Narrator: Coming up on Mayo Clinic Q&A,
Dr. Kevin Arce: Oral cancer is basically considered within the
oral cavity. There's also, when we look at a statistics, it is
cancers of the oral cavity as well as the back of the throat
or pharynx. It's about 3% of new cancers in the U.S. on a yearly
basis.
Narrator: Treatment for oral cancer depends on that cancer's
location and stage. Treatment options can include surgery,
radiation, and chemotherapy. But as the saying goes, the best
treatment is often prevention. And there are some steps to take
that can lessen the chance of contracting oral cancer.
Dr. Kevin Arce: The two main risk factors is tobacco use and
tobacco of any type as well as alcohol. To that we see
patients that are immunocompromised as another set
of patients that have high risk factors. But when we think of
risk factors that individuals that we can control, you know,
certainly is the smoking or tobacco use in general, as well
as heavy alcohol consumption.
DeeDee Stiepan: Welcome, everyone to Mayo Clinic Q&A, I'm
Deedee Stiepan sitting in for Dr. Halena Gazelka. Oral Cancer
refers to cancers that originate in the mouth, tongue and back of
the throat. Early detection of oral cancer can lead to better
treatment options and outcomes. April happens to be oral cancer
awareness month, a time to remind the public that there are
steps to take to reduce your risk of developing oral cancer.
Joining us to discuss those risk factors, prevention and
treatment of oral cancer is Mayo Clinic oral and maxillofacial
surgeon, Dr. Kevin Arce. Welcome to the program. Dr. Arce.
Dr. Kevin Arce: Thank you. Thank you for the opportunity of
being here this afternoon.
DeeDee Stiepan: Of course. So, let's start off with how common
is oral cancer?
Dr. Kevin Arce: So, oral cancer is basically considered within
the oral cavity. But there's also, when we look at
statistics, is cancers of the oral cavity as well as the back
of the throat or pharynx. When we think of those cancers, you
know, together, it's about 3% of new cancers in the U.S. on a
yearly basis. So, it's approximately about 54,000
cases, you know, that we see yearly here in the United
States.
DeeDee Stiepan: Okay. So, would oral cancer be considered part
of head and neck cancers or are we talking a separate category?
Dr. Kevin Arce: It is one of the sub sites of the head and neck
cancers. And when we think of the oral cavity cancers, we've
got to think of the lips, you know, the gums, the floor of the
mouth, the roof of the mouth, and also the lining in the cheek
area, you know, as well. So, all those would be the areas where
we think of, and the tongue itself, but all those areas are
what would be considered oral cavity or oral cancers.
DeeDee Stiepan: What are the risk factors for developing oral
cancer?
Dr. Kevin Arce: So, one of the main, the two main risk factors
is tobacco use and tobacco of any type, as well as alcohol
consumption, you know, as well. And then, you know, after that,
you know, we see patients that are immunocompromised as another
set of patients that have high risk factors for developing
cancers, because those patients don't have the ability for their
bodies to fight cancers of any type, you know, including this
type of cancer. But when we think of risk factors that we
can control, in some ways, it's you know, certainly is the
smoking or tobacco use, you know, in general, as well as
heavy alcohol consumption.
DeeDee Stiepan: What are the signs and symptoms of oral
cancer, and then how would it be diagnosed?
Dr. Kevin Arce: So, one of the challenges with oral cancer is
that when we think of the signs and symptoms, it can be very
nonspecific. And that's why a lot of times it goes
unrecognized, by both the patient as well as providers for
a period of time before we figure it out that it's actually
a cancer. But some of the most common signs that we see is a
sore that doesn't heal, a lump or a bump, loose teeth, some
patches that just look or feel different, and it's a new
change, you know, for the patient. And then we also see
pain, but that's at times what is somewhat confusing is that at
times these cancers don't cause pain. We all associate cancer
with being a painful condition, which it can be but not in its
early phases, you know, at times. So, these lumps and
bumps that can develop in the mouth at times are not painful,
and that's why they go unrecognized. But those are the
most common signs and symptoms that we see. And then also we
can see, you know, later on in the evolution of the cancers,
ear pain, you know, mouth pain, and also some difficulty with
swallowing.
DeeDee Stiepan: Okay, interesting. What's the typical
treatment?
