One of our cousins announced that she was diagnosed with late stage HPV-related tonsillar cancer. She was a fitness trainer having dedicated her life to healthy living.  After a heroic and relentless battle with the disease, she lost her life 16 months later at the age of 46. This month would have marked her 50th birthday.  She leaves behind a husband and three beautiful daughters.  A wonderful life that gave so much to others gone far too soon.

The changing face of oral cancer

There are two distinct pathways related to the cause of oral cancer: smoking and sexually related HPV. It is the second pathway that has caught both the medical and dental profession off guard. Over 75 percent of sexually active Canadians will have an HPV infection in their lifetime.  For those who are health compromised, or have had persistent exposure and infection to a high risk strain of HPV, abnormal cell development may occur and advance to a malignancy. The highest risk for transmission of HPV is through oral sex; however, it may be passed on through kissing if the virus is active in the mouth.

“The biggest misconception surrounding oral cancer is that if you are a non-smoker, non-drinker you are not at risk.”

The biggest misconception surrounding oral cancer is that if you are a non-smoker, non-drinker you are not at risk. In a 20 year study, smoking related or non-HPV related oral and oropharyngeal cancer had declined by 50 percent, while HPV-related oral and oropharyngeal cancer had increased by 225 percent. Historically we would have identified the older male who was a heavy smoker and possibly heavy drinker. However, now, it is the younger male who is often a non-smoker, non-drinker.

Prevalence and prevention

HPV is the fastest growing sexually transmitted disease worldwide. Research suggests that by 2020, HPV-related oral and oropharyngeal cancer will surpass HPV-related cervical cancer — making it the predominant HPV-related cancer in Canada.

Regular oral cancer screenings by your dentist or dental hygienist as well as self-examination are critical. Also, there are additional screening devices that are available to identify what normal white light examination may not have revealed. The Gardasil vaccination is also important to protect against nine high-risk strains of HPV.  As more young boys and girls are vaccinated, we will begin to see the decline of this escalation in oral cancers. However, even oral sex is not safe sex as it is the highest mode of transmission for the HPV virus and its connectivity with oral and oropharyngeal cancers.

The hopeful future

The present challenge is to elevate awareness amongst dental professionals to effectively screen and be aware of subtle life-saving symptoms when treating today’s dental patient. The future is to see much earlier awareness of oral cancer discovery, better survival outcomes, and enhanced quality of life for survivors.