Cancer: The Clinical and Diagnostic Approach

John P. Gobetti, D.D.S., M.S.Oral Medicine/Diagnosis Section

Dept. of Oral Medicine, Pathology, OncologyUniversity of Michigan School of Dentistry

Ann Arbor, Michigan 48109-1078(734) 763-3375 or (734) 764-1543

e-mail: jgobetti@umich.edu

Cancer Facts

• 1.4 million new cases diagnosed every year

• 29,000 oral cavity/pharynx* 19,000 men and 10,000 women.* 7,300 deaths, 4,910 men and 2,410 women.* Higher number of deaths than Hodgkin’s

Disease, and cervix, brain, and thyroid cancer.

Oral Cavity/Pharynx Cancers

• Highest incidence/mortality rates in African Americans.

• Five year survival rate 56%.

• Majority are squamous cell carcinomas.* Ventrolateral border tongue* Floor of mouth* Lip* pharynx

Oral Cavity/Pharynx Cancers cont’d

• 90% in people 45 years and older.

• Average age of diagnosis 60 years old.

• Most cases attributed to tobacco use.* Cigarettes, cigars, pipes, and smokeless

tobacco

Oral Cavity/Pharynx Cancerscont’d

• Other risk factor includes:

* Human papilloma virus (HPV)* Low consumption of fruits/vegetables* Long-term sun exposure, lip cancer* Chronic alcohol use

National Health Objectives – Healthy People 2010

• Reduces oropharyngeal cancer rate.• Increased early detection.• Increased availability of oral cancer

examinations.* American cancer society recommends:

- annual oral cancer examination at 40 years old and older.

- three year oral cancer examination 20 to 39 years old.

• Only 13% of those 40 and older reported oral cancer examination (1994).

Signs and Symptoms of Oral Cancer

• Signs and symptoms include:* Sores that do not heal* Lumps on lip, mouth, or throat* White and/or red patches* Unusual bleeding, pain, or numbness in

mouth* Sore throat that does not go away* Difficulty or pain with chewing/swallowing

Survival Rates

• 1 year – 81%

• 5 years – 59%

• 10 years – 44%

• 15% of newly diagnosed oropharyngeal cancers will have another cancer in nearby areas, larynx, digestive systems, or lungs.

• 10 to 40% develop a second oral cancer or cancer in associated organs.