1. Cancer: The Clinical and Diagnostic Approach
John P. Gobetti, D.D.S., M.S.
Oral Medicine/Diagnosis Section
Dept. of Oral Medicine, Pathology, Oncology
University of Michigan School of Dentistry
Ann Arbor, Michigan
(734) or (734)

2. Cancer Facts 1.4 million new cases diagnosed every year
29,000 oral cavity/pharynx
19,000 men and 10,000 women.
7,300 deaths, 4,910 men and 2,410 women.
Higher number of deaths than Hodgkin’s Disease, and cervix, brain, and thyroid cancer.

3. Oral Cavity/Pharynx Cancers
Highest incidence/mortality rates in African Americans.
Five year survival rate 56%.
Majority are squamous cell carcinomas.
Ventrolateral border tongue
Floor of mouth
Lip
pharynx

4. Oral Cavity/Pharynx Cancers cont’d
90% in people 45 years and older.
Average age of diagnosis 60 years old.
Most cases attributed to tobacco use.
Cigarettes, cigars, pipes, and smokeless tobacco

5. Oral Cavity/Pharynx Cancers cont’d
Other risk factor includes:
Human papilloma virus (HPV)
Low consumption of fruits/vegetables
Long-term sun exposure, lip cancer
Chronic alcohol use

6. National Health Objectives – Healthy People 2010
Reduces oropharyngeal cancer rate.
Increased early detection.
Increased availability of oral cancer examinations.
American cancer society recommends:
- annual oral cancer examination at years old and older.
- three year oral cancer examination 20 to 39 years old.
Only 13% of those 40 and older reported oral cancer examination (1994).

7. Signs and Symptoms of Oral Cancer
Signs and symptoms include:
Sores that do not heal
Lumps on lip, mouth, or throat
White and/or red patches
Unusual bleeding, pain, or numbness in mouth
Sore throat that does not go away
Difficulty or pain with chewing/swallowing

8. Survival Rates 1 year – 81% 5 years – 59% 10 years – 44%
15% of newly diagnosed oropharyngeal cancers will have another cancer in nearby areas, larynx, digestive systems, or lungs.
10 to 40% develop a second oral cancer or cancer in associated organs.