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    Oral Cancer Awareness Month: Converging Past and Present: The Evolution of Oral, Head, and Neck Cancer Management

    Oral Cancer Awareness Month: Converging Past and Present: The Evolution of Oral, Head, and Neck Cancer Management

    Courtesy Photo | April is Oral Cancer Awareness Month, serving as a reminder of the importance of early...... read more read more



    Courtesy Story

    Walter Reed National Military Medical Center

    By U.S. Navy Capt. (Dr.) Jason Burkes
    Walter Reed National Military Medical Center

    Editor’s note: U.S. Navy Capt. Jason Burkes is an oral maxillofacial surgeon at Walter Reed and assistant professor of surgery at the Uniformed Services University of the Health Sciences (USUHS).

    April is Oral Cancer Awareness Month, serving as a reminder of the importance of early detection, education and support for patients with oral cancer.

    Oral cancer can strike anyone, regardless of age or lifestyle. It encompasses cancers of the mouth, tongue, lips, throat and even the salivary glands. Its symptoms can go unnoticed in its early stages, allowing it to progress stealthily, therefore dentists and patients should remain vigilant in screenings and education efforts concerning oral health and cancer.

    A disease known for thousands of years

    Oral cancer is a disease that has been known for thousands of years with the earliest known description in the Edwin Smith Papyrus, an ancient Egyptian medical text dating back to approximately 3000 B.C.
    Hippocrates and his followers described tumors as “karkinos” and “karkinoma,” which referred to the Greek word for crab. Later, in 30 A.D., the Roman scholar Celsus translated these terms into the Latin word “cancer,” which refers to the crab-like appearance and difficulty in surgically removing these lesions. Galen used the term “oncos” to describe swelling related to tumors, which is the origin of the term “oncology.”

    In 2024, the American Cancer Society estimates there will be about 58,450 new cases of oral cavity and oropharyngeal cancers (cancer of the mouth and upper throat) in the United States, and about 12,230 deaths oral cavity and oropharyngeal cancer. Worldwide, its estimated that more than 450,000 new cases of oral cancer are diagnosed each year, according to the World Health Organization (WHO).

    Traditionally, oral, head, and neck cancers have been associated with tobacco smoking and excessive alcohol consumption, which have a synergistic effect. Smoking is considered the single most significant risk factor, with smokers being six times more likely to develop oral cancer and nearly 90 percent of all oral cancer patients having a history of tobacco use. While moderate alcohol consumption alone is not a risk factor, heavy intake is an independent risk factor, with a relative risk significantly higher than that for tobacco alone. The combined use of tobacco and alcohol results in an even greater risk. The risk of oral, head, and neck cancer declines with the cessation of smoking, approximating a non-smoker’s risk after 20 years, and a similar decrease is associated with the cessation of heavy alcohol intake.

    Oral cancer symptoms

    The most common symptoms of oral cancer include:
    • Swelling in the neck
    • Red or white patches in the mouth
    • Bleeding gum
    • A cancerous growth on the lip
    • Non-healing ulcer on lip
    • Difficulty in wearing dentures
    • Tongue cancer and/or non-healing ulcer over the tongue
    • Persistent pain or tenderness when swallowing

    HPV and cancers

    Studies have established a connection between the human papillomavirus (HPV) and various cancers in the oral cavity, head, and neck regions. HPV is widespread in the U.S., with millions of new cases each year, and stands as the country’s most common sexually transmitted infection. Oropharyngeal cancers, which can develop in the throat, base of the tongue, and tonsils, now represent the majority of HPV-related cancer cases among men in the U.S. While cervical cancer caused by HPV remains a leading concern among women globally, the emergence of oropharyngeal cancer as a prevalent HPV-associated cancer in the U.S. underscores the importance of heightened awareness and preventive measures.

    Among the numerous strains of HPV identified, over 100 in total, around 40 are sexually transmitted, impacting not only genital areas but also the mouth and throat. Although most people with oral HPV overcome the virus in time, it can linger in some and increase with age.

    HPV vaccine

    The HPV vaccine is a series of shots that protects people from the human papillomavirus (HPV), often spread through sexual contact. Approximately 80 percent of sexually active people will have an HPV infection. Although most people with oral HPV overcome the virus in time, it can linger in some and increase with age.

    Those who should get the HPV vaccine include:
    • Children between 11 and 12
    • Adults up to and including age 26
    • In some cases, adults up to and including age 45

    Treatment of head, neck cancers

    Historically, head and neck cancers were treated by general surgeons with specialized training in head and neck surgery, followed by ear, nose, and throat (ENT) surgeons starting in the 1970s. In recent decades, there has been a surge of oral and maxillofacial surgeons (OMS) who subspecialize in head and neck oncologic surgery and microvascular reconstructive surgery. These OMFS surgeons have completed extensive training equipping them with the necessary knowledge and skills to manage tumors and perform complex reconstructions.

    The field of oral and maxillofacial surgery, particularly in head and neck oncologic surgery, blends the disciplines of dentistry and medicine, providing a unique perspective in treating patients with oral, head, and neck cancer. OMFS surgeons can navigate the intricate anatomy of the oral cavity, often resulting in less extensive facial incisions. Additionally, their dental expertise ensures the restoration of functional occlusion during the reconstruction process.

    Oral, head, and neck cancer remains a devastating disease; however, advancements in surgical training and technology have significantly improved the quality of life for these patients and their families. Dentists are often the first line of defense in identifying oral cancer. By facilitating earlier detection and appropriate referral to OMFS surgeons, we can contribute to better outcomes and improved long-term survival for these patients.



    Date Taken: 04.29.2024
    Date Posted: 04.29.2024 12:32
    Story ID: 469766
    Location: US

    Web Views: 65
    Downloads: 0