Jan 9, 2021

Oral cancer risks increase significantly for patients who smoke and drink heavily and there are also associations with HPV.

About 80 percent of people with oral cancer and oropharyngeal cancers use tobacco in the form of cigarettes, chewing tobacco, or snuff. Oropharyngeal cancer is a disease in which malignant cells form in the tissue of the oropharynx. The oropharynx is the middle part of the throat that includes the base of the tongue, the tonsils, the soft palate, and the walls of the pharynx. The pharynx is the tube or cavity, with its surrounding membrane and muscles, that connects the mouth and nasal passages with the esophagus.

The risk of developing oral cancer depends on the duration or frequency of tobacco use. For people who smoke and also drink excessive amounts of alcohol, the risk of developing oral cancer is substantially higher than for people who neither smoke nor drink.

With regard to prevalence, oral cancer and oropharyngeal cancer are twice as common in men as in women. The difference may be related to more use of alcohol and tobacco among men. However, according to the American Cancer Society, gender difference is decreasing among oral cancer patients as tobacco and alcohol use among women is increasing.

There has also been research regarding the human papilloma virus, HPV, which includes about one-hundred similar viruses. Many of these viruses cause warts, but some are involved with cancer. Most noteworthy, the HPV virus that is related to the development of cervical cancer is also a risk factor for oral and oropharyngeal cancers.

About 25 percent of patients with oral cancer are also infected with the same HPV cancer viruses that are seen with cervical cancer. The HPV virus appears to be a more serious risk factor for oropharyngeal cancers than for other oral cavity cancers. It is interesting that patients with HPV virus-related cancers may be non-smokers or non-drinkers.

These patients may have a very good prognosis, because these virus-involved cancers do not produce any symptoms and only a small percentage of these infections actually develop into cancers. We are aware, however, that many patients will come in with small papillomas on their palettes and these are all biopsied for the HPV virus.

Oral cancer treatment can involve something as simple as an excision with early cancers. These early cancers are can just be excised with an appropriate margin of tissue removed, and that can be the cure. The more invasive or more aggressive type cancers may require more extensive excision of tissue and bone. For these reasons, attention to lifestyle issues and early diagnosis are really the key with these cancers.

Dr. Leonard Spector