7 steps to preventing oral cancer

Each year, approximately 53,000 Americans find out they have oral (mouth) cancer. But following the COVID-19 pandemic, experts worry that this number will grow.

The concern stems from the recent increase in alcohol and tobacco use. These are the two biggest risk factors for cancer in the oral cavity, which includes your lips and all the pink areas in your mouth back to, but not including, your tonsils.

But according to Abie Mendelsohn, MD, a UCLA Health ear, nose and throat (ENT) specialist, the rise in risk isn’t the only problem. “In addition to an increase in smoking and alcohol use during the pandemic, we’ve seen a big decrease in health maintenance,” he says. “That means people are increasing their risk of oral cancer and not scheduling routine care with their dentist or doctor.”

Oral cancer is harder to detect early without regular screening, and late-stage oral cancer can be lethal. The 5-year survival rate is 67% if the cancer spreads locally and 40% if it spreads to distant parts of the body.

Preventing mouth cancer

Fortunately, there are steps you can take that may help prevent cancer in your oral cavity. Follow this advice from Dr. Mendelsohn to keep your mouth as healthy and cancer-free as possible:

1. Understand the oral cancer risk factors

There are some risk factors for mouth cancer that cannot be changed, but the biggest risk factors are lifestyle choices. Risk factors for oral cavity cancer include:

  • Tobacco use, including cigarettes, cigars and all forms of smokeless tobacco
  • Alcohol use, which multiplies the risk when used alongside tobacco
  • Betel quid and gutka (betel nut), chewed by people in Southeast Asia, South Asia and other parts of the world
  • Age, making people over 50 at a higher risk
  • Gender, with oral cancer twice as common in men than women
  • Human papillomavirus (HPV), accounting for a small portion of oral cavity cancers
  • Sun exposure, for oral cancer that develops on the outer lip

Even without risk factors, you should still be on the lookout for mouth cancer. According to Dr. Mendelsohn, there is an increasing rate of people (mostly women) aged 40 to 60 who have no additional risk factors and are developing mouth cancer.

“Just because you’ve done the right thing by never smoking and simply being a social drinker, that doesn’t preclude you from oral cavity cancer,” he says. “Oral cavity health is critical for all adults.”

2. Know the symptoms of mouth cancer

The most common symptom of oral cavity cancer is a mouth sore or lesion that does not heal and is white (where it should normally be pink). But a wide range of abnormalities can signal cancer, including:

  • A white, red or black discoloration in the soft tissues
  • A lump or hard spot in the tissue (usually at the edge of the tongue)
  • A growth in the tissue that protrudes and may resemble the head of cauliflower
  • Any mouth abnormality that bleeds easily when touched

A cancerous or precancerous ulcer is an actual change in the color of the mouth’s tissue, and not just a white coating (which may signal bacteria or infection). If a biopsy (tissue sample) of the ulcer shows that it’s precancerous (called leukoplakia), your doctor may offer treatment to prevent cancer from developing.

3. Avoid or stop tobacco use

Tobacco use, both smoking and smokeless forms, is the top risk factor for oral cavity cancer. Certain forms of tobacco, such as cigars and chewing tobacco, do not affect the risk of lung cancer but greatly increase your chance of developing mouth cancer. To help you quit smoking or using tobacco, your primary care provider (PCP) can connect you with the resources you need.

Keep in mind, even if you stopped using tobacco years ago, your risk for oral cancer may still be high. Discuss your health history with your doctor and don’t wait to get any symptoms checked.

4. Limit alcohol consumption

Your risk for oral cancer increases with the amount of alcohol you consume and multiplies by 30 times if you drink and smoke heavily.

“When alcohol is used along with any tobacco products, the two together promote the development of oral cancer,” Dr. Mendelsohn says. “Having a drink while smoking a cigar or cigarette creates an extremely high-risk situation.”

5. Check your mouth for signs of oral cancer

Oral cavity cancer is a very slow-developing and slow-progressing cancer. But if ulcers go unnoticed and routine health maintenance is ignored, cancer may present at a more advanced stage. Dr. Mendelsohn recommends that when you brush your teeth, take an extra two seconds after rinsing to check out your mouth in the mirror.

6. See your dentist regularly

Dentists are required to do an oral cavity screening with every examination, according to Dr. Mendelsohn. Seeing your dentist every 6 to 12 months, as recommended by American Dental Association, means you’ll have a full oral cancer screening at least once a year.

7. Don’t wait to get symptoms checked out

Whenever you notice an abnormal sore or growth in your mouth, it’s best to have it looked at by a professional.

“The mouth heals very quickly,” Dr. Mendelsohn says. “If you have a sore that doesn’t heal within a week, make an appointment with your PCP, dentist or ENT specialist. Three weeks of a non-improving lesion should be considered urgent.”

If you suspect you may have oral cancer, make an appointment with a UCLA Health primary care provider.

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