According to the Oral Cancer Foundation, www.oralcancerfoundation.org, if diagnosed with oral cancer, the five-year survival rate is just over 50%, which has not changed in over 25 years.
The major reason for such a poor survival rate is that oral cancer is often not diagnosed until a significant, persistent lesion prompts a patient to ask his or her dentist or doctor about it. Unfortunately, because of the aggressive nature of oral cancers, the lesion may already have spread into the lymph system by the time it is noticed. However, when cancer is recognized early, the five-year survival rate increases to 82%. Therefore, early diagnosis saves lives!
We perform oral cancer screening exams as part of our everyday practice. The exam takes only a few minutes to perform and is often done routinely at dental check-ups.
We inspect the inside and outside of the mouth for unusual lumps, bumps, red spots, white spots, and ulcers. The cheeks and lips are usually felt for masses. A very critical part of the oral cancer exam is inspection of the tongue. Usually the tip of the tongue is grasped with a piece of gauze and stretched forward while we look at the sides, top, and bottom of the tongue for anything suspicious. This exam has been considered to be the standard of care for many years.
We also use the Velscope Vx® routinely as no additional charge to our patients. Essentially, a special light is used to inspect the soft tissues of the mouth. No rinse or dye is needed. It works on the principle that rapidly reproducing cells, such as cancer cells, do not allow the light to penetrate down to the collagen level of the skin. Healthy tissue reflects the light and appears green through the viewing filter. Suspicious lesions appear as black spots in a field of green.
Once a lesion is discovered, further tests are necessary to reach a diagnosis. If further studies are needed, then a scalpel biopsy is performed, where a part or all of the lesion is removed surgically and viewed by a pathologist under a microscope. Obtaining a diagnosis is essential for determining the appropriate treatment. Fortunately, a simple excisional biopsy or even no treatment is all that is needed for very early lesions.
These are actual photographs of oral cancer on the side of the tongue of one of our actual patients. The photo on the left is the cancerous lesion that was discovered during a routine cancer screening exam, and the yellow circle represents what would typically be removed during a normal biopsy procedure. The green photo on the right is the same lesion as seen through Dr. Huff’s Velscope. The dark areas are areas of cancerous tissue (confirmed by biopsy) that would have been left behind if the Velscope had not been used because they were not visible to the naked eye.