Oral Health Month

SATURDAY, APRIL 13, 2024 • SUPPLEMENT TO THE FREE PRESS Oral Health Month 6 DENTISTS HELP DETECT ORAL CANCER BY JENNIFER MCFEE T here's no reason to be closed- mouthed about oral cancer since it's not always easy to spot. Dr. Darryll Iwaszkiw encourages everyone to watch out for early warning signs of oral cancer. These signs include any new abnormal lumps or bumps or discolouration in the mouth, voice changes or an ulcer on the tongue or cheek that isn't healing. "Sometimes you can get bumps around the head and neck, which could be an indication that something is going on," says Iwaszkiw, who works with head and neck wounds for CancerCare Manitoba. "You might notice a change in the fitting of a denture, a change in chewing or swallowing or a persistent sore throat. Those are some of the earliest signs." However, oral cancer often tends to go unnoticed longer than cancers in other parts of the body. "With oral cancer, only about a third of them are diagnosed early simply because people aren't looking in their mouths every day with illumination or magnification," she says. "Over half of oral cancers are diagnosed once they have spread to a regional lymph node, and then the five-year survival rate drops to the high 60s." The main known risk factors of oral cancer include using tobacco or alcohol, chewing betel nuts, or having a family history of squamous cell carcinoma. Other risk factors include high sun exposure, a weakened immune system and having HPV (human papillomavirus). Overall, instances of oral cancer remain reasonably stable, Iwaszkiw notes, although cases related to HPV are increasing slightly while tobacco-related cases are decreasing slightly. Treatment usually involves a combination of surgery, chemotherapy and radiation. "The surgical nature of treating head and neck cancers can be a little bit disfiguring, so it's very important that we can catch them early to limit that as much as possible," she says. If the cancer isn't caught early, then more radical measures must be taken. "The bigger the cancer, the more invasive the surgery must be," she says. "When we're dealing with the head and neck, there are also a lot of important structures, so it can get complicated very quickly." Surgery might not be an option in some cases, depending on how invasive the cancer is. "Sometimes the location could prohibit a surgeon f rom being able to access the area. If it's HPV-related, the good news is that the prognosis tends to be better. Those cancers respond better to treatment." At the same time, early detection can also lead to a much better prognosis. "It's hard for patients to see changes on their own, so when the dentist asks for a recall exam, the dentist is doing an oral cancer screening as well," she says. "A lot of patients don't know that's what we're doing at those recall appointments." That's why it's so important to keep up with those appointments regularly, adds Iwaszkiw. "If there are any very early signs, they can be caught and referred to the appropriate health-care provider to check or perform a biopsy if necessary." To minimize risk, she recommends avoiding all forms of tobacco — including vaping and chewing tobacco — and avoiding or limiting alcohol intake. "It's also important to make sure children are vaccinated against HPV. The vaccination is offered through Manitoba Health to all children in Grade 6," she says. "That vaccine helps to protect against nine different types of HPV that can cause different types of cancer." " Only about one-third of oral cancers are diagnosed early because people aren't doing regular checks for warning signs." — Dr. Darryll Iwaszkiw. " It's hard for patients to see changes on their own, so when the dentist asks for a recall exam, the dentist is doing an oral cancer screening as well." — Dr. Darryll Iwaszkiw.

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