MOUTH CANCER IS ON THE INCREASE

I'm posting this article as a warning as there is an increase in mouth cancer

Some examples of cancer lesions

Symptoms of mouth cancer

The two most common symptoms of mouth cancer are:

• an ulcer in your mouth or on your lip that won't heal
• constant discomfort or pain in your mouth

Other symptoms can include:

• red or white patches in your mouth
  
• a lump on your lip, tongue or in your neck
  
• bad breath
  
• unexplained bleeding in your mouth
  
• numbness in your mouth
  
• loose teeth
  
• problems chewing or swallowing, difficulty moving your jaw or a feeling that something is caught in your throat
  
• changes to your voice – it may sound husky or quieter or you may slur your words
  
• weight loss because of problems swallowing

These symptoms aren't always caused by mouth cancer but if you have any of them, see your GP or dentist.

The earlier it's detected the better the prognosis and another good reason why it's essential to have regular dental check ups as your dentist will be examining your mouth and not just your teeth

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ARTICLE BELOW FROM THE DAILY MAIL

You should NEVER ignore a mouth ulcer that won't heal. Natalie did for just six weeks - and now faces tragic consequences

• She thought it was just a typical ulcer, and her GP didn't tell her otherwise
• Two months later, Natalie found out it was actually mouth cancer
• By that time, it had spread to her right lung; now, Natalie's outlook is bleak
• Mouth cancer is on the rise, in part because its signs are often missed

Natalie Hurley was eight weeks pregnant with her third child when she noticed a small mouth ulcer on the side of her tongue.

The 34-year-old thought it was merely an annoyance, but became more concerned when it had still not disappeared after a  few weeks. 'It was quite painful, but as far as I could tell it was a typical mouth ulcer,' says Natalie, who runs an embroidery and printing business with her husband Phil, 37.

'It was slightly smaller than a 5p coin and white on top. I put up with it for a fortnight, then went to France on holiday for three weeks and forgot about it.'

Mouth cancer: Natalie, pictured with her youngest son Tait, 16 months, Rocca, 5, and Jensen, 3, thought what was really mouth cancer was just an unusually long-lasting ulcer

The ulcer first appeared in July 2011, shortly after Natalie's mother had died from breast cancer, so she believed it was caused by the stress of that ordeal, combined with her pregnancy. But after six weeks Natalie saw a doctor.

'The GP said it was an ulcer and I was quite happy. But during a routine dental appointment the following week, I asked the dentist to look at it,' she says.

'I could tell by her face that something was wrong - she said mouth ulcers shouldn't last longer than two weeks.'
Her dentist referred Natalie to a specialist, but the letter went astray. While waiting for an appointment, Natalie visited her GP again, but was told not to worry.

More than two months since first spotting the ulcer, and desperate for a diagnosis, she saw another dentist, who immediately referred her to Musgrove Park Hospital in Taunton, Somerset.

'By then it was hurting most of the time and kept growing - it had trebled in size. I took painkillers, but could feel it almost burrowing into my tongue,' she says.

Doctors took a biopsy and Natalie received a phone call within days, asking her to see a consultant maxillofacial surgeon with a specialist interest in head and neck cancer.

Brave front: Natalie is determined not to let the cancer dominate her future

He revealed she had a type of mouth cancer called squamous cell carcinoma - a disease that usually affects only the over-50s.

'My world fell apart,' says Natalie, who lives with Phil and their sons Rocca, five, Jensen, three, and Tait, 18 months, in Exmouth, Devon. 'I thought I was just going to have a simple operation to have an ulcer taken off.'

She had to have, in fact, half her tongue removed, followed by reconstructive surgery using skin grafts from her arm and stomach.

After radiotherapy and chemotherapy, it was discovered the cancer had spread to her right lung. Latest scans have shown this tumour has grown to around 2in and Natalie faces major surgery to have the lung removed.

Unless she has the operation, scheduled for later this month, her outlook is bleak - doctors have said she could have just months to live.

Though Natalie knows the disease will eventually prove terminal, she is determined not to let it dominate her future. But she wants others to be aware of the signs of mouth cancer, which can often be missed by doctors and dentists.

Nearly 8,000 people are diagnosed with mouth cancer every year and there has been a 50 per cent increase in cases between 1999 and 2007, according to the charity Mouth Cancer Foundation.

