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Oral cancer symptoms: Causes are on the rise as HPV cases rise in the UK

The number of oral cancer cases in the UK has increased by more than a third over the last decade to a record high, according to a new report.

The number of cases has more than doubled in the last generation, with previous common causes such as smoking and drinking added to by other lifestyle factors.

According to the Oral Health Foundation in the UK, 8,864 people were diagnosed with the disease last year – 36 per cent more than ten years ago, with 3,034 people losing their lives from it in a year.

This means an increase in deaths of 40 percent in the last 10 years and 20 percent in the last five.

The findings are part of the new State of Mouth Cancer UK Report 202, which was published in November with Mouth Cancer Action Month.

In the early stages, the symptoms of oral cancer can be subtle and painless, making them easy to miss.

These may include mouth ulcers that do not heal within three weeks, white or red patches in the mouth, unusual lumps or swellings in the mouth, head or neck, or any persistent hoarseness in the voice.

One in three oral cancers is on the tongue and 23 percent are on the tonsils.

Other places to check for oral cancer include the lips, gums, inside of the cheeks, as well as the bottom and palate.

Almost two out of three people have never had their mouth checked for signs of oral cancer, even though it took less than a minute.

People are three times more likely to be routinely screened for testicular or breast cancer.

Survival rates for oral cancer have hardly improved over the past 20 years, partly because so many cases are diagnosed too late. Just over half of all oral cancer cases are diagnosed in stage four – when the cancer is at its most advanced.

Dr Nigel Carter, chief executive of the Oral Health Foundation, said: “While most cancers are declining, cases of oral cancer continue to rise at an alarming rate.

“Traditional causes such as smoking and excessive alcohol consumption are rapidly being replaced by emerging risk factors such as human papillomavirus (HPV).

“The stigma associated with oral cancer has changed dramatically. Now it is a cancer that can really affect anyone.

“We have seen with our own eyes what a devastating impact oral cancer can have on a person’s life. It changes how someone talks, makes it harder to eat and drink, and often changes a person’s physical appearance.

“During Oral Cancer Month, we will be raising awareness about oral cancer.

“We urge everyone to become more aware of their mouths by recognizing the early signs of oral cancer and being aware of the most common causes.

“Most importantly, if you notice anything unusual, don’t delay and seek help from a doctor or dentist.”

Charlotte Webster-Salter received the life-changing news that she had oral cancer when she was just 26 years old. The former cabin crew member, now in training to become a midwife, does not fit the typical oral cancer patient – being an active young woman who does not smoke.

But Ms Webster-Salter represents the growing number of younger people diagnosed with the condition.

Ms Webster-Salter, who lives in Petersfield, Hampshire, said: “I had several ulcers for about three to four years before I had [mouth cancer] operation.

“At first I wasn’t worried about them because I get exhausted. In my job, I was delayed on plane trips and flew all the time, and often ulcers are a sign of the celiac disease I have, so I put it down to that.

“They came and went but always in the same area, never fully went but lit up when I was exhausted.

“They felt like ulcers but just a bigger blotch and they started to turn white and there were red around them as well so they looked quite inflamed. I thought maybe it was an infection or something.

Just in case Mrs. Webster-Salter went to the dentist and asked about them.

She said: “About a year before the surgery, I went to the dentist and they said, ‘Well, I don’t really know what it is, it could be caused by teeth grinding, so we would advise you to maybe straighten your teeth and get your wisdom teeth out.’

“So I did it. I paid for braces, had a wisdom tooth pulled and had really great teeth but still had ulcers.

“My mother kept telling me to go get it checked, so I went to my doctor who sent me for a biopsy.”

She finally underwent a biopsy in April 2021 after her ulcers got much worse. A biopsy showed that the ulcers were oral cancer.

She added: “I went to get the results and he asked, ‘Do you have anyone with you today? I looked at him and said, “That’s not good, is it?” He replied, “No, it isn’t. I’m really sorry, you have cancer.”

“I remember telling him, ‘What do you mean? Certainly not.” And I think I almost laughed. It was such a shock because otherwise I’m a healthy person.”

Ms Webster-Salter underwent nine and a half hours of life-saving surgery during which part of her tongue was removed. The piece that had been removed was replaced with muscle from her leg.

They also took a lymph node from her neck to see if the cancer had spread, which it hadn’t.

As a result of the swelling after the operation, she had a tracheostomy, in which a tube was inserted into her neck to help her breathe.

Ms Webster-Salter said: “My tracheostomy was fitted for seven days, so my body didn’t swallow or breathe through my mouth for so long that often your muscles take a while to get back into it.

“I remember the first time they tried to take it out. They covered this hole so I could breathe here and it couldn’t, it just couldn’t, I think my body wasn’t ready because it was like suffocating because I couldn’t breathe through my mouth.

“It was like having a mouth full of straw or hay. It was just so hard, so hoarse, so stuck. And I remember the panic I was like no I can’t so they tried again the next day and then every day it got better and better.

After surgery, Ms. Webster-Salter had to relearn how to speak, eat and walk through speech and physiotherapy, but did not require further treatment.

Ms Webster-Salter added: “There is a stereotype about oral cancer. I was told “oh, you’re too young”, “God, this won’t be it”. But it really can happen to anyone, not just smokers.

“People think you have to be a really old man who smokes 50 cigarettes a day, but that’s not the case. I needed this little poster at the clinic to say, ‘Oh my God, it’s oral cancer,’ and by then it was too late anyway.”

The goal of the Oral Health Foundation is to improve people’s lives by reducing the damage caused by oral diseases, many of which are completely preventable.

Oral Cancer Awareness Month runs throughout November.



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