Oral cancer rates are on the rise. While it may not be amongst the most common or deadly cancer types, many oral cancers could be prevented or caught early when treatment is less extensive and more successful.
Dr. Denise Laronde is an affiliated scientist with BC Cancer and the acting director of the BC Oral Cancer Prevention Program. In addition to leading a team of health professionals who conduct monthly clinics in Surrey and Vancouver, she has been researching oral cancer as part of the BC Oral Cancer Prevention Longitudinal Study, which has been running since the late 1990s.
“We have amassed a large databank of clinical, demographic, and histopathological data, and a biobank of tissue and cell samples,” says Dr. Laronde. “From this data, we are looking for early markers of malignant transformation, so that we can identify lesions at high-risk of progressing to oral cancer.”
Precancerous and early oral cancer lesions may be very hard to differentiate from more common benign lesions. Dr. Laronde recommends watching out for white or red patches in your mouth that last for more than a couple of weeks. More advanced cancers may cause lumps in the neck, numbness, difficulty swallowing, unexpected bleeding, loose teeth, and changes in speech. People who get regular routine dental checkups may not be aware that their dental professional is checking for early signs of oral cancer as part of their appointment. The BC Oral Cancer Prevention Program works with dentists and hygienists on how to spot early cancer and precancers.
“Dental health professionals can screen for oral cancer, pre-cancer and other conditions, by performing extra- and intra oral examinations,” says Dr. Laronde. “The exam includes checking for lymph nodes along the jaw and neck, asking a patient to stick out their tongue to check the tongue and its borders, and having patients say "ahh” to visualize the back of their mouth.”
If anyone is unsure about whether they have been screened, she recommends people check with their dental health professional.
While oral cancer can happen at any age and in the presence or absence of risk habits, some oral cancers can be prevented. As with many cancers, tobacco and alcohol consumption can increase a person’s risk. For tobacco, this includes smoking and chewing. Another significant risk factor for oral cancer is chewing betel nut, a seed from a type of palm tree, which is popular in some Asian and South Asian populations. People living in India, for example, account for approximately a third of the world’s annual oral cancer diagnoses, according to Dr. Laronde. In B.C., research from the BC OCPP found South Asians have a greater risk than the general population, 33 per cent and 66 per cent higher risk in men and women, respectively.
“To reduce risk, it is important to educate people about the danger of betel nut amongst those who consume and sell it, and the health professionals, both medical and dental, who may treat these individuals.”
Wearing sunscreen to protect the lips, and getting the human papillomavirus (HPV) vaccine are two other ways people can reduce their risk. Oropharyngeal cancers, meaning cancers in the back of the mouth, are rising due to HPV. “The same high-risk strains of HPV responsible for cervical and other ano-genital cancers are also responsible for many oropharyngeal cancers,” says Dr. Laronde.
The BC Oral Cancer Prevention Program sees about 10 people per day in their clinic due to enhanced COVID-19 safety precautions. Clinics run 1-2 times per month. For more information, visit the Oral Cancer Prevention program website.