Mouth Cancer

We all know a lot more about mouth cancer now that Hollywood actor Michael Douglas has been diagnosed with the disease. The earlier you catch it, the better. But what are the signs to look out for? We talk to the experts.'The fact that Michael Douglas, the iconic Hollywood star, has been diagnosed with mouth cancer has raised its profile significantly,' says Dr Nigel Carter, chief executive of the British Dental Health Foundation. 'It's very sad for Michael, who is fighting the later stage of the disease. But it means that far more people know about it and are thinking about how it might affect them,' he says.

Catch it early
The earlier the disease is caught, the better. Survival rates rise to 90 per cent if the cancer is treated before it has spread. Sadly, the survival rates for this disease have not increased over the last 40 years because symptoms are often picked up too late. In fact, over two thirds of cases are picked up at late stage. 'It can be hard to pinpoint, particularly if the disease is in the throat,' says Dr Nigel Carter. Medical practitioners may also miss important signs. Michael Douglas went to frequent appointments complaining of pain in his throat and ear. But doctors failed to pick up the cancer, which was in the back of his throat. 'What you are looking for is red or white patches on the tongue or an ulcer that doesn't heal within three weeks,' says Dr Carter. Other symptoms include unusual lumps anywhere on the head or neck.

Risk factors
Mouth cancer is on the increase, and people affected by it are getting younger – although most people affected are still over 40. Tobacco is considered to be the main cause of mouth cancer, with three in four cases being linked to smoking.
Michael Douglas had a 'half a pack a day' habit until he quit the habit for good several years ago. Drinking in excess is also a known factor, with those who both smoke and drink excessively being up 30 times more likely to be at risk.
More recently, it has also been associated with the human papilloma virus (HPV), which is a sexually transmitted infection. Other risk factors include a poor diet. Research has shown that an increased intake of fish, vegetables, fruit and eggs can help lower risks of cancer. In the past, it was predominantly a male disease. But now the number of women with mouth cancer is growing because their smoking and drinking habits have changed. 'Thirty years ago, mouth cancer was five times more common in men than women. Now it's only twice as common in men as in women,' says Dr Carter.

Diagnosis
Most diagnosis is done after a visual examination, followed by a tissue biopsy. A new swab test, which will look for tell-tale signs of low levels of certain chemicals in the saliva, is still in the development stage. But it should help to make diagnosis easier in future. Scientists at the University of California Los Angeles School of Dentistry published their exciting findings in the October 2009 issue of the Chemical Cancer Journal. 'It's a breakthrough, but we have to wait until the technology is available in the UK,' says Dr Carter.

What's the treatment?
Once the disease has been diagnosed, it can be treated with a combination of radiation therapy and chemotherapy – as well as surgery, either a partial or complete laryngectomy, which can cause voice changes or the loss of voice completely. 'This case shows just how devastating and life-changing mouth or oral cancer can be, and it really is vital the public know what to do if they spot a problem,' adds Dr Carter. But everyone agrees that the best thing is to avoid the problem in the first place.
Regular trips to the dentist are a must because half of all mouth cancer cases are detected by dentists. 'Every time you see a dentist, you should get a thorough examination of the soft tissue of the mouth as a matter of course,' says Dr Carter.
'The dentist will be able to spot any tell-tale signs and refer you to a specialist for further examinations.'

Posted in: types of illnesses