Oral cancer: What does sex have to do with it?

The incidence of oral cancer is on the rise among men, and researchers say the cause is not the use of tobacco and alcohol,

risk factors we have been aware of for years. According to them, the culprit is the human papillomavirus, virus transmitted through oral sex, reports Sade Oguntola.

Oral sex may be viewed as being safer than intercourse. Certainly, people think more about risks coming from intercourse. But oral sex does have risks - human papillomavirus, or HPV, the sexually transmitted virus responsible for the majority of cases of cervical cancer and genital wart in women.

Unfortunately, people are especially at risk for spreading HPV because the virus oftentimes does not show symptoms, as it has the ability to “hide”. The virus is able to evade the immune system and trick the body into thinking that nothing is wrong. Unluckily, even when genital warts appears several weeks or months after exposure, most cancers do not develop for many years.

Tobacco and alcohol users traditionally have been considered the populations at the greatest risk for these cancers. But doctors have not been able to link tobacco use with the rising oral cancer rates, especially among sexually active adults, since they do not smoke.

Oral cancer is cancer that arises in the head or neck region, including the nasal cavity, sinuses, lips, mouth, thyroid glands, salivary glands, throat or larynx (voice box).

Recent research indicates that the increase in oral cancers cases among sexually-active adults who do not smoke, is due partly to the increase in number of people with the human papillomavirus (HPV) virus, a cancer-causing infection that can be transmitted by oral sex.

A study by the American Association for the Advancement of Science found that the spread of HPV by oral sex was the number one cause of oral cancers, surpassing tobacco and alcohol. Certainly, the situation is not different in Nigeria. “We have seen quite a number of young people with oral cancer, who do not smoke or drink, which was connected to HPV,” stated Dr Ifeolu Akinmoladun, an oral cancer expert at the University College Hospital (UCH), Ibadan, Oyo State.

Certainly, all cases of oral cancer cannot be attributed to oral sex. However, Dr Akinmoladun declared “when you see oral cancer in younger people, oral sex could be one of its reasons.”

Unfortunately, HPV