Ask the Doctor: Oral and Throat Cancers Have Numerous Potential Causes

oral and throat cancersWhile oral and throat cancers can develop even in nonsmokers, most people with these cancers use tobacco, says The American Cancer Society. There are other risk factors that everyone should know about. In this column, Nader Sadeghi, MD, FRCSC, Director of Head and Neck Surgery at the George Washington University Hospital and Professor of Surgery, talks about the risk factors as well as a new, highly effective treatment at GW Hospital for advanced oral and throat cancers. 

What causes these cancers?

Smoking, smokeless tobacco, tobacco chewing and excessive use of alcohol substantially increase the risk of developing oral and throat cancers, which can affect any part of the oral cavity – lips, tongue, mouth and throat. Poor diet, low in fruits and vegetables, may augment the effects of these carcinogens. Recently, it’s been discovered that human papilloma virus (HPV) also contributes to the cancers’ development. Particularly strong association is noted in throat cancer – such as base of tongue, tonsil cancer and to some degree, oral tongue. 

What are some of the signs to look for?

The most common symptom is a sore in the mouth that bleeds easily and does not heal. Other symptoms include a lump or thickening in the cheek; a white or red patch on the gums, tongue, tonsil or lining of the mouth; a sore throat; pain in swallowing; or trouble swallowing, chewing or moving the tongue in the jaw. Sometimes the initial presentation may be a lump in the neck.

Can I prevent myself from developing the disease and can I be checked for it?

The best way to prevent oral and throat cancers is by not using tobacco and limiting use of alcohol. Even after years of smoking and drinking, quitting can help. Many cancers can be found early with a combination of screening by a doctor or dentist and through self-examination. 

What’s the treatment for this cancer if it has already advanced?

Traditional treatment involves surgery followed by radiation therapy with or without chemotherapy, or simultaneous use of chemotherapy and radiation. Both of these methods involve radiotherapy. At GW Hospital, in addition to these standard methods of treatment, in appropriately selected patients, we use chemotherapy to reduce the size of the tumor, then perform minimally invasive transoral robotic surgery or laser microsurgery to strategically and precisely remove the remaining cancer, while maintaining all the functions of the involved organ. This method, in our experience, gives the best long-term functional outcome and hence quality of life.

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