Oral and Oropharyngeal Cancer: What You Should Know Part 1

Oral cancer may not be among the most common cancers in America, but it is responsible for the death of at least one person per hour. Here is what you need to know about it.

Scope

According to the American Society of Clinical Oncology (ASCO), “cancer in the oral cavity and cancer of the oropharynx are two of the most common types of cancer that develop in the head and neck region, a group called head and neck cancer. The oral cavity and oropharynx, along with other parts of the head and neck, contribute to our ability to chew, swallow, breathe, and talk.”

To differentiate the two, oral cancer is the growth of malignant tumors in the following areas: lips; lining of the cheeks and lips; upper and lower gums; the front of the tongue and under it; hard palate; and the small area behind wisdom teeth called retromolar trigone. On the other hand, oropharynx cancer refers to the following: part of the throat behind the mouth; base of the tongue; tonsils; and soft palate.

It is believed that over 90% of oropharyngeal and oral cancers begin in the lining of the throat and mouth. These squamous cells commonly develop in the gums, floor of the mouth, tonsils, tongue, and oropharynx.

Prevalence

According to the National Cancer Institute (NIH) Surveillance, Epidemiology, and End Results Program (SEER), “Approximately 1.1% of men and women will be diagnosed with oral cavity and pharynx cancer at some point in their lifetime.”

On a global scale, there are 450,000 new cases of oral and oropharyngeal cancers in the world.

At least 49,670 new cases were expected to be diagnosed in America last year, totaling to a 2.9% new diagnoses rate for the cancer. According to the same source, it is expected to take the lives of at least 9,700 Americans annually, with 24 dying per day at a rate of one death per hour.

From 2007 to 2013, the ratio of surviving the disease five years after diagnosis was at 65%. Now, however, this survival rate has now dwindled to 57%.

Dangers

The increase in the incidence of oral and oropharyngeal cancers and, in turn, its dismal survival rate, is partially blamed on the HPV16 virus. This type of the human papilloma virus is considered as high-risk, as the majority of high-risk HPV infections lead to cancer. Infections from HPV16 does not always manifest in physical symptoms, so the diagnosis of the disease often occurs when it is already too late for intervention.

Oral and oropharyngeal cancers also tend to metastasize. As was mentioned above, it can grow in the squamous cells and spread to nearby regions, such as the lymph nodes. It is at an increased risk of producing secondary tumors while the primary tumor embeds itself on the body.

To make matters worse, oral and oropharyngeal cancers also tend to recur, or if not, then trigger another cancerous growth. In fact, patients who survive the disease is 20 times likely to develop another malignant tumor, albeit it may be in a different part of the body. This danger lasts up to five to 10 years of conquering the primary cancer.

For these reasons, oral and oropharyngeal cancers are therefore deemed to be dangerous.

How It Develops

“Cancer is defined as the uncontrollable growth of cells that invade and cause damage to the surrounding tissue,” says WebMD. Instead of dying, these cells instead multiply and can infect healthy cells around them. The body’s immune system meanwhile is unable to effectively fight off the malignant growth, resulting in the mass growing in nature.

Meanwhile, according to SEER, “Most lip and oral cavity cancers start in squamous cells, the thin, flat cells that line the lips and oral cavity. These are called squamous cell carcinomas. Cancer cells may spread into deeper tissue as the cancer grows. Squamous cell carcinoma usually develops in areas of leukoplakia,” which are “white patches of cells that do not rub off.”

Oral and oropharyngeal cancers may be caused by a person’s genetics, which means the gene mutation that causes cancer is inherited from a carrier. It may also be triggered by several risk factors.

Risk Factors

ASCO writes, “A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do.”

The lifestyle risk factors associated with oral and oropharyngeal cancers are tobacco use and alcohol. It is worth pointing out that 85% of neck and head cancers are associated with tobacco use. The risk for lip cancer increases with pipe smoking, while chewing tobacco or snuff increases the risk of mouth cancers with a 50% rate. Similarly, secondhand smoke can increase the risk of many kinds of cancer.

On the other hand, frequent and heavy alcohol intake also increases the risk of incurring oral and oropharyngeal cancers. Since many people who drink alcohol also smoke, the risk doubles. Only 25% of oral and oropharyngeal cancers occur in people who do not smoke and only occasionally drink.

Meanwhile, an environmental factor that can cause the disease is prolonged sun exposure, aggravated by having fair skin. Unprotected sun exposure can lead to cancer on the lip area, while having fair skin is also known to have the same risk factor. To mitigate this, make it a point to wear sunscreen and other forms of protection when under the sun.

Another risk factor is a person’s gender, as men are twice as likely to develop it as women. It is also likely to occur in people above the age of 45, although it can also occur in younger Americans.

Finally, HPV, poor nutrition, and poor oral hygiene can also put a person at an increased risk of contracting the disease.

What’s Next?

There is much to learn about oral and oropharyngeal cancers. Sit tight for our next article, where we will talk about its symptoms, treatment, and other prevention methods.