The answer is … plenty! This issue will focus on oral cancer awareness. While there are many topics we can delve into regarding this dreadful disease, we will focus on a few topics. We will share two personal and very poignant stories. Kim Anzalotti, Bill Wislon, and Eva Grayzel impart information that will move you and make you think about your daily in-office procedures. JoAnn Gurenlian, RDH, PhD, will share insights on the human papillomavirus, or HPV, a sexually transmitted virus, and its relationship to oral cancer. And last, but certainly not least, Jamie O'Day, Treatment Facilities Coordinator, The Oral Cancer Foundation Inc., The Bruce Paltrow Oral Cancer Fund, will share her insight on oral cancer screening and the need for a thorough examination.One personal story is shared by Eva Grazel, an international motivational speaker, author, performer, and cancer survivor.(1) I had the pleasure of meeting Eva a number of years ago. In 1998 at age 33, Eva, a non-smoker, saw a number of dentists and physicians for over two years for an “ulcer” on her tongue that became larger and more painful, without any resolution. She was finally diagnosed with advanced oral cancer, Stage IV squamous cell carcinoma, on the lateral border of her tongue. After the many missed opportunities for diagnosis, Eva was given a 15% chance of survival. While her late stage diagnosis is not uncommon, her recovery was unique, as she beat the odds. After diagnosis, Eva underwent a partial tongue reconstruction, a modified radical neck dissection, and a maximum dose of radiation therapy. The good news is that Eva is very much alive today, and helps to motivate professionals and patients about oral cancer examinations and risk factors. She also authored the Talk4Hope book series, written to inspire children and parents who have a family member with cancer.(2) This Family Book Series helps families cope with their feelings about cancer, enlightens parents on how to communicate with their children, and creates special moments to cherish. Read Eva’s contribution in this eVillage FOCUS issue.
For the 12th year in a row, April was the official oral cancer awareness month in the U.S.(3) Oral cancer awareness means raising public awareness through group collaboration to ensure that oral cancers get the national media attention necessary to highlight risk factors and oral cancer screening. Free oral cancer screenings were held throughout the country. But it does not have to be a special month to conduct oral cancer screenings in the community. There are a variety of forms for editable press releases for events.(4,5) Conduct your community activity when it is convenient for you.Rates of oral cancer are on the rise among men, and researchers say the cause is not the use of tobacco and alcohol, risk factors we have been aware of for years. The number of smokers in the U.S. has steadily declined in the past 50 years, according to the CDC, yet the rate of oral cancer has remained relatively steady, and has recently been on the increase.(6) The culprit is the human papillomavirus, or HPV, the sexually transmitted virus responsible for the majority of cases of cervical cancer in women. Approximately 65 percent of oral cancer tumors were linked to HPV in 2007, according to the National Cancer Institute.
The other vaccine is Cervarix (GlaxoSmithKline).(12) According to the CDC, both vaccines are very safe, and are made with very small parts of the human papillomavirus (HPV) that cannot cause infection. As with any pharmaceuticals, there can be side effects. For a recently updated Q & A page on these vaccines, visit the CDC website.(13)
In girls and young women ages 9 to 26, Gardasil® helps protect against two types of HPV that cause about 75% of cervical cancer cases, and two more types that cause 90% of genital warts cases. In boys and young men ages 9 to 26, Gardasil helps protect against 90% of genital warts cases. Gardasil also helps protect girls and young women ages 9 to 26 against 70% of vaginal cancer cases and up to 50% of vulvar cancer cases.
While the vaccines available are not approved for prevention of oral cancer, the impact the vaccines may have on oral cancer should be considered. The Oral Cancer Foundation believes that elimination of a causative agent (HPV16), by preventing infection from it by use of a vaccine, will subsequently prevent any disease that agent may have produced in the protected individual.(14) This is simple scientific extrapolation, and a view shared by many in the science community. Makes sense to me!
To view a video on HPV & Oral Cancer, visit this website.(15)
Oral cancer has a low survival rate because it is generally not discovered until it has spread to other areas, according to the CDC. Only half of people who've been diagnosed with oral cancer will live longer than five years. Prevention is the name of the game. Do not use tobacco products, use alcohol in moderation, limit the number of sexual partners and use protection, and screen (or be screened) annually for oral cancer. Anyone old enough to have engaged in sexual behaviors which are capable of transferring the HPV needs to be screened annually for oral cancer. There are many cancer screening protocols available.(16, 17, 18,19) Education, prevention, screening and early intervention can save lives.
References
1. www.evagrayzel.com/.
2. www.talk4hope.com/Talk4Hope.com/Home.html.
3. oralcancerfoundation.org/events/oral-cancer-awareness-month.html.
4. docs.google.com/#folders/folder.0.0BzLm7bA7Qdw6ZDIyN2ZlMjMtMDFiZi00OGFiLWI4MzYtMGM2ZDA5YjNlOWM5.
5. docs.google.com/leaf.
6. Centers for Disease Control and Prevention. Tobacco Control State Highlights, 2010. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2010.
7. D’Souza G, Kreimer AR, Viscidi R, Pawlita M, Fakhry C, Koch WM, Westra WH, and Gillison ML. Case–Control Study of Human Papillomavirus and Oropharyngeal Cancer N Engl J Med 2007;356:1944-56.
8. Herrero R, Castellsague X, Pawlita M, et al. Human papillomavirus and oral cancer: the International Agency for Research on Cancer multicenter study. J Natl Cancer Inst 2003;95:1772-83 and Smith EM, Ritchie JM, Summersgill KF, et al. Human papillomavirus in oral exfoliated cells and risk of head and neck cancer. J Natl Cancer Inst 2004; 96:449-55.
9. Increasing Incidence of Oral Tongue Squamous Cell Carcinoma in Young White Women, Age 18 to 44 Years. JCO April 10, 2011 vol. 29 no. 11 1488-1494.
10. www.gardasil.com/.
11. www.cdc.gov/vaccines/vpd-vac/hpv/default.htm.
12. www.cervarix.com/.
13. www.cdc.gov/vaccines/vpd-vac/hpv/vac-faqs.htm.
14. www.oralcancerfoundation.org/hpv/index.htm.
15. www.youtube.com/watch.
16. oralcancerselfexam.com/ (with photos).
17. www.oralcancerfoundation.org/hpv/index.htm.
18. www.oralcancerselfexam.com/.
19. www.nidcr.nih.gov/OralHealth/Topics/OralCancer/TheOralCancerExam.htm.
Sincerely,
Maria Perno Goldie, RDH, MS
To read previous RDH eVillage FOCUS introductions by Editorial Director Maria Perno Goldie, go to introductions.
