In 2003, an estimated 3,100 Canadians were newly diagnosed with oral cancer. That same year,
1,090 people died of the disease. In the US, oral cancer kills roughly one person per hour, 24
hours a day. Of those who are newly diagnosed, only half will be alive five years later. The death
rate for oral cancer has not declined for decades.
Those statistics are frightening, but the good news is that early detection plays a major role in
preventing or curing oral cancers. The front line of defense is formed by dentists and dental
hygenists, professionals who are specifically trained to recognize alterations in the oral cavity,
and take action.
“Alberta dentists are trained to conduct oral cancer screening tests when they are students, and
receive reminders and updates from the Alberta Dental Association and College during their
practice,” says Dr. Seema Ganatra, an oral pathologist who teaches in the Faculty of Medicine
and Dentistry at University of Alberta.

Pre-malignant lesions usually manifest as white patches (leukoplakias) that can look like small
calluses. They could be benign, the mark of skin thickened by trauma or normal wear and tear of
oral tissues. However, dentists do not take any chances, especially when the spots appear in areas
where normal trauma is unlikely to occur such as on the soft palate of the mouth or under the
tongue. When the white spots are seen, particularly when there is no known cause, the dentist will
strongly recommend their removal and refer the patient to an oral and maxillofacial surgeon for
this day surgery procedure. The oral and maxillofacial surgeon sends the excised tissue to an oral
pathology laboratory for testing.

Red patches (erythropkaisa) may also signal oral cancer and more frequently are diagnosed as
such. “The best thing is to remove all suspicious lesions,” says Dr. Ganatra. “Oral cancer has a
similar progression as many other cancers such as cervical cancer – when dysplasia (abnormal
cells) are seen, these cells may evolve into cancer cells if they are not removed. It is impossible to
predict which lesions will go on to become cancer. Follow-up screening and patient education
complete the cycle.”

Having an annual check-up with your dentist is a good way to protect yourself, since early
detection can save lives. Reducing risk factors is another way. “Not surprisingly, people who
smoke are at high risk for oral cancer but so are those who consume large amounts of alcohol.
People who are both heavy smokers and drinkers have 18 times the risk of developing oral
cancer,” says Dr. Ganatra.

“The group at highest risk are the indigent; not only do they often have these addictions, they
don’t get regular dental check-ups. By the time their symptoms worsen enough for them to seek
medical help, they are usually in the advanced stages of the disease.”
But oral cancer is not restricted to the poor. Director producer Bruce Paltrow (father of actress
Gweneth Paltrow) died of oral cancer in 2002. According to his wife, actress Blythe Danner,
Paltrow had a hoarse throat for some time but ignored it. His cancer was discovered in the late
stages. Actors Jack Klugman and Colleen Zenk-Pinter were more fortunate; their oral cancers
were discovered early enough for treatment.

At present, 95% of oral cancers are found in people over 45, but an alarming trend points to
younger people getting the disease from another source. There is a rise in oral cancer in people
who don’t smoke or drink that has been linked to specific strains of the human papilloma virus
(HPV), an infection can be contracted through sexual activity. According to the Oral Cancer
Foundation, the HPV group is the fastest growing segment of the oral cancer population.
Dentists have a number of screening tools available to help them spot the tell-tale signs of oral
cancer such as fluorescent lights, blue lights and oral brushes, but visual diagnosis and biopsy
remain the best detection methods, according to Dr. Ganatra. “It is in the pathology lab that we
have a better chance of making the diagnosis.”

Public awareness is key to lowering the incidence of oral cancer. Reduce or remove risk factors
like tobacco, alcohol and unprotected sexual activity. Have regular dental check-ups and schedule
another appointment if you see unusual spots in your mouth or experience symptoms like fatigue
or a hoarse throat. Follow your dentist’s advice on prevention and treatment. “Screening is vital,”
says Dr. Ganatra. “Two thirds of oral cancers are found in the late stages; if we had caught them
early, those people might still be alive. Education and early detection save lives.”
For more information about oral cancer, talk to your dentist or go to the following websites:
Alberta Dental Association and College website www.abda.ab.ca and Oral Cancer Foundation
www.oralcancerfoundation.ca

Media contact:
Kimberly McDonald
Alberta Dental Association and College
Phone: (780) 432-1012 or toll free 1-800-843-3848