Most cases occur in people over 50, but it's becoming more common in younger people, and doctors are looking into the reasons why. Recent studies show human papilloma virus number 16 (HPV-16) - the same one associated with cervical cancer - is linked to mouth cancer in much younger people with good oral health and no history of smoking or drinking alcohol.

'These HPV mouth cancers appear to be responsive to treatment and the survival rate is much better than non-HPV mouth cancer,' says Dr Vinod Joshi, a consultant in restorative dentistry and founder of the Mouth Cancer Foundation.

However, heavy smokers and drinkers are the most high-risk group. 'The dehydrating effect of alcohol on cell walls makes it easier for tobacco toxins to penetrate mouth tissues, where they can turn cells cancerous,' says Dr Joshi.

Even with treatment, mortality rates from mouth cancer are high, with around half of patients not surviving five years or more. This is partly down to the fact that patients, dentists and doctors can miss the signs and the cancer spreads before it is diagnosed.

'The biggest complaint by patients is late detection from doctors and dentists,' says Dr Joshi.
'Patients are generally unaware of the symptoms and the fact they're supposed to receive a full cancer examination at every routine dental visit. And people often put up with symptoms before getting them checked out.'

 

'My world fell apart. I thought I was just going to have a simple operation to have an ulcer taken off.'

Graham Merrick, consultant maxillofacial surgeon at Musgrove Park Hospital, adds: 'It's a relatively rare cancer, but the consequences are severe if it's missed.

'If you have a specific ulcer that's increasing in size and it's been there for more than two weeks, see your doctor or dentist.

'The earlier you present, the much better your chances of survival. We tend to see a three-month lag between patients first noticing that something is wrong and getting to us.'

As well as an ulcer, or a red or white patch, or anywhere in the mouth that does not heal within two or three weeks, symptoms can include a lump or swelling in the mouth, jaw or neck that persists for at least three weeks.

Other signs are difficulty in swallowing, chewing or moving the jaw or tongue, mouth numbness, a feeling that something is caught in the throat or a chronic sore throat or hoarseness lasting more than six weeks. An unexplained loosening of the teeth is another symptom.

In a bid to raise awareness among dentists, the Mouth Cancer Foundation has introduced a screening accreditation scheme.  The idea is to encourage dentists to check for signs of mouth cancer by examining the face and neck, as well as thoroughly looking inside the mouth, during routine dental visits.

Natalie believes her story should act as a warning to others and also wants health professionals to learn from her experience.

'I feel I should have been listened to more. A few weeks could have made a difference. I just want my story told,' she says.

A week after diagnosis, Natalie began a lengthy treatment process. After a MRI scan revealed the cancer had spread to the lymph nodes in her neck, she had a nine-hour operation in which part of her tongue was removed and reconstructed. This was followed by 24 hours in intensive care.

Natalie also picked up an infection in her tongue, which was treated during another two-week stint in hospital, before she underwent chemotherapy and radiotherapy two months later.

Hopeful, yet realistic: All Natalie wants to do now is make the most of the time she has with her three sons and her husband Phil

Just before this stage of her treatment started, her baby son, Tait, had to be induced at 32 weeks in January 2012. 'I heard him cry and I just felt so relieved,' she says.

But in August last year a scan showed that the cancer had spread to Natalie's right lung. Parts of it have been removed in two operations. Despite the surgery, the tumour has returned and caused the lung to collapse.

Natalie is realistic about her future, but is hopeful about her upcoming operation.

'I know this cancer will kill me, and very quickly. My lung doctor has been more optimistic. He said that I'm young, I've managed really well with all the treatments so far,' she says. 'I'm hoping that if they take out my lung, it will buy me some years. I'm determined that it's not going to be months.'

Doctors were unable to say why Natalie developed the cancer and did not think it was linked to her mother's breast cancer. She had smoked only the occasional cigarette in her early 20s.

For now, though, Natalie is getting on with life as best she can. Her collapsed lung is incredibly painful and she struggles with intense episodes of coughing.

She is on strong painkillers, which make her drowsy most of the time. But she can still speak clearly and eat and drink, despite being left with just one salivary gland instead of two.

All Natalie wants to do now is make the most of the time she has with her family.

'Before I had cancer, I had short views on things - you do the school run, get ready for nursery, have your dinner. I forgot about quality of life, what it means to have young children and how amazing they are.'

mouthcancerfoundation.org

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