Editor’s Note: I went to see my dentist (Joanne Le, who runs the Akamail Dental Center in Honolulu) and the conversation turned to a subject that is quite new to dentistry and certainly new to me–the correlation between Oral Cancer and HPV. Suffice it to say, with the prevalence of HPV in our society, this is something we should all be aware of.


Approximately 48,250 people in the US will be newly diagnosed with oral cancer in 2016. This includes those cancers that occur in the mouth itself, in the very back of the mouth known as the oropharynx, and on the exterior lip of the mouth. While some think this is a rare cancer, mouth cancers will be newly diagnosed in about 132 new individuals each day in the US alone, and a person dies from oral cancer every hour of every day1.

Studies have shown that the leading cause of oropharyngeal cancer is from the human papilloma virus (HPV); a small number of oral caners also occur from HPV. Transmission of the virus can occur through direct skin-to-skin contact or sexual contacts (both conventional and oral). It is one of the most common viruses in the United States1.

Signs and Symptoms
• An ulcer or sore lasting more than 2-3 weeks
• White, black, or red discoloration on the soft tissues in the mouth
• Difficult/painful swallowing. A sensation that things are sticking in the throat when swallowing
• Pain when chewing
• A swelling or lump in the mouth
• A painless lump felt on the side of the neck that has persisted for more than two weeks
• An ear ache on one side

Risk Factors2
• Gender: Oral cancer and oropharyngeal cancer are twice as common in men as in women. This difference may be related to the use of alcohol and tobacco, a major oral cancer risk factor that is seen more commonly in men than women. According to the American Cancer Society, the gender difference is decreasing among oral cancer patients as more women are using tobacco and drinking.
• Age: The average age at diagnosis for oral cancer is 62, and two-thirds of individuals with this disease are over age 55.
• Ultraviolet light: Cancers of the lip are more common among people who work outdoors or others with prolonged exposure to sunlight. Poor nutrition: Studies have found a link between diets low in fruits and vegetables and an increased oropharynx and oral cancer risk.
• Tobacco use and alcohol consumption: When you combine tobacco with heavy use of alcohol, your risk is significantly increased, as the two act synergistically. Those who both smoke and drink, have a 15 times greater risk of developing oral cancer than others.

After a definitive diagnosis has been made and the cancer has been staged, treatment may begin. Treatment of oral cancers is ideally a multidisciplinary approach involving the efforts of surgeons, radiation oncologists, chemotherapy oncologists, dental practitioners, nutritionists, and rehabilitation and restorative specialists. The actual curative treatment modalities are usually chemotherapy with concurrent radiation, sometimes combined with surgery.

When cancer is diagnosed, it may be discovered in a site that is not the location of the primary tumor. The most deadly aspect of cancer is its ability to spread, or metastasize. Cancer cells initially group together to form a primary tumor. Once the tumor is formed, cells may begin to break off from this tumor and travel to other parts of the body. This process is metastasis. These cancer cells that travel through the body are capable of establishing new tumors in locations remote from the site of the original disease. Metastasis is a very complicated process that still has yet to be completely understood1.

The Centers for Disease Control and Prevention states that up to 80% of Americans will obtain an HPV infection in their lifetime, and 99% will clear these infections without knowing they even had the infection. This occurs because the body’s immune system is naturally able to fight against the infection, and many infections come and go without causing any consequences. This information is not meant to scare you but rather its purpose is to educate you about the risk factors and signs of oral cancers. An informed individual is a proactive individual! Be aware of your health and detect unusual signs as soon as possible1.

“Early discovery has many positive impacts when you consider cancer”
– See more at: http://www.oralcancerfoundation.org/hpv/#sthash.NehurbR1.dpuf

1. “Oral Cancer Facts.” The Oral Cancer Foundation. N.p., Jan. 2016. Web. 03 May 2016.
2. “Oral Cancer Risk Factors.” Cancer Treatment Centers of America. N.p., 2015. Web.