Cancer: The Clinical and Diagnostic Approach John P. Gobetti, D.D.S., M.S. Oral Medicine/Diagnosis Section Dept. of Oral Medicine, Pathology, Oncology University 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 Cancers cont’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.