Oral cancer and its prevention | The Guardian Nigeria News

Mouth cancer or oral cancer occurs in any part of the mouth. Cancer of the oral cavity (mouth) can occur on the lips, gums, tongue, roof of the mouth (palate), floor of the mouth (under the tongue) and parts of the throat.

Oral cancers are quite common. It is the 11th most common cancer in the world and the most common cancer in the head and neck region. In Nigeria, at least 1100 people were diagnosed with oral cancer in 2012 and around 750 people with oral cancer died that year. This is a very conservative figure based on the lack of precise data. They occur more in men than in women and although they can occur at any age, they are more common after the age of 40 with an age peak at 60.

Oral cancer survival is low and less than 50% of patients are alive after five years, but early detection increases the chance of survival to 80%. The low survival rate is due to the late presentation of patients to the hospital. This late presentation is due to patients not paying attention to the early signs and symptoms of oral cancer. People with oral cancer may experience sores in the mouth that do not heal, a lump in the mouth, unusual bleeding, white spots or red spots on the gums, tongue or mouth, speech changes or difficulty pronouncing words, loose teeth, difficulty/pain when chewing or swallowing, mass or lump in the neck, chronic sore throat or hoarseness and pain in the mouth and/or ears. However, experiencing these symptoms does not necessarily mean that one has cancer, as these signs and symptoms may be due to other reasons. Only a qualified doctor can make this diagnosis.

Oral cancer begins when changes occur in the DNA of normal cells that line different parts of the mouth, causing cells to grow and multiply abnormally. These changes happen repeatedly and over time.

Tobacco use in various forms is the main known risk factor for oral cancer. Tobacco can be in smoked or smokeless form. Forms of tobacco smoked include cigarettes, shisha, cigars, and cigarillos. Tobacco products contain chemicals like tar, which can irritate the lining of the mouth when burned and cause changes in the DNA of cells lining the mouth, leading to oral cancer. People who drink alcohol excessively are also at risk for oral cancer. In fact, 60% of oral cancers are caused by a combination of smoking and alcohol consumption.

Smokers are 15 times more likely to get mouth cancer than non-smokers. Alcohol consumption along with combustible tobacco use further increases the risk of oral cancer. The use of shisha is becoming more and more common in our society. Unfortunately, many shisha products sold in the country come from unregulated sources and may contain high levels of carcinogens. The habit of placing the burning end of the cigarette in the mouth adopted by some people has an even higher risk of causing cancer due to the heat applied directly to the tissues of the mouth.

Smokeless tobacco use in Nigeria is more common among older people who use snuff. They can either apply it inside their cheeks or on their nose. These agents remain in contact with the gums and the mucous membrane of the nose, irritating it and increasing the risk of cancer development. Snus, a creamy snuff-like paste made of tobacco, clove oil, glycerin, spearmint, menthol and camphor sold in a popular toothpaste tube in India and Sweden is marketed among young people as a trendier/more fashionable product. Other agents that can cause oral cancer include chewing areca nut, betel, paan, or gutka wrapped in tobacco leaves.

Human papillomavirus (HPV) infection is known to cause oral cancer and in particular throat cancer. HPV is usually transmitted orally, which is common among young people. Certain workplace chemicals or agents, such as asbestos fibers, wood dust, dry-cleaning solvents, or certain types of paints or industrial chemicals, may increase the risk of getting cancer from the mouth.

Poor oral health and gum disease have been linked to cancers of the oral cavity; strong sun exposure can cause skin cancer on the lip. People with low immunity such as people living with AIDS and people who have had organ transplants have a higher risk of developing oral cancer. A diet low in fruits and vegetables and in vitamin A increases the risk of cancer of the mouth and/or pharynx. Having one or more of these risk factors does not mean you will develop head and neck cancer. You should talk to your dentist if you have any concerns. It is important to note that 25-40% of people who develop oral cancer do not smoke or have other known risk factors.

People with oral cancer need not feel hopeless as there are treatment options to treat oral cancers to enable them to live well and long. Treatment includes surgery, radiation therapy and chemotherapy. Every year new drugs are discovered that have improved the chances of long-term survival.

Is there hope for the prevention of oral cancer? Certainly! Prevention starts with avoiding the main causes of oral cancer. Quit smoking and reduce consumption of all forms of alcoholic beverages. Having a regular dental check-up, every six months, ensures early detection of any abnormalities in the mouth.

In addition, as an individual, you can do a monthly self-check of your oral cavity. In front of a mirror and a bright light, remove any dentures, with washed hands, look and feel the inside of your lips and the front of your gums. Don’t ignore any suspicious lumps or color changes in your mouth. Go get a dental check-up. Visit your dentist every six months for a professional examination.

As a society, the government has taken some steps to control the sale and use of tobacco by banning the advertising of tobacco products and putting in place the labeling of cigarette packages with warning labels. However, the government still has a lot to do. For example, there is a ban on the sale or access to tobacco products to persons under the age of 18 among other laws in the National Tobacco Law (NTC Law), but enforcement of these laws is sorely done. fault.

Excessive alcohol consumption should be discouraged through media campaigns and regulated sales. In addition, the use of industrial chemicals should be regulated and safety protocols should be enforced for workers in industrial complexes.

Advocacy to raise awareness of these diseases and their risk factors in our society, particularly among health personnel and non-governmental organizations is desirable. A more preventive approach should be adopted by both healthcare workers and society as a whole. For those who have already been exposed to risk factors, smoking cessation programs should be initiated and tobacco substitutes offered to voluntary patients. Lagos University Teaching Hospital (LUTH) offers such preventive services to those who need to quit smoking. Healthcare workers at all levels should be trained to recognize early symptoms of oral cancer and promptly refer these patients appropriately for specialist care at the LUTH Cancer Center.
Drs. Effiom, Akinshipo and Aforka are from the Department of Oral Pathology while Professor Uti is from the Department of Preventive Dentistry, Faculty of Medicine, University of Lagos.

About Margaret Shaw

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