Oral Cancer
Cancer Screening
Dr. Denison recommends that all adult dental patients have a cancer screening test performed once a year. The patient simply rinses with a solution for 30 seconds and Dr. Denison uses a photo-luminescent stick to evaluate the patients' cheeks, gums, tongue and throat to detect any suspicious growths or discolorations.
About Oral Cancer
In the last five years the incidence of oral cancer has risen faster than any other form of cancer. The primary cause of oral cancer has historically been associated with habits such as smoking or chewing tobacco. Increasingly, another cause of oral cancer is exposure to HPV-16, (human papilloma virus version 16). Alarmingly, HPV-16 is quickly becoming the dominant cause of oral cancer. In 2007 there was a major jump of over 11% in that single year! More alarming is that the incidence of oral cancer is occurring most frequently in young healthy adults. The fastest growing segment of oral cancer patients is young, healthy, nonsmoking individuals.
Oral cancer is the largest group of those cancers which fall into the head and neck cancer category. Common names include mouth cancer, tongue cancer, tonsil cancer, and throat cancer. They includes those cancers that occur in the mouth itself, in the very back of the mouth known as the oropharynx, and on the exterior lip of the mouth. In the last few years there has been a significant increase in the rate of occurrence of oral cancers, There are two distinct pathways by which most people come to oral cancer. One is through the use of tobacco and alcohol, a long term historic problem and cause, and the other is through exposure to the HPV-16 virus (human papilloma virus version 16), which is also known to cause the majority of cervical cancers.
When found at early stages of development, oral cancers have an 80 to 90 % survival rate. Unfortunately at this time, the majority are found as late stage cancers, and this accounts for the very high death rate of about 45% at five years from diagnosis, and high treatment related morbidity in survivors. One of the biggest problems associated with oral cancer is that in the early stages of its development, it is often painless, and the physical signs may not be obvious.
The dental community is the first line of defense against oral cancer, through the process of early discovery. Therefore, dental patients should have regular checkups twice a year and a cancer screening test performed annually.
Oral Cancer treatments
Surgery, radiation therapy, and chemotherapy are the most common treatments designed to stop the spread of cancer by killing and/or removing cancerous cells. Unfortunately, in the process of radiation therapy and chemotherapy, many of thebody's healthy cells are also damaged or destroyed.
Cancer treatment is very taxing on the body, creating a need for plenty of calories (some say 2500 calories per day) and lots of fluid (some say 2 liters per day). Because some or the entire throat is compromised during treatment, swallowing can be very difficult, very painful and/or impossible at times. The need for extra calories and regular fluids makes this a dangerous situation. Without sufficient calories and fluids, the body will be less successful at fighting off infection and physical symptoms are greatly exaggerated, and discomfort rises.
Dental Considerations
It is very important for a patient who is about to undergo treatment for oral cancer to make sure that they have good oral health. Patients should immediately have a dental examination in order to clean their teeth and also to have periodontal treatments performed if necessary. An unhealthy oral environment weakens a patients' immunity and makes them more susceptible to infection. Any teeth in poor to hopeless condition should be extracted, and decayed teeth should be repaired. This is not only because it creates a more healthy mouth, but because dental treatment while undergoing oral cancer treatment can be difficult. The patient should have fluoride trays made and start daily fluoride treatments to protect against cavities. Oral cancer and treatments associated with oral cancer cause changes to the mouth that include decreased salivary flow, changes in taste or loss of taste and susceptibility to infection, so close attention should be given to maintaining oral health.
What can you eat after surgery, chemotherapy and radiation treatments?
It is very important that during treatment patients maintain their health. It can be very difficult to swallow and patients often lose the ability to taste foods or they taste bad. Patients undergoing treatment are usually given a percutaneous endoscopic gastrostomy (PEG) tube. This allows them to get food to their stomach, while bypassing the oral cavity. The bottom line is eat whatever you can; Pudding, apple sauce, ice cream, thin soups, creamy soups, broths, oatmeal, cottage cheese, yogurt, smoothies, milk shakes, scrambled eggs, pureed fruits. Ensure and Ice Cream, Carnation Instant Breakfast and many different flavors of baby food. Equate Plus (from Wal-Mart) is very inexpensive and has the same calorie content. Also, try soy milk. Try smoothies blended with silken tofu for protein and try adding very small noodles (that don't have to be chewed) to broth. Campbell's beef consume' is good because it tasted a little richer and it has more protein in it than plain broth. Be warned though that all canned soups and broth have a lot of salt in them. Oatmeal has some substance. Get the whole rolled oats kind, not the quick oats.
Use some honey or brown sugar to sweeten. Put a banana in small pieces in it. You can eat fish, hearty soups, asparagus, sweet potatoes and almost anything blended. Try to think maximum calories per swallow. If you can tolerate canned soups stir in some cream or whole milk powder; it will get better with time. Carnation Instant Breakfast VHC is like a supercharged Ensure Plus with 560 calories. Remember to use your blender. You can liquefy anything if you have to.
You should also drink lots of water.
The bottom line is that you need to maintain your health and you can do it with protein/calorie intake and plenty of fluids.
Percutaneous Endoscopic Gastrostomy (PEG) tube
You should not be afraid to use the PEG if needed, as "food is medicine" and it is vital to not neglect nutrition and hydration. Be sure to speak about your diet to a general nutritionist DURING treatment - particularly the calories you get and the water you consume – because they have a HUGE impact on how well you heal, how quickly you heal and whether or not you heal. Give that peg tube some serious consideration - not just to save you from swallowing, but to assure that you can consume sufficient calories and water to promote your recovery.
You should follow the advice of your treating physician and nutritionist but typically you will need 2500 to 3500 calories per day to survive the treatment and recover. Not eating does NOT force your body to burn only fat - it usually causes the slow destruction of muscle – you do lose weight but it's at the expense of your strength. Too few calories means you experience more pain, more treatment symptoms, more depression, more infections, more stiffness, more lethargy, etc.
Adjunctive therapy
Many Cancer Centers are now recommending patients to providers of massage, acupuncture, reiki, guided imagery and yoga. These alternative treatments have been shown to be effective in helping patients cope with side effects from treatment, to shorten healing time and to increase both comfort and mobility.
We want to give special thanks and recognition to the Oral Cancer Foundation and its Member Forum for the valuable information regarding oral cancer included on this site.
