Check yourself - Early detection of oral cancer could save your life

Kristen Becker, Alberta Health Services - South Zone

Oral cancer is the sixth most common type of cancer in North America. In 2013, the Canadian Cancer Society predicted that more than 4,100 people would be diagnosed with oral cancer; they estimate that more than 50 per cent of those diagnosed will die as a result. That means the death rates from oral cancer are three times higher than cervical cancer and almost double the rate of liver cancer. The reason: Although oral cancer is not difficult to diagnose, it’s often not found until it’s already metastasized, or spread. The good news: When detected early, oral cancer has an 80-per-cent survival rate; and often, the early signs/symptoms are visible and can be discovered by performing a quick routine self-examination at home.

What to Look For:

When doing an oral cancer self-examination, look for:

• White patches (leukoplakia),
• Red patches (erythroplakia), 
• Red and white patches (erythroleukoplakia),
• A sore that won’t heal and bleeds easily,
• An abnormal lump or thickening of the tissues,
• Chronic sore throat or voice hoarseness,
• Difficulties chewing or swallowing, and
• Loose teeth and/or ill-fitting dentures.

Where to Look:

• Neck – Check both sides of the neck for symmetry. Feel the glands and lymph nodes and pay special attention to any enlargements. Enlarged, painless nodes are rarely the result of an infection and should be looked at more closely. Place your fingers gently over the “Adam’s apple” and swallow; it should move up and down and not deviate to either side. 
• Lips – Look for symmetry in contour, colour and texture. Be sure to check the outer borders of the lips as this is a common site for oral cancers. Use your thumb and forefinger to touch and examine the lip for lumps or masses. Then check the inside of the lip; pull it out and check the creases where the lip meets the gums. This is an extremely important area to inspect if you use smokeless tobacco which causes visible changes in tissue color and texture where you hold the tobacco. Repeat these steps with the upper lip.
• Oral cavity – First, remove all dental appliances, including dentures. Use a bright light and check the areas around the teeth, the inside of the cheeks and the roof of the mouth. Use your fingers to feel for lumps, keeping in mind that it’s normal to have a bony growth in the middle of the roof of your mouth. 
• Tongue – Extend the tongue out of the mouth and thoroughly check the side borders as this is one of the most common sites for oral cancer. Use your fingers to feel for any lumps on the sides, top or underneath the tongue. Say “ah” to check the back of your tongue, as well as the back of your throat and tonsils. Look for discolouration, ulcerations, asymmetry and swellings.

When doing at-home oral cancer screening, remember that everyone’s mouth is different. Make note of what’s normal for you and keep track of how long things take to heal. On average, healing should take about two weeks. If you have a lesion, lump or soreness lasting longer than two weeks, see a physician to have it assessed. Keep in mind the following oral cancer risk factors: tobacco and alcohol use, human papillomavirus (HPV), sun exposure and poor nutritional habits. Do what you can to decrease risks and perform a monthly self-exam. Early detection of oral cancer could save your life!

Kristen Becker is a dental hygienist with Alberta Health Services’ Population Health Promotion and can be reached at 403-388-6776 or email Kristen.Becker@albertahealthservices.ca.