Oral Cancer

Tracy: Welcome to Charter Local Edition. I’m Tracy Young. 

In 2010, 37,000 new cases of oral cancer were discovered in the United States alone. And joining us to discuss the causes of this form of cancer is Dr. Armond Kotikian. He’s an oral and maxillofacial surgeon in the San Gabriel Valley. Nice to have you with us, Doctor.

Dr. Armond: Thank you. Thank you for inviting me.

Tracy: I look at that, I think 37,000 new cases of this. Maybe I shouldn’t have been surprised, but do we normally have this many new cases every year, or was this an anomaly?

Dr. Armond: No, no, that’s about average. It’s usually in the 30,000 range. Every year it’s 30 to 38,000.

Tracy: So the obvious one that comes to my mind is smoking. 

Dr. Armond: Definitely. 

Tracy: We know that smoking is not good for us. 

Dr. Armond: Definitely.

Tracy: How bad is smoking in relation to oral cancer?

Dr. Armond: Smoking itself increases the risk of oral and pharyngeal cancer by seven times compared to someone who doesn’t smoke. If they drink alcohol on top of that, it increases their risk by 32 times.

Tracy: Oh my goodness. I want to ask you something that’s become really popular. 

Dr. Armond: Sure. 

Tracy: And you see a lot of ballplayers do this.

Dr. Armond: Right. 

Tracy: And that is they chew, or a lot of cowboys I see will do it. They’ll think, “Well, I’m not smoking. I’ll chew it. It’s not going to be as bad.” Why is that not accurate?

Dr. Armond: That is not accurate because it does increase the chance of oral cancer, not as high, but it definitely is still there of causing oral cancer.

Tracy: And what about something you were telling me about? I know something, it’s about a betel nut? Is that what it is?

Dr. Armond: Correct. 

Tracy: Okay, tell me about that.

Dr. Armond: So in certain cultures, especially the Indians from India and Pakistanis, they chew on something called a betel nut. And what they do is they wrap the betel nut in the leaf —

Tracy: And it’s just a nut.

Dr. Armond: It is just a nut —

Tracy: Okay.

Dr. Armond: — from a tree.

Tracy: Indigenous to that part of the world. 

Dr. Armond: Definitely. And what they do is they chew on it. It causes euphoria. And that has shown to increase the chance of oral cancer. Actually, in India, in men, the number one cancer is oral cancer.

Tracy: And basically the same thing. It’s something that you’re putting in your mouth. You’re keeping it in there for a long period of time. 

Dr. Armond: Absolutely.

Tracy: All right. So it probably can’t be good for gums and teeth and everything, right?

Dr. Armond: That’s correct.

Tracy: Tell me about something, the HPV, human papillomavirus. What are we learning now about the link between that and oral cancer?

Dr. Armond: Correct. So as we all know, HPV, also known as human papillomavirus, you know, everyone knows it causes cervical cancer, but it’s actually been shown to cause pharyngeal—meaning back of the pharynx, meaning back of the mouth—oral cancer as well.

Tracy: Oh my goodness. So unfortunately, there’s lots of causes here. 

Dr. Armond: Correct. 

Tracy: Tell me about the progress we’re making. Is this a cancer that people get? We tend to detect it early, lots of cures, we should feel really good about it? Or is the fact of the matter we’re not doing a good job of detecting it early and curing it?

Dr. Armond: It’s being detected as long as the patients see their general dentist or their physician on a regular basis. We are making progress. But studies have shown if you see your general dentist, you have a higher chance of being diagnosed at an early stage.

Tracy: Oh my goodness. And what about those who’ve — once they have been diagnosed, is the success rate real? Are we good at, once we know what it is, actually dealing with it, eradicating it, and people can live long lives? Like some cancers, we’re learning that if you get to them early, the success rate is really good.

Dr. Armond: Definitely. If it’s caught in the early stages, meaning stage 1 or stage 2, it has a great prognosis. Stage 1, for instance, has about a 90 to 95% success rate. But if the cancer spreads, meaning it gets into lymphatics, it already drops by 50%. 

Tracy: So what kind of advice would you give to people? What kind of symptoms can someone — we know I’m not a medical professional, you are. But if you’re saying to me, “Here’s just some symptoms that you should look for.”

Dr. Armond: Right. In the oral cavity, if you see an ulcer that’s not healing, meaning it’s been there for over a week or two, we tend to get suspicious. If they have some type of growth that, you know, has been there for more than a couple of weeks, we get suspicious. Or if the patient notices a lump in their neck, those are signs of possibly having oral cancer or other cancers as well.

Tracy: And we obviously shouldn’t diagnose ourselves, but you’re saying if there’s something going on, it’s not normal. Something comes away, and it’s not going away. But that’s true for anything. 

Dr. Armond: That’s correct. Absolutely.

Tracy: I mean, if you have it and it doesn’t go away. So, how often do you recommend that people see their dentist or their oral and maxillofacial surgeon? It sounds like Medical 101, but what’s your best advice?

Dr. Armond: If they have no history of oral cancer, at least twice a year.

Tracy: Twice a year.

Dr. Armond: Definitely. See your general dentist so they can do a good head and neck examination, and based on that, if there is anything that needs to be done, they’ll send it to us.

Tracy: All right. And the bottom line is, it’s always we say it’s that early detection. See your dentist, your doctor on a regular basis.

Dr. Armond: Definitely.

Tracy: That’s the best cure there obviously is, right? Thank you so much for your time, sir.

Dr. Armond: Thank you. Thank you for having me.

Tracy: Thank you for watching Charter Local Edition. I’m Tracy Young.