Oral cavity and oropharyngeal cancer

They are a rare type of tumor, less than 5%, affecting the squamous epithelium covering different structures of the mouth (lips, tongue, etc.) and oropharynx (tonsils, throat, etc.). They usually present clinically with diverse manifestations depending on their location. Survival and prognosis are variable depending on the structure affected and the degree of dissemination.

This type of tumors have a fundamentally environmental cause, predominantly related to tobacco and alcohol consumption, although oral infection by the human papillomavirus (HPV) is increasingly relevant, especially in non-smoking and non-drinking patients. In addition, vitamin A and C deficiency, poor oral hygiene or poorly fitted dentures, other Epstein-Barr virus infections, or exposure to ultraviolet radiation in outdoor workers have also been related to oropharyngeal and oral cavity tumors.

Symptoms

They frequently appear after the age of 50 years with very variable clinical forms depending on their location:

  • Lesions on gums, tongue, tonsils or lining of the mouth of whitish or red color.
  • Ulcers or sores on the lip or in the mouth that do not heal well.
  • Constant bleeding from the mouth.
  • Mouth pain, sore throat, swelling or pain in the jaw, ear pain.
  • Difficulty swallowing or chewing, moving the jaw or tongue.
  • Foreign body sensation trapped in the throat that does not go away.
  • Changes in the tone of voice or nasal voice.
  • A lump or thickening of the lips, mouth or cheek, neck, or back of the throat.
  • Loosening of the teeth or pain around the teeth, dentures that do not fit well or are uncomfortable.
  • Weight loss.

Many of these symptoms may be present due to different diseases or even other types of cancer. It is important to see a physician or dentist if any of these symptoms are prolonged over time to identify the cause.

Prevention

Preventive measures focus on avoiding risk factors:

  • Avoidance of tobacco and alcohol as they are the most important risk factors. In addition, the combination of both increases the carcinogenic effect of tobacco. Quitting tobacco also greatly reduces the risk of developing these cancers, even after years of use.
  • Avoid HPV infection often associated with sexual transmission, or get vaccinated against it, preferably at a young age, although adults can also be vaccinated.
  • Limit exposure to ultraviolet light, or in case of sun exposure, protect the head from the sun, use sunscreen and lip balm with a sun protection factor of at least 30.
  • Maintaining a healthy weight and eating pattern based on fruits, vegetables and whole grains, and limiting or avoiding red and processed meats, sugary drinks and highly processed foods, can help reduce the risk of these cancers (and many others).
  • Get regular dental checkups and maintain proper dental hygiene.

Number of observed variants

13.5 million variants

Number of risk loci analyzed in the study

6 loci

Bibliography

The American Cancer Society. [March 2022].

Sociedad Española de Oncología Médica [March 2022].

Cancer Research UK [March 2022].

Lesseur C et al.Genome-wide association analyses identify new susceptibility loci for oral cavity and pharyngeal cancer. Nat Genet. 2016 Dec ;48(12): 1544-1550.

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