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Oral Cancer: Jun'13

Tags: cancer , dental

Dr Uchenna Okoye discussed oral cancer, along with its symptoms, causes and treatments.

Ruth asked: A few years ago I had a strange smooth patch on my tongue, the biopsy said it was benign and I was told I shouldn't worry and it was probably related to a skin condition. Is this something I should keep an eye on? Sometimes I feel like it stings a bit.

Dr Uchenna Okoye answered: Hi Ruth, Yes this is definately something to keep an eye on.  Your dentist should check on it each time you visit and take a picture as a baseline to compare.  As it was benign thankfully I wouldn't worry too much.  If things change e.g. you get an ulcer or discolouration then definately ask your dentist to refer you back to the hospital to make sure all ok

Ruth commented: Ok thanks, I'll start making sure my dentist checks each time

Heather asked: Are there any early warning signs of oral cancer? What would they be?

Dr Uchenna Okoye answered: The earliest sign is an ulcer that won't go away.  So if you have an ulcer anywhere in your mouth that is still there after 3-4 weeks head straight to your dentist to get checked out.

 

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Fiona asked: Recently the dentist told me I had what is sometimes called 'map tongue' due to markings on my tongue and said it was down to eating citrus fruits. Can you explain why this happens, and if it can be dangerous?

Dr Uchenna Okoye answered: 'Map tongue' is probably referring to geographic tongue. You'll be relieved to know that geographic tongue is a harmless, benign condition that isn't linked to any infection or cancer.. The cause is unknown, we think it's probably genetic as often runs in families. Spicy or acidic foods can cause irritation, it's not the cause though

Fiona commented: Thanks!

Anonymous2 asked: Does flossing regularly help to protect from gum cancer?

Dr Uchenna Okoye answered: Flossing regularly is very important for preventing gum disease.  It is not help protect from cancer.  Main culprits in causing oral cancer is tobacco and alcohol and also the HPV virus

Karen1 commented: HI, My dentist has used a phase " point of no return" wiht regards to my gums and recommended seeing the hygenist.  Do you know what that could mean?   Also  - two splits in the tongue curious about what that is about - on the top?

Dr Uchenna Okoye commented: Your dentist probably means that the gum will not grow back.  Slightly harsh terminology I think! Sometimes the Periodontist (gum specialist) can actually graft the area

Ianto asked: Is there an increased risk of oral cancer with  nicotine repacement therapies that are taken orally (e.g. gum, lozenges) over a long period of time?

Dr Uchenna Okoye answered: There have been some studies suggesting this. The researchers studied the activity of a gene known as FOXM1 that is often found mutated in many tumours.  The presence of nicotine is thought to increase it's activity. This is why it is recommended you only use the substitutes for a short period of time

Andy_M asked: Is mouth cancer uncurable? I read that you're only likely to live 5 years after diagnosis of early stage mouth cancer

Dr Uchenna Okoye answered: If mouth cancer is spotted early, the chances of a complete cure are really good, and the smaller the area or ulcer the better the chance of a cure. However, too many people come forward too late, because they do not visit their dentist for regular examinations. The 5 year survival rate is over 90% which is one of the best!

M asked: is it true that poor dental hygiene is a contributor to oral cancer?

Dr Uchenna Okoye answered: Not really, although it can be a sign of deprivation and so there can be other contributing health factors.  Most cases of mouth cancer are linked to tobacco and alcohol.Over-exposure to sunlight can also increase the risk of cancer of the lips.
Mouth cancer has now been linked to the human papillomavirus (HPV).

M asked: Also - are mouthwashes are good, bad or indifferent thing regarding oral cancer?

Dr Uchenna Okoye answered: Some mouthwashes have alcohol in them and so have been linked to mouth cancer.  It is a very small risk but I recommend using an alcohol free mouthwash.  Most companies have now changed their formulations to give this choice

Mrs Rabbit commented: My husband uses mouthwash daily ... Listerine ... and I always tell him that it's a chemical and not good for him ... who is correct?  Also when we were kids, things like dental floss and inter dental brushes were not invented ... how regularly should we floss?

Dr Uchenna Okoye answered: One of the issues with Listerine was it had alcohol in it, but there has been a change in formulation now. Flossing, ideally every day :) Most cavities are caused in between the teeth and you need to use something specific to clean this area

Anonymous116 asked: Will oral cancer affect your speech even after treatment?

Dr Uchenna Okoye answered: Your speech will only be affected if you have had to have radical surgery.  Eg if the cancer has unfortunately spread so part of your jaw has to be resected

Anonymous123 asked: I know that smoking is a contributing factor to mouth cancer however, should all smokers be concerned that they will get mouth cancer?

