue cancer in
women around age 40. The other is of gum cancer in women
in their late 70s and early 80s. But no one really knows why.
One thing that gives me hope is a clinical trial being
led by Maura Gillison, M.D., Ph.D. She’s
been treating patients with oral cancer with a combination of chemotherapy and
an immunotherapy drug
called pembrolizumab. And, some of her patients have seen a complete response.
That means when surgeons went to operate on their tumors, there wasn’t any
cancer left to remove. That’s pretty amazing.
Myth #3: I’m too young to get oral
cancer.
Fact: Cancer tends to develop in older
people, so it’s unusual to see oral cancers in someone younger than age 40. But
it’s not impossible. That’s why it’s so important to get anything odd checked
out, even if you think you’re too young to have cancer.
Sometimes, even doctors don’t believe someone in their
20s or 30s could have cancer. They just keep throwing antibiotics at the
problem.
I’ve also seen more patients coming in with larger
cancerous tumors lately, because they’ve put off seeing a doctor or dentist due
to COVID-19 restrictions.
But cancers are easiest to treat when they’re diagnosed early, and here
at MD Anderson, we’re taking every possible step to
ensure the health and safety of our patients while they’re on our campuses.
Myth #4: My oral cancer is gone now,
so I don’t have to worry anymore.
Fact: Once you’ve had an oral cancer,
you’re automatically at greater risk for developing another.
That’s why vigilance is crucial, even after you’ve been
cured. Usually, that only amounts to a check-up once every six months, unless
you notice pre-cancerous changes.
Other oral cancer symptoms to look for include:
·
A sore that
won’t heal — most minor cuts and scrapes in the mouth will resolve on
their own within a few weeks; but if one doesn’t, get it checked out
·
A lump or a
bump — especially if it’s growing large
·
A red or white
patch — especially if it bleeds when you touch it
·
Loose teeth —
sometimes caused by cancer of the gums
·
Problems
speaking, chewing or swallowing — once a tumor gets big enough, it may
hurt to eat or speak, or you might not be able to move your tongue well enough
to chew or swallow
·
Unexpected
weight loss — often caused by problems chewing and swallowing
The most important thing to look for is changes over
time, such as a white spot changing to red, a small spot growing larger, a spot
bleeding when it didn’t used to, or a lump or bump becoming painful when it
wasn’t before. Those are the things you want to investigate.
Request an appointment at MD Anderson online or by calling
1-888-512-7249.
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