Experts say screening vital to detect oral cancer

Friday, November 16, 2001

ST. LOUIS -- It might look like a small red patch on your tongue, or a gray spot underneath. Either way, you're not likely to notice it.

"One of the problems with oral cancer is that it's mostly painless and progresses very slowly, but the mortality rate is very high," said Dr. Doug Miley, a professor at St. Louis University's Center for Advanced Dental Education. "Patients might notice it themselves, but normally that's not the case."

And missing that bump, spot or lesion -- or discovering it in time -- can make a life or death difference: Only 50 percent of patients with oral cancer survive more than five years.

That's why screenings for the disease -- which affects more men than women, and more blacks than whites -- are vital. Miley and others spent much of Thursday working to get that message out, offering free tests at four sites in the St. Louis area on the 25th anniversary of the Great American Smokeout.

30,000 new cases

More than 30,000 new cases of the disease are diagnosed every year, even though the screening is a relatively simple procedure and is normally part of a dental checkup.

"But a lot of people don't have a dentist, or don't see a dentist on a regular basis," Miley said.

The exam usually takes about 10 minutes, although because dental students from St. Louis and the Southern Illinois University were conducting the test Thursday, it took a little longer because a dentist also consulted.

The test starts with the tongue, which is pulled out and checked on both sides for spots or lesions.

"The tongue has a mind of its own. Sometimes you just have to grab it," said Spencer Zaugg, a dental student at Southern Illinois who was conducting screenings Thursday.

A look around the mouth, and a check of the lymph nodes and throat completes the exam. Dentists are looking for a variety of abnormalities, because the disease can manifest itself in several ways.

"The hard part is looking in the mouth and knowing what's normal and what's not normal," Miley said. "If you're able to find it when it's relatively small, the long-term prognosis for the patient is much better."

Sue McGahan of St. Louis, who works at St. Louis' School of Allied Health, said her dentist doesn't include a screening for cancer during checkups. So even though she doesn't smoke or use any kind of tobacco product -- 90 percent of oral cancer victims have used tobacco -- McGahan made the trip across campus for a screening.

"It's better to be safe," McGahan said. "They were great. They just pulled around a lot in my mouth."

Miley said the risk of oral cancer increases with the amount of tobacco smoked or chewed and the duration of the habit. And quitting smoking doesn't preclude the need for screening; the disease can develop years after a victim quits using tobacco.

Besides tobacco, which is the primary risk factor for the disease, about 75 percent of victims also frequently consume alcohol.

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