One American dies every hour of oral cancer!

Oral cancer or squamous cell carcinoma early detection has not improved in four decades, despite enormous efforts to educate the public and health professions, and despite a number of media activities.

Nationally recognized baseball players have suffered from oral cancer as a direct result from chewing tobacco.

Beyond genetics, tobacco, alcohol and direct sunlight as well as human papillomavirus infections are critical factors in the multiple mutations within DNA that result in squamous cell carcinoma. Mutations in those genes that regulate the cell cycle are particularly important.

Whereas early detection can lead to favorable outcomes, all too often victims are diagnosed too late and prognosis becomes very poor. For advanced oral cancer patients following surgery, radiation and chemotherapy, essentially half of patients die within five years following treatment. For patients who survive, they are often compromised by extreme xerostomia (dry mouth) and thereby further suffer from rampant tooth decay. It is truly painful to admit that our dental profession has not been highly successful in reducing oral cancer in America.

Oral cancer is a term often used to encompass oral, nasal and pharyngeal squamous cell carcinoma. Oral cancer malignant lesions often spread from oral to nasal to pharyngeal areas and also may involve the floor of the mouth and the lateral surfaces of the tongue. Late diagnosis and radical resection used for therapy can result in a person without part of the mandible, loss of a major portion of the tongue and much more. Cancer patients may require extensive implants and prostheses following surgery, radiation and chemotherapy.

Oral cancers are much more prevalent in people who smoke and drink and are over 45 years of age; especially African American as well as Hispanic males. Like so many other preventable diseases and disorders, oral cancer is also more prevalent in people who live in poverty, have poor education and lack access to care. Like so many preventable diseases and disorders, oral cancer is linked to poor health literacy, poor behavior and lifestyle choices, and socioeconomic status.

Oral cancers are readily apparent in the children of West Virginia and parts of Kentucky and Tennessee. Oral cancers are readily detected in the men of Oakland and Compton, Calif. And lifestyle related oral cancers are also identified in the rich and famous such as Sigmund Freud and others who chose to smoke. Tobacco products and their use is "the" major cause of oral cancers.

Our challenge is to better understand cultural diversity and human behavior. How can we better communicate, motivate and present interventions that enhance or promote health and healthy choices, reduce risk factors such as tobacco use and alcohol, or eliminate diseases and disorders? Using our knowledge and improved communication skills, can we fully engage in a major prevention effort to eliminate oral cancer in America? In Los Angeles? Around the USC campuses? In our families?

Our USC Dental Hygiene Program partnered with the USC School of Pharmacy to promote oral cancer awareness and techniques to eliminate tobacco use. Our USC School of Dentistry has screened large numbers of people for oral cancer in underserved and high-risk communities. And we must do more. Now is an excellent opportunity for each of us to consider how can we better promote health and prevent disease and disorders in our patients and in our communities. Now is a good time to start!

For additional information, visit:
www.nih.nci.gov
www.nih.nidcr.gov
www.oralcancer.org