Health Tips

Mouth cancer, also known as oral cancer, rarely gets the spotlight as much as other types of cancers. Nonetheless, it is the sixth most common malignancy worldwide, with over 657,000 new cases diagnosed annually, and its incidence is rising in many countries. Particularly in South and South-East Asia, where Malaysia is located, many people lead a lifestyle that increases their odds of developing oral cancers.

Oral cancer on the side of the tongue, a common site along with the floor of the mouth. Image credit: Welleschik, CC BY-SA 3.0, via Wikimedia Commons

Oral cancer is divided into two categories – those occurring in the oral cavity (your lips, the inside of your lips and cheeks, teeth, gums, the front two-thirds of your tongue and the floor and roof of your mouth) and those occurring in the oropharynx (middle region of the throat, including the tonsils and base of the tongue). Just like many other types of cancers, the earlier mouth cancer is detected, the better the treatment outcomes may be, and that could mean a life saved. The 5-year survival rate of those diagnosed is approximately 60 percent.

These can increase the risk of developing mouth cancer 

Tobacco use

Smoking is the most common cause of oral cavity, oropharyngeal, hypopharyngeal, and laryngeal cancer, and the risk is even higher for smokers aged over 50. The risk of these cancers is about 5 to 10 times higher for current smokers than for people who have never smoked, and is linked to how much and how long the person has smoked. This is not good news for Malaysia, considering 22.8% of Malaysian population aged 15 years old and above were smokers.

Excessive alcohol consumption

The risk of oral cavity, oropharyngeal, hypopharyngeal, and laryngeal cancer increases with the number of alcoholic drinks consumed per day. The risk of these cancers is 2 to 6 times higher in people who have 2 or more alcoholic drinks per day compared with those who don't drink alcohol. Moreover, it appears that when you combine tobacco with heavy use of alcohol, your risk is even higher — 5 to 14 times greater risk of developing oral cancer than others.

Betel quid chewing 

Image credit: Thamizhpparithi Maari, CC BY-SA 3.0, via Wikimedia Commons

Betel quids is the fourth most common psychoactive habit after the usage of tobacco, alcohol, and caffeine beverages. 600 million people are chewers of betel quid, which they may chew it with or without tobacco. Users chew betel quids for its pharmacological effects, such as well-being sensations and euphoria, heightened alertness, and focused attention, as well as diminished hunger and improved digestion— kind of similar to tobacco smoking. However, it is known that betel quid can contribute to negative health effects, with oral cancer being one of them. 

Human papillomavirus (HPV) infection

There are various subtypes of HPV, and a systematic review and meta-analysis demonstrated that HPV type 16 (HPV-16) infection causes most of the oropharyngeal cancer. In a small portion of cases, the cancer was caused by another subtype called HPV type 18 (HPV-18).

Prevention of oral cancer

Start cultivating these healthy habits today to minimize your risk of catching oral cancer:

1. Quitting smoking – Studies have shown that when people stop smoking cigarettes, their risk of oral cavity, oropharyngeal, hypopharyngeal, and laryngeal cancer decreases by one half (50%) within 5 to 9 years. Within 20 years of quitting, their risk of these cancers is the same as for a person who never smoked cigarettes.

2. Stop alcohol consumption – Likewise,stopping your alcohol consumption leads to a decrease in oral cavity and laryngeal cancer risk 20 years or more after stopping. 

3. Quit chewing betel quid if you do.

Whereas for preventing HPV infection, it’s a little bit tricky. While vaccination against HPV-16 and HPV-18 has been shown to prevent approximately 90% of oral HPV-16/HPV-18 infections within 4 years of vaccination, we’re not sure whether vaccination can really reduce your risk of oral cancers or not. More studies need to be done to find out the benefits of HPV vaccination with regards to oral cancers.

Ulceration on the left lower lip caused by cancer. Image credit: Coronation Dental Specialty Group, CC BY-SA 4.0, via Wikimedia Commons

Early detection is key

Besides living a healthy lifestyle, you should also have a regular dental check-up with your dentist. Your dentist is trained to not only ensure you have healthy teeth, but also to detect any abnormalities in your oral cavity.

In addition, you may carry out self- examination by following these steps:

1. Use a bright light and mirror. Dentures, if any should be removed prior to mouth examination. Look at your face and neck in the mirror for any swellings, sores or any changes in colour. Press along the sides and front of the neck to feel for any tenderness or lumps.

2. Examine the lips in closed and open positions. Look for any changes of colour, texture and surface abnormality.

3. Raise the upper lip and look inside for any ulcers or colour changes. Feel for any lumps or changes in texture. Repeat this procedure on your lower lip.

4. Pull your right cheek back to look at the lip and cheek lining along the top and bottom of the mouth. 

5. Put your index finger on the inside of your cheek and your thumb on the outside. Gently feel to check for any lumps. Repeat on the other cheek.

6. Tilt your head back and open your mouth wide to see the roof and back of your mouth. Note any changes or lumps.

7. Place the tip of your finger on your palate. Examine the floor of your mouth.

8. Stick out your tongue and look for any changes in colour and texture. Inspect and gently press along the underside of your tongue to feel for any swelling. Inspect the right and left margins and the tip of your tongue.

Source: https://mda.org.my/home/self-check-oral-cancer/

A word from Doc2Us

If you have any questions related to oral health and cancers, you can consult our professional doctors and healthcare professionals on Doc2Us. Doc2Us is a mobile application that allows you to talk to a doctor or any healthcare professionals via text chat at any time and from anywhere.  For better communication, you can even send our online doctor images or voice messages related to your medical inquiry.

Download Doc2Us app on Apple App Store, Google Play Store and Huawei App Gallery; or use our web chat at https://web.doc2us.com/

Note: Doc2Us is not for medical emergencies. In the event of urgent medical conditions, please call 999.

Disclaimer: As a service to our users and general public, Doc2Us provides health education contents. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

References

1. Moore, S., Johnson, N., Pierce, A. and Wilson, D., 2008. The epidemiology of lip cancer: a review of global incidence and aetiology. Oral Diseases, 5(3), pp.185-195.

2. National Cancer Institute - Oral Cavity, Oropharyngeal, Hypopharyngeal, and Laryngeal Cancer Prevention (PDQ®)–Patient Version

3. MyHealth - Oral Cancer

Cover image credit:  Coronation Dental Specialty Group, CC BY-SA 4.0, via Wikimedia Commons

Written by

Ms Joyce Toh