Dr. Kevin Arce: So, the typical treatment is once we evaluate a
patient, we go in and have to do a biopsy because even if it
looks abnormal, and somewhat what we call suspicious, you
know, it just doesn't look like it should but that it belongs
there and it's worrisome for a cancer we go in and do a biopsy.
Once we get confirmation that it is a cancer, then the oral
cavity cancers within the head and neck cancers are
predominantly treated with surgery first, because for one
thing is we can get to them, and we can actually remove them. And
then once we do that, then we go ahead and do other treatments
such as radiation therapy and chemotherapy. It's not for all
patients, you know, it depends on the size of, the extent of
the involvement of the cancer or how big it is. And also, these
cancers do have a tendency to go elsewhere, you know, in the
body, but elsewhere the lymph nodes do a good job of filtering
them. So, when we think of treatments, most of the time
we're treating both the cancer where this starts in the oral
cavity, but also doing some sampling of the lymph nodes or
so-called neck dissection, you know, as well. And that's going
to determine whether patient's then need extra treatment like
radiation therapy, or chemotherapy, or both.
DeeDee Stiepan: Does Mayo Clinic approach treatment differently?
Dr. Kevin Arce: Well, the approach is similar to what the
guidelines are at other cancer centers across the country. We
have an integrated practice, so the communication with other
disciplines or other specialists, such as medical
oncology, and radiation oncology is very seamless. So, it's very
straightforward in that aspect. We do have technology that can
be unique to some centers, you know, for example, for proton
beam therapy, which is along the lines of radiation type
treatments that are given to patients with these type of
cancers, you know, at times.
DeeDee Stiepan: Let's talk about the advances being made in
surgery for oral cancer. So, starting with anatomic modeling
lab and 3D printing, what can you tell us about that?
Dr. Kevin Arce: Yes, absolutely. So, one of the advances that
we've seen in the last, you know, 20 or 30 years in the
treatment of head and neck cancers certainly has to do with
the reconstruction. We have better abilities to reconstruct,
you know, the structures that have been lost. Because, you
know, as part of the cancer, we have to remove not only the
cancer, but also surrounding the tissue that is, you know, at
times normal tissues. And to replace that can be quite
challenging. But we've made advances in general in the
treatment of head and neck cancers, so we can bring tissues
from different areas of the body and reconstruct either a tongue
or rebuild a jaw. When it comes to jaw reconstruction, the
anatomical lab, 3D printing has helped tremendously because we
can do a patient specific type of reconstruction. So, we can
replace what's been lost, and place it where it was, you
know, prior to the surgery. We can replace what's been lost,
but also make sure that the function, you know, is there
after this type of reconstruction. Here at Mayo
Clinic, we also have the discipline of maxillofacial
prosthodontics, which allows us to not only replace the tissue
parts, but also the dental alveolar. And what I mean by
that is, basically replace the teeth, the dentition, you know,
as part of the comprehensive reconstruction, which is
important to be able to restore form and function. So, patients
can obviously not only look the same, but speak, eat, you know,
as they did prior to the surgery. And at Mayo Clinic we
can also do that, you know, all in house, you know, within, you
know, within the institution. We have a group of
neuroradiologists, biomedical engineers, that are a part of
the institution, and we collaborate with them in these
types of reconstructions.
DeeDee Stiepan: Great to hear about those advances for sure.
Dr. Arce, is there anything else that you'd like to share?
Anything else that you think is important for people to know?
Dr. Kevin Arce: I think it's, you know, the awareness is
important. You know, it's when we think of percentage of
cancers, new cancers in United States, you know, per year, you
know, it would be considered relatively low. But I think it's
still in the awareness that, you know, oral cavity cancers do
happen. And it's also important to maintain that relationship
with either your dentist or your primary care physician that they
do at least an annual screen of the oral cavity to make sure
that there is nothing unusual or a lesion that needs more
DeeDee Stiepan: Very good. Well, our thanks to Mayo Clinic oral
attention.
Surgeon, Dr. Kevin Arce, for being here today to discuss
diagnosing and treating oral cancer. Thanks so much, Dr.
Arce.
Narrator: Thank you. Mayo Clinic Q&A is a production of the Mayo
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