13 Nov 2017

Within the last decade, mouth cancer rates in British women have shot up by more than a third (40%). Over 2,500 women in the United Kingdom are given the devastating news they have mouth cancer every year but why is this happening, what can you do to reduce your risk and how can you become more Mouthaware to spot mouth cancer as early as possible?

We put your questions about mouth cancer to Dentist Dr Ben Atkins, Trustee of the Oral Health Foundation, to find out what you really need to know about mouth cancer?

Q: How at risk from mouth cancer am I?

The lifetime risk for a woman in the UK to be diagnosed with mouth cancer is around 1 in 150 - odds which have increased in the last few generations. Developing mouth cancer is still unlikely but with more cases occurring, it is something that all of us need to be aware of.

Most mouth cancers, around nine in ten, are linked to lifestyle choices but it is important to remember that this is not the case for everyone and while you can take steps to reduce your risk, nobody can totally prevent being diagnosed with mouth cancer at any stage of life.

The main traditional behaviours associated with mouth cancer still ring true. The major cause in the UK remains smoking, with drinking too much alcohol a significant issue too. But one, often overlooked and important, factor is that of the human papillomavirus (HPV).

You may have heard of HPV already, it is the virus which causes cervical cancer, but you may not know that it also causes many other diseases including mouth cancer. In fact, research carried out by the Oral Health Foundation worryingly discovered that only 16% of women in Britain knew of HPV's relationship to mouth cancer.

The World Health Organization believe that every single sexually active person on the planet will get HPV at some time during their life, HPV is spread to the mouth through oral sex. There has been a HPV vaccination programme for school age girls in place since 2008, but anybody who was older than 13 in this year has a very high risk of getting HPV.

Thankfully, for most of us there will be no effect. Many will not even know they have it, but for an unfortunate few it can be devastating. Many experts believe HPV will overtake smoking as the leading cause of mouth cancer within a few years, underlining the significance of its potential impact.

Q: Has my risk increased?

In the last decade, mouth cancer cases have risen by a heart-breaking 39% in the UK. This is more than five times the increase of all cancer cases in the UK during the same time (7%). Mouth cancer is now the 12th most common cancer in women in the UK and as time goes on it is moving quickly up that list.

Traditionally considered a disease for men over 50 who drink and smoke, mouth cancer has for too long been ignored as something other people got. But as cases have continuously risen at a time when other cancer rates are decreasing, this is no longer the case and mouth cancer has rapidly developed into a significant issue that all women need to be aware of to protect themselves.

Q: Why has the risk increased?

It comes down to lifestyle and environmental factors. As I mentioned, most mouth cancer cases are lifestyle related and even though the amount of people smoking in Britain may have fallen, ex-smokers are also at greater risk than those who have never smoked. There are also other causes which are on the rise.

The main factor which is influencing mouth cancer rates is arguably changes in our sexual behaviour. Studies are beginning to suggest that the more sexual partners you have could increase your chances of developing mouth cancer through contraction of HPV.

Our environment has also changed. More vehicles on the road and other pollution has been linked to increased risk of mouth cancer.

Q: Why have I not heard much about mouth cancer before?

Research by the Oral Health Foundation discovered that only one in five (20%) women think they are at risk of mouth cancer. As I mentioned, mouth cancer has long been considered an ‘old man's disease', something that does not affect women and therefore might have gone under the radar.

But as cases have increased the more important it is to be aware of mouth cancer. This is largely due to the time when cases of mouth cancer are detected. Many mouth cancers are caught too late to give a person the opportunity of a positive outcome. It is estimated that chances of 5-year survival based on a late diagnosis is in the region of 50% but this can be transformed to 90% if it is caught early enough. This is exactly why all of us must be aware of any changes in our mouth and get anything that we feel is unusual checked out by our dentist or doctor straight away.

I would bet that almost everybody knows that a lump in the breast could potentially be a sign of breast cancer and would have to be looked at straightaway, but disturbingly this is not the case for our mouth where symptoms can be hidden from sight and less obvious.

Q: What's signs should I be aware of?

Mouth ulcers which have not healed within three weeks, read and white patches and unusual lumps and swellings are the main early warning signs of mouth cancer.

Worryingly. only one in four (25.6%) women can identify these symptoms. It is important that you are able to recognise the early signs and act on anything unusual in the mouth by getting checked out by a dentist or doctor.

Q: Can I do anything to protect myself or my family?

Quitting smoking is the number one thing you and any family members can do, as well as limiting your alcohol intake. Regarding sexual activity, while using condoms can slightly reduce the chances of HPV infection in the mouth, it will not completely prevent it.

More actions you could take which may help, include increasing the amount of fruit, vegetables and fish in your diet, taking adequate protection against extreme sunlight and reducing second-hand exposure to smoke and other fumes.

By being alert to the signs and symptoms and checking for them regularly, in the same way you should do for breast cancer, you can catch any cases early enough to provide effective intervention.
Regarding HPV, the best and most effective time to get vaccinated is before you become sexually active. Only school age girls currently receive the HPV vaccine in the UK, but you can opt to get your son vaccinated too, speak to your doctor or a pharmacist about this.

Q: What effect can mouth cancer have on me?

Mouth cancer treatment characteristically leaves people with permanent, challenging oral health problems such as chronic pain and discomfort, significant tooth loss, dry mouth and severe gum disease, requiring long term dental care.

After treatment, mouth cancer patients often have problems with swallowing, drinking and eating. Speech may also be affected. Facial disfigurement is a common side effect of surgical treatment which leaves the patient with additional psychological trauma.

This can lead to other problems such as depression. Difficulties in communication, low self-esteem, social isolation and the impact on relationships can cause as much distress as the cancer itself. Catching cases early can help to limit this impact though, so awareness is vital.

Q: Where can I get more information?

As part of Mouth Cancer Action Month, which runs throughout November, the charity is determined to raise awareness of the signs and symptoms of mouth cancer, to get more cases caught early enough to make a difference to the chances of survival.

By drawing attention to the disease, they want to help prevent mouth cancer cases increasing even more in Britain and draw attention to the sad fact that even for those who have survived mouth cancer it is those things we take for granted that they often lose, the ability to eat, drink, speak and even breath.

I have spoken to many mouth cancer survivors and many of them have the same advice for the public, "be more aware of what is going on in your mouth, it could save your life".