December 10, 2014 | by Denise Heady
Even as the overall rate of oral cancers in the United States steadily declines, the rate of tongue cancer is increasing — especially among white females ages 18 to 44.
An oral cancer diagnosis, although rare, is serious. Only half of the people diagnosed with oral cancer are still alive after five years, according to the federal Centers for Disease Control and Prevention. In large part, that's because of the late diagnoses of this disease. Early signs of this cancer in young adults can be easily overlooked by primary physicians.
Although the reason for the rise among young adults is unclear, people can take steps to reduce their risk of serious disease, especially a late-stage diagnosis.
Ellie Maghami, M.D., chief of head and neck surgery at City of Hope, offers this advice:
1. Know your risks.
Smoking and drinking, particularly when combined, are considered the most significant contributing factors to oral cancer. Approximately 75 percent of oral cancers are attributed to the use of tobacco.
Other risk factors include age, sunlight (skin and lips only), poor nutrition, weakened immune system, immune deficiency and genetic syndromes.
However, you don’t have to be a heavy smoker and drinker to have the disease, said Maghami. “Just because you’re a nonsmoker and under 40 doesn’t mean you won’t get cancer. Anyone can get cancer.”
2. Remember that oral cancer isn’t always painful.
Early on, ulcers don’t always cause pain. It isn’t until they're more destructive, and in the later stages, that they become painful.
“Pain by itself is not a telltale sign,” Maghami said. “Ulcers don’t always hurt. So if it’s not bothering someone and it’s not painful, it’s not always easy to tell something is wrong.”
3. Never let an ulcer linger.
If an ulcer hasn’t gone away in two weeks, have it checked out. A persistent ulcer in your mouth is not normal.
“If you have a sore in your mouth, no matter where it is in your mouth, no matter what gender you are, your age, your smoking status, your sexual history — no matter what — an ulcer that’s there for two weeks needs an exam with a biopsy,” Maghami said.
4. Get a second opinion.
Don't necessarily rely on the first physician you see, Maghami said. Patients must be their own advocates and take an active role in their health concerns.
“Community providers may be unfamiliar with the presentation of tongue cancer in young nonsmokers as it is generally a rare occurrence,” Maghami said. “They’ve never seen it or they don’t know that it can happen."
Bottom line: If the problem has not resolved itself in a couple of weeks, get a second opinion. If you’re not getting the answers you need from one person, get a second opinion.
5. Be mindful of your body.
“Be mindful of what’s normal for you and what is not the normal you,” Maghami said. “If you have this unexplained pain or discomfort, you should see someone for it.”
One way to be mindful of your body is to check your mouth regularly for anything unusual. You can look at the tongue, under the tongue, gum, cheek and the palate. All these areas are visible. This is easy to do while brushing your teeth. Simply take a look in your mouth. Also, if something doesn’t feel right, look at the area to assess for potential abnormalities.
Learn more about treatment of head and neck cancers at City of Hope.
Learn more about becoming a patient or getting a second opinion at City of Hope by visiting our website or by calling 800-826-HOPE (4673). City of Hope staff will explain what's required for a consult at City of Hope and help you determine, before you come in, whether or not your insurance will pay for the appointment.