ACCORDING to the World Health Organisation (WHO), there are around 657,000 new cases of cancers of the oral cavity and oropharynx, and more than 330,000 associated deaths every year.
According to the WHO 2008 statistics, PNG had the highest incidence rate of oral cancer in the world, with around 32 in 100,000 people suffering from it.
Cancer is the uncontrollable growth of cells that invade and damage surrounding tissues.
Oral cancer affects lips, tissue that lines lips and cheeks, teeth, front two-thirds of the tongue (the back third of the tongue, or base, is considered part of the oropharynx, or throat), gums, area of the mouth underneath the tongue, called the “floor and roof” of the mouth.
University of PNG fourth-year bachelor of dental surgery student Christina Torosa conducted a review on oral cancer in PNG as her project under the course community oral health monitored by her lecturer Dr Matupi Apaio.
Torosa wants to create awareness on oral cancer in PNG.
“The spectrum of cancer in PNG” analyses malignant tumours registered with the Tumour Registry of PNG from 1958-1988.
During this period, the cancer rate was generally low in PNG because of the lack of exposure to environmental carcinogen (substance capable of causing cancer).
Betel nuts and tobacco were the two known carcinogens introduced to PNG.
In 2012, the International Agency for Research on Cancer declared betel nuts, with or without tobacco, a group one human carcinogen.
Betel nut chewing has been associated with the development of oral cancer in PNG both in a case-control study and systematic review.
In 2012, the global cancer incidence, mortality and prevalence showed that PNG had the highest rate of oral cavity cancer and oropharyngeal cancer in the Oceania region and in the world. Torosa said awareness on dental issues including oral cancer was important so that people could seek treatment early.
Symptoms of oral cancer
In the early stages, mouth cancer may cause no pain. A visit to the dentist must be made if the following signs and symptoms persist for more than two weeks:
- WHITE or reddish patch or a mixture of both on the inside of the mouth;
- SORE in the mouth, tongue or on the lip that does not heal;
- GROWTH or lump inside the mouth;
- UNEXPLAINED bleeding in the mouth;
- UNEXPLAINED numbness, loss of feeling, or pain/tenderness in any area of the face, mouth or neck;
- DIFFICULTY chewing or swallowing, speaking or moving the jaw or tongue;
- HOARSENESS, chronic sore throat or change in voice;
- EAR pain;
- A CHANGE in the way the teeth or dentures fit together;
- DRAMATIC weight loss.
Risk factors for the development of oral cancer include:
- TOBACCO use of any kind;
- EXCESSIVE consumption of alcohol;
- EXCESSIVE exposure especially of the lips to the sun;
- HUMAN papillomavirus (HPV);
- REGULARLY chewing betel nuts;
- FAMILY history of cancer;
- GASTROESOPHAGEAL reflux disease;
- PREVIOUS radiation therapy in the head, neck or both;
- EXPOSURE to certain chemicals, especially asbestos, sulfuric acid and formaldehyde;
- HAVING a long-standing wound or chronic trauma;
- DRINKING very hot tea, popular in South America.
To prevent or reduce the risk of oral cancer:
- STOP smoking or using tobacco;
- DRINK alcohol in moderation;
- LIMIT exposure to the sun;
- HAVE vaccination to protect against HPV;
- AVOID chewing betel nuts;
- HAVE a regular dental check;
- CONDUCT self-examination of the mouth at least once a month;
- MONITOR changes in the mouth and see a doctor or dentist if any occur; and,
- EATING a healthy, balanced diet.
Stages and treatment
There are four stages of cancer from the earliest advanced; stage 0 to stage III.
Different treatment regimens or combination of treatments are used according to the stages. The treatment for oral cancer include surgery, radiation therapy, chemotherapy, targeted therapy and nutrition.
Betel nut chewing is the main risk factor in PNG, followed by smoking.
However, non-smokers and non-chewers are also at risk of developing cancer due to HPV infections, UV rays, and alcohol consumption.
That is why it is very important that everyone is aware of the early signs of oral cancer and seek medical assistance quickly at the nearby hospitals for it to be treated.