Oral Health Buzz
Oral Cancer and Esophageal Cancer
Richard A Huot, DDS
Oral cancer and esophageal cancer have something in common: The majority of these types of cancer are diagnosed late and have high death rates. Early detection by health care professionals is key to successful treatment. While your dentist and dental hygienist can easily check for oral cancer at your preventive maintenance visit, esophageal cancer may be caused by gastroesophageal reflux disease (GERD). Some GERD cases include a release of stomach acids, which may be clinically detected by erosion of upper (maxillary) teeth if the acid reaches the oral cavity.
Who Is at Risk?
Both types of cancer are three times more likely to be found in males, and both have higher risk rates in smokers and in patients who consume alcohol. Oral and esophageal cancers are also more prevalent among African-American males, and cancer rates are higher in countries outside of the United States.
According to the Oral Cancer Foundation, close to 42,000 Americans will be diagnosed with oral or pharyngeal cancer this year. The result will be 8,000 deaths, which the foundation states is the equivalent of killing one person per hour, 24 hours per day. For those 42,000 newly diagnosed individuals, the survival rate after 5 years is only 57 percent.
The American Cancer Society estimates that there are about 17,460 new cases of esophageal cancer in the United States per year, and about 15,070 deaths from it. Esophageal cancer is difficult to treat, and survival rates vary from 3 to 38 percent depending on how localized the cancer is.
Dentists play a vital role in the early detection of both types of cancer because most patients visit a dentist more routinely than they visit a physician. Both cancers are relatively hard to detect by patients in their early phases and become painful or symptomatic only in the later stages.
For oral cancers, most general dentists refer potential cases to oral surgeons or to ear, nose and throat physicians to examine and biopsy the suspect area. The area in question is either removed in its entirety, or a section of the area is sent to an oral pathologist who is a specialist in examining oral tissue to confirm the presence of cancer. Depending on the diagnosis of the tissue, the treatment can range from doing nothing to radiation and chemotherapy treatment for more severe cases.
There are currently no screening tests for esophageal cancer. A dentist must refer the patient to a medical specialist for further testing when he finds symptoms that indicate that the patient should be tested for that type of cancer. For esophageal cancers, most general dentists refer potential cases of esophageal cancer to the patient's primary care doctor or to a gastroenterologist, who can perform an upper endoscopy procedure. A small tube is inserted down the patient's throat, and the camera at the tip of the tube is used to look for suspicious areas all the way down to the stomach. The tube can also take small tissue samples, which are then reviewed by a pathologist to confirm the presence of cancer. The patient may undergo surgical removal of the affected area and radiation and chemotherapy treatment in more severe cases.
Learn more about oral cancer in the Colgate Oral Care resources.