Putting your good health where your mouth is

Joe Roe was watching TV one night last year when he saw an ad for the upcoming Mouth Cancer Awareness Day.

He decided to go along to the local open day at Cork University Hospital to have a small sore under his tongue checked out and ended up being diagnosed with mouth cancer.

“If I had not seen that ad, I would still be walking around carrying on as normal. I was very lucky it had not spread. The sore on the underside of my tongue was there a while, it was bigger than a five cent piece but it was not a pronounced lump and was never really painful.”

Roe (56) was one of 13 people diagnosed during last year’s Mouth Cancer Awareness Day out of about 10,000 who were examined.

There are 300 cases of mouth cancer detected in Ireland each year – this type of cancer now kills more Irish people than cervical cancer or skin melanoma.

Overall, fewer than 50 per cent of patients diagnosed with mouth cancer survive more than five years. However, if it is detected early, the chances of a good outcome are greatly enhanced.

Approximately 50 per cent of all mouth cancers are diagnosed at an advanced stage, according to the National Cancer Registry. This can result in more complex treatment with a greater impact on quality of life and survival rates. The majority of cases are diagnosed by dentists or dental hygienists.

Free mouth examinations
To mark Mouth Cancer Awareness Day tomorrow, hundreds of dentists around the State will provide free mouth cancer examinations as will the Cork University Dental Hospital. The examination is painless and takes less than five minutes.

Since the first awareness day in 2010, about 18,000 free examinations have been carried out and 21 cases of cancer have been diagnosed.

Mouth cancer can affect any part of the mouth including the lips, gums, cheeks, tongue, palate, throat, salivary glands and larynx.

Signs and symptoms may include a sore or ulcer in your mouth that does not heal within three weeks; white or red patches inside the mouth; a lump in the mouth or neck; or a persistent sore throat or hoarseness.

Having had surgery to remove a malignant tumour in his mouth within two weeks of diagnosis followed by a course of radiotherapy, Roe is now doing well and his medical team are happy with his progress.

The retired An Post worker says: "I had radiotherapy on my mouth and neck area and I reacted okay to the treatment. I was glad I didn't have to have chemo, I wasn't sick at all.

“Eating was painful for a while afterwards and even now, crisps or very spicy foods can sting but I did okay compared with some stories. I’m very lucky it was caught before it had spread any further.”

Early treatment
Professor of oral and maxillofacial surgery at Trinity College Leo Stassen says the annual Mouth Cancer Awareness Day campaigns have been very successful in saving lives, bringing patients to treatment early and saving the HSE a significant amount of resources.

"The mouth is such an important part of what we do," he says. "It amazes me that the disease was more or less ignored from a strategic point of view for so long. The mouth/larynx are important for speech, taste, drinking, eating, swallowing, our teeth, smiling, looks and kissing. Surgery to the area can also interfere with hearing and seeing. How awful to lose any of these gifts."

Chance of cure
If a mouth cancer is seen and treated early with a tumour size less than two centimetres, Stassen adds, the chance of a cure is about 85 per cent. However, if the tumour is any bigger or glands in the neck are involved, the prognosis becomes much worse.

“If you are worried about something that has changed in your mouth, throat or neck and is there for more than two weeks, seek advice and assessment early. Ask your friends, talk to your pharmacist, see your dentist or doctor but do not just sit and wait,” he advises.

Dr Eleanor O'Sullivan from Cork University Dental School and Hospital says oral cancer is the sixth most common cancer for men in Ireland and the incidence of the disease among women is increasing.

“This disease doesn’t get as much attention as other cancers but it is very important that people become aware of the risk factors,” she says.

“Raising awareness is what Mouth Cancer Awareness Day is all about but many people will also have to take the next stop and make necessary lifestyle changes if required.”

The cause of mouth cancer is not fully known but your risk is greater if you smoke, consume excess alcohol, especially spirits (the risk is greater if you do both), if you are exposed to the human papilloma virus (HPV) through sexual contact or if your lips are continually exposed to sunshine.

For more information and lists of participating dentists, go to mouthcancerawareness.ie

Five tips to reduce your risk of mouth cancer

1. Check your mouth regularly. When brushing your teeth, watch for any unusual changes, especially any of the signs and symptoms mentioned in this article.

2. Avoid the risk factors for mouth cancer, especially the combination of smoking and heavy alcohol consumption.

3. Eat a healthy diet high in fruit and vegetables. A good diet rich in vitamins helps the body to protect itself from most types of cancer.
4. Use a lip balm with sun block if you spend a lot of time outdoors to prevent lip cancer.

5. Visit a dentist regularly even if you wear dentures. A mouth cancer examination is part of a routine dental check-up. If you cannot attend a participating dentist for a free examination tomorrow (September 18th) , try to have your mouth checked once a year. Eighty per cent of adults in Ireland are entitled to a free dental examination under the medical card or PRSI scheme.