Posts for: April, 2013

Understanding the causative factors of cancer will contribute to prevention of the disease. Age is frequently named as a risk factor for oral cancer, as historically it occurs in those over the age of 40. The age of diagnosed patients may indicate a time component in the biochemical or biophysicas processes of aging cells that allows malighant transformtion, or perhaps, immune system competence diminishes with age. Very recent data leads us to believe that the fastest growing segment of the oral cancer population are non-smokers under that age of fifty, which would indicate a paradigm shift in the cause of the disease, and in the locations where it most freqently occurs in the oral enviornment. The anterior of the mouth, tobacco and alchol associated cancers have declined along with a corresponding decline in smoking, and posteriorof the oral cavity sites associates with the HPV16 viral cause are increasing.

However, it is likely that the accumlative damage from other factors, such as tobacco use, alchol consumption and persistent viral infections such as HPV, are the real culprits. It may take several decades of smoking for instance, to precipitate the development of a cancer. Having said that, tobacco use in all its forms is number one on the list of risk factors in individuals ofer 50. Historically at least 75% of those diagnosed at 50 and older have been tobacco users. This percentage is now changing, and exact percentages are yet to be defitvely determined and published, as new data related to viral causes are changing the demographics very rapidly. When you combine tobacco with heavy use of alchol, your risk is signficantly increased, as the two acr synergistically. Those who both smoke and drink, have a 15 times greater risk of developing oral cancer than others.

Tobacco and alcohol are essentially chemical factors, but they can also be considered lifestyle factors, since we have some control over them. Besides these, there are physical factors such as exposure to ultraviolet radiation. This is a causative agent in cancers of the lip, as well as other skin cancers. Cancer of th lip is the one oral cancer whose numbers have declined in the last few decades. This is likelu due to the increased awarenes of the damaging effects of prolonged exposure to sunlight, and the use of sunscreens for protection. Another physical factor is exposure to x-rays. Radiographs regularly taken during examinations, and at the dental office, are safe, but overexposure over a lifetime has been implicated in several head and neck cancers.

Biological factors include viruses and funji, which have been found in assocation with oral cancers. The human papilloma virus, particularly HPV16, has been defintively implicated in oral cancers, particularly those that occur in the back or the mouth. HPV is a common, sexually transmitted virus which infects about 40 million Americans today. There are over 130 strains of HPV, the majority of which are thought to be harmlesss. Most Americans will have some version of HPV in their lifetimes, and even be exposed to the onogenic/cancer causing versions of it. But only approximatley 1% of those infected, have a lack of immune response to the HPV16 strain which is a primary causative agent in cervical cancer (with HPV18), cancers of the anus and penis, and now is a known cause of oral cancer as well. So we wish to be clear. Infection with even a high risk HPV virus does not mean that you will develop oral cancer. Most people's immune systems will clear the infection before malignancy has the opportunity to occur. It is likely that the changes in sexual behaviors of your adults over the last few decades, and which are coninuing today, are increasing the spread of HPV, and oncogenic versions of it. There are other minor risk factors which have been associated with oral cancers, but have not yet been definitvely shown to participate in their development. These include lichen planus, an inflammatory disease of the oral soft tissues, and genetic predispsitions.


    The demographics of those who develop this cancer have been consistent for some time. While historically the majority of people are over the age of 40 at the time of discovery, it’s now occurring more frequently in those under this age. Exact causes for those affected at a younger age are now becoming clearer in peer reviewed research, revealing a viral etiology (cause), the human papilloma virus number 16. There are also links to young men and women who use conventional 'smokeless' chewing or spit tobacco. Promoted by the same as a safer alternative to smoking it has in actuality not proven to be any safer to those who use it when referring to oral cancer.

     Campaigns to promote the safety of smokeless are being initiated, but it is clear that while it may reduce lung cancers, it has a negative effect on the rates of oral cancers, pancreatic cancer, periodontal disease, and the chronic infections that it produces may link to heart disease. The gains against lung cancer may occur, but there will be new losses in other areas. The jury is out on other new smokeless tobacco dissolvable products, and until their use has acceptable research behind it we recommend avoiding it. It is also confirmed that in a younger age group, including those who have never used tobacco products, have a cause which is a HPV16 viral based.

     The human papilloma virus partially vision 16, has now been shown to be sexually transmitted between partners, and is conclusively implicated in the increasing incidence of young non smoking oral cancer patients. these public statistics do not conceder such social economic factors as income levels education availability of proper health care and the increased use of both tobacco and alcohol by different ethnic populations, but all of these factors likely play as role in who develops diseases. 


April 03, 2013
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Close to 42,000 Americans will be diagnosed with oral or pharyngeal cancer this year. It will cause over 8,000 deaths, killing roughly 1 person per hour. Of those 42,000 newly diagnosed individuals, only slighlty more than half will be alive in 5 years. (Approximately 57%) This is a number whick has not significanly improved in decades. The death rate for oral cancer is higher than that of cancers which we hear about routinely such asa cervical cancer, Hodgkin's lymphoma, laryngeal cancer, cancer of the testes and endocrine system cancers such as thyroid, or skin cancer. If you expand the definition of oral cancers to include cancer of the larynx, for which the risk factors are the same, the numbers of diagnosed cases grow to approximatley 54,000 individuals, and 13,500 deaths per year in the U.S. alone. Worldwide the problem is much greater, with over 640,000 new cases being found each year. Statistics on worldwide occurrence Oral cancers are part of a group of cancers commonly referred to as head and neck cancers, and of all head and neck cancers they comprise about 85% of that category. Brain cancer is a cancer category unto itself, and not included in the head and neck cancer group.

Historcally the death rate associated with this cancer is particularly high not because it is har to discover or diagnose, but due to the cancer being routinely discovered late in its development. Today, (2013) that statment is still true, as there is not a comprehensive program in the U.S. to opportunistically screen for the disease, and without that; late stage discovery is more common. Another obstacle to early discovery (and resulting in better outcomes) is the advent of a virus, HPV16, contributing more to the incidence rate of oral cancers, partularly in the posterior part of the mouth (the oropharynx, the tonsils, the base of tongue areas) whick many times does not produce visible lesions or discolorations that have historically been early warning signs of the disease process.

Ofter oral cancer is only discovered when the cancer has metastasized to another location, most likley the lymph nodes of the neck. Prognosis at this stage of discovery is significantly worse that when it is caught in a localized intra oral area. Besides the metastasis, at these later stages, the primary tumor has had time to invade deep into local structors. Oral cancer is particularly dangerous because in its early stages it may not be noticed by the patient, as it can freqently prosper withour producing pain or symptoms they might readily reconize, and because it has a high risk of producing second, primary tumors. This means that patients who survive a first encounter with the disease, have up to 20 times higher risk of developing a second cancer. This heightened risk factor can last for 5 to 10 years after the first occurrence. There are several types of oral cancers, but around 90% are sqamous cell carinomas. It is estimated that approximately $3.2 billion is spent in the United States each year on treatment of head and neck cancers




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