Dr Uchenna Okoye answered: Absolutely!  The evidence shows that clearly. Treatment chosen will depend on the type of cancerous cells, location in the mouth and size of the lesion.  It can include surgery to remove any lesion, chemotherapy, radiotherapy or a combination of all.  The good thing is if caught early, treatment is really successful

Anonymous124 asked: How is oral cancer treated? Do parts of the mouth always need to be removed or can it be treated in other ways?

Dr Uchenna Okoye answered: Treatment chosen will depend on the type of cancerous cells, location in the mouth and size of the lesion. It can include surgery to remove any lesion, chemotherapy, radiotherapy or a combination of all. The good thing is if caught early, treatment is really successful

Anonymous116 asked: What medications are available to ease the pain caused in your mouth by mouth cancer - mouth ulcers can be unbearable enough

Dr Uchenna Okoye answered: The oncologist will prescribe the best pain relief for any pain caused due to the cancer.  For general ulcers, ask your dentist for advise.  I often recommend Corsodyl gel as helps them heal faster

Anonymous123 asked: I saw in the press recently that Michael Douglas blamed mouth cancer on oral sex and the HPV. How likely is it that you would develop mouth cancer from contracting HPV

Dr Uchenna Okoye answered: Yes there is now a definite link between HPV, especially type 16 and oral cancer. The virus can cause genetic changes in cells that make them more likely to become cancerous in the future.
The risks are also even greater if smoking

Andy_M asked: What is the link between betel nuts and mouth cancer?

Dr Uchenna Okoye answered: The harmful substances in tobacco and betel quid can cause cancer if they are in contact with the gums and tongue over long periods. Chewing betel quid without tobacco increases the risk of mouth cancer but chewing mixtures containing tobacco increases the risk even more

AXA PPP healthcare:
We've just had a question come through from Andrew on Facebook:
"Who is most at risk from oral cancer?"

Dr Uchenna Okoye answered: Smoking and  Alcohol are the two biggest risk factors, and combining the two is really potent. Human Papilloma Virus (spread by sexual contact) and excess sunlight (for lip cancers) are also key risk factors

Fiona asked: Can sugar contribute to oral cancer?

Dr Uchenna Okoye answered:
No there is no link between sugar and oral cancer.  Sugar attacks your teeth, not the soft tissues

Chris asked: Does the risk of oral cancer increase as you grow older?

Dr Uchenna Okoye answered:
Yes the risk factor does increase with age. In the UK For men, age-specific incidence rates increase sharply from around age 45 and peak at ages 60-69, For women, it increase sharply from  around age 45, but peaks in the over-80s.  However it is affecting younger people more often than it used to

Mrs Rabbit commented: How common is oral cancer in the over 50s?

Dr Uchenna Okoye answered:
In the UK between 2007 and 2009, an average 44% of oral cancer cases were diagnosed in people aged 65 and over; more than 25% were diagnosed in the under 55s. The figures are probably higher now

Anonymous125 asked:
Can the contraceptive pill cause oral cancer?

Dr Uchenna Okoye answered: No there are no known links between the pill and oral cancer

Ruth asked:
What are the best ways to prevent oral cancers?

Dr Uchenna Okoye answered: The most important way you can help prevent oral cancer is to cut out smoking completely and reduce your daily intake of alcohol. See your dentist regularly so any lesions in the back of your mouth can be spotted early

Karen1 asked: My dentist used a phase " point of no return" wiht regards to my gums and recommended seeing the hygenist. Do you know what that could mean? Also - two splits in the tongue curious about what that is about - on the top?

Dr Uchenna Okoye answered: Your dentist probably means that the gum will not grow back.  Slightly harsh terminology I think! Sometimes the Periodontist (gum specialist) can actually graft the area

Anonymous124 asked: Could bleeding gums be a sign of oral cancer?

Dr Uchenna Okoye answered: If you are suffering from this, the answer is no! Bleeding gums is an early sign of gum disease. It needs treatment by your dentist or hygienist as it can progress to full periodontal disease and you can actually loose teeth

AXA PPP healthcare:
We've had a question come through from Chloe on Facebook:
"I go to the dentist every 6 months. Will my dentist pick up on signs should oral cancer look to be developing?"

Dr Uchenna Okoye answered: As part of your check up your dentist should do an oral cancer screen.  This will involve checking the lymph nodes around your head and neck, feeling your muscles in this area, looking inside your mouth to check all your soft tissues, your tongue, palate, floor of your mouth.  DOing this, any lesions will definitely be picked up early

AXA PPP healthcare: The live chat is now closed. Thank you for all your questions and thank you to Dr Uchenna for her great answers.

We hope your questions have been answered.

 

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