This patient friendly review is on oral cancer or mouth cancer, which is cancer of the lining of the mouth, gums, upper throat and even the lips. It can start as a painless white patch, which thickens and continues to grow. It may also appear as an ulcer.
The Statistics for Oral or mouth cancer
This cancer refers to cancers of the mouth or oral cavity, and cancers of the throat or oropharyngeal cancers. It is part of the group called Head and Neck Cancers.
In the UK some 12,200 people will contract mouth cancer - a condition that has (according to a Cancer Research UK survey) increased by a quarter in the last decade and kills more people than cervical and testicular cancer combined. It seems to be a predominantly male disease (US figures say six men are diagnosed to every woman). In the USA, about 53,260 people will develop oral cavity or oropharyngeal cancer this year. Approximately one fifth will die. In the UK some 4,000 die - roughly one third.
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Most sufferers are over 40, although an increase in younger people has been tracked in recent years. The big booze culture is thought to be a strong factor. Eminently treatable if caught early, mouth cancer is dangerous because early symptoms (which appear harmless) are easily missed and public awareness is low - so low, in fact, that a recent survey found nearly 33 per cent could not name a single symptom.
It seems to be a predominantly male disease and most sufferers are over 40
Causes of mouth or oral cancer
UK experts say that 75 per cent of oral cancers could be avoided by a healthy lifestyle and diet. Prevention will always be better than cure:
It's still little known that smoking, or chewing tobacco or betel are implicated in a high number of cases, whilst smokers who also drink a lot have an increased risk factor. Alcohol based mouthwash can be a factor. A diet poor in fruit and vegetables can increase risk, while a high consumption of these good foods are protective. There also seems to be a viral link, with the HPV (human papilloma virus) strains 16 and 18 involved, especially in younger people.
The linking factor between smoking and alcohol is the Oral Microbiome where gum disease or a link to an imbalance of gut bacteria caused by yeasts, viruses such as HPV, bacteria such as E coli, and even parasitic infection can lead to this cancer. The latter was certainly the case for Sir Geoffrey Boycott, who had a tumour on his tongue. He still credits Chris Woollams with having saved his life.
Lichen planus can also be a factor in Oral cancer. It can be caused by dysbiosis in the gut microbiome and the patient may have several areas in the mouth. it appears as thin white lines or small spots. In about 40% of cases it can be erosive and cause oral cancer. Women are twice as likely to develop Lichen planus as men.
As with all gut microbiome led diseases, drugs, antibiotics, poor diet, lack of whole soluble fibre in the diet, parasites, alcohol, smoking and/or stress are key factors.
Go to: The Oral Microbiome and your health
Warning signs of mouth cancer include a white or red patch of tissue in the mouth or on the tongue, an ulcer that is slow to heal, difficulty swallowing or chewing, jaw swelling, unexplained earache, prolonged hoarseness or numbness in the mouth or face regions. Any worrying signs that persist beyond a fortnight should be checked out. The hidden danger of oral cancer is that it can spread with relative speed to the lymph nodes of the neck and can also trigger additional primary tumours. Late detection also raises the risk of disfigurement or losing part of the tongue, as befell John Diamond, the late, journalist, husband of Nigella Lawson, and author of "C - Because Cowards get Cancer too".
Early signs are often picked up during routine dental checks, which makes the decline of NHS dentistry in the UK of particular concern. Further, outpatient hospital investigations for mouth cancer include biopsy, fine needle aspiration and nasoendoscopy. But brush biopsy- a new technique, developed in the USA, now offers a swift, cheap, pain-free and non-invasive way of assessing unusual oral spots and pre-cancerous changes, whilst still in the dentists chair.
Treatment alternatives for oral cancer
The treatment for oral cancer is most usually surgery and radiotherapy first, with chemo to follow. Small, accessible tumours may be simply removed by lasers and perhaps treated with photodynamic therapy. Micrographic surgery, during which surrounding tissue is tested to ensure complete removal, is also used. More extensive cancers may involve skin or bone grafts to the cheek or jaw, and even prosthetic replacements.
Go to: Patient friendly guide on cancer drugs, off label drugs, immunotherapy and chemotherapy.
Radiotherapy usually follows surgery and may include a made-to-measure face mask to help target the radiation and protect healthy tissue. Chemotherapy of up to six cycles, one every three to four weeks is likely to include Cisplatin and 5-FU, while recurrences are treated with combined Taxotere, Taxol and Gemzar. Synchronous radio and chemotherapy (both treatments at the same time) is sometimes prescribed; doctors hope the future will yield improved success using immunologic response modifiers such as Alpha Interferon and Interleukin.
Complementary and Integrative Therapies for Oral cancer
As always with cancer, patients are advised to ensure their vitamin D levels are above 40 ng/ml; there blood oxygen should be approx 99%, and their fasting blood sugar and blood fats should be low.
Since the oral cavity is so clearly linked to the gut microbiome, patients should think to kill yeasts (Oregano oil) and negative bacteria (artemisinin) and even parasites (Para Free Plus).
Vaccines and gene therapy are new treatments increasingly showing promise.
Several natural compounds have shown promise with HPV.
Go to: Mushroom eradicates HPV
Natural compounds such as turmeric, EGCG, coriander seeds, and Manuka honey may help manage symptoms.
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