Speaking out about mouth cancer
Mouth cancer action month in November is a charity campaign. It aims to raise awareness of mouth cancer and save thousands of lives through early detection and prevention. So what causes mouth cancer and what are we doing about it here at Worldwide Cancer Research?
How many people get mouth cancer and how bad is it?
Worldwide, more than 300,000 new cases of lip and mouth cancer were estimated to have been diagnosed in 2012. That's the same as the entire population of Nottingham, England.
In the UK alone, mouth cancer cases have increased by a third in the last ten years. That means that for every two people that were diagnosed in 2005, that figure is now 3 people. And it is predicted to increase more in the future.
Worldwide, more than 145,000 people were estimated to have died from lip and mouth cancer in 2012. To give you an idea of how many people that is, it is more than the entire population of Cambridge. In the UK it kills around 6 people very day and death rates have increased by around 10% in the last ten years. Last year in the UK mouth cancer claimed more than 2000 lives – more than road traffic accidents and more than testicular and cervical cancer combined.
What causes mouth cancer?
There are some known risk factors including smoking, alcohol and infections that are heavily linked to the disease and account for the vast majority (91%) of cases. Second hand tobacco smoke, chewing tobacco and a poor diet low in vegetables and fruit are also linked to a higher risk of oral cancer.
Smoking tobacco (cigarettes, pipes and cigars) accounts for roughly two out of every three cases. Drinking excessive amounts of alcohol is associated with roughly one in three oral cancer cases. But don’t worry – using mouthwash containing alcohol has no effect.
In terms of infections, the human papilloma virus (HPV) is a big risk factor. It can be contracted through oral sex which is why it is linked to mouth cancer. Many experts believe it could overtake tobacco as the main cause of oral cancer in the next ten years.
HPV is very common and most sexually active people will get it at some point in their lives. The majority of infections go away themselves in a couple of years. But in other people it is responsible for genital warts and abnormal tissue growth which can cause oral and cervical cancer.
But these risk factors are not always the cause. It also depends on a person’s age and genetics - it can affect anyone. That is why it is important to get any mouth ulcer that has been present for more than 3 weeks looked at. And don’t ignore any red or white patches in your mouth – get it checked by your doctor or dentist.
What are we doing about oral cancer?
We are currently funding Dr Salvador Aznar-Benitah (pictured above) at the Institute for Research in Biomedicine (IRB) in Barcelona, Spain. Dr Aznar-Benitah is identifying and characterising the cells in tumours of the mouth and lip that allow the development of secondary tumours.
One of the main factors making tumours so dangerous is their ability to spread, known as metastasis. Individual cancer cells squeeze between the normal cells nearby and push their way through the tissue. They are then carried in the blood stream or lymphatic system and can form new tumours in other parts of the body, known as secondary tumours or metastases. These tumours can stop key organs from working which can have dire consequences for the patient and make successful treatment much more difficult.
There is still much that scientists don’t understand about the tumour cells that are able to break away from the original tumour. Dr Aznar-Benitah is using his Worldwide Cancer Research grant to study these cancer cells in tumours in the lining of the mouth and lips.
The team have already identified a group of cells within these tumours that may be the 'cells of origin'. They are using this grant to further investigate what makes these cells unique from the rest of the tumour cells and what characteristics enable them to break away and start new tumours.
The work is being done using mouse models of the disease and samples taken directly from human tumours of the mouth and lip lining. As this project involves studying how cells move from the mouth and lip to other places in the body it simply would not be possible without the use of mice.
If Dr Aznar-Benitah is able to identify how these cancer cells break away and start new tumours then his team, or other scientists, could begin work on finding ways to stop the process from happening. If scientists can stop tumours from spreading, successful treatment of a patient would be much easier to achieve.
Watch Dr Aznar-Benitah talk about his cancer research journey here.
Saving lives through oral cancer screening
Dr Rengaswamy Sankaranarayanan, Chief of the Cancer Screening Group at the International Agency for Research on Cancer (IARC), in Lyon, France received 9 years of Worldwide Cancer Research funding.
He showed that three rounds of screening for oral cancer reduces deaths by a third. This was one of the first large-scale studies showing that simple screening methods can significantly cut mouth cancer deaths. The work we funded is driving screening policies around the world. For example by helping to influence the American Dental Association guidelines on oral cancer screening, and helping to save lives, particularly in developing countries.
We are eager to stop lives being cut short by oral cancer. To help this become a reality, we have recently awarded a grant to identify genetic changes when mouth cancer starts so that it can be diagnosed earlier. This work will start in early January 2016, watch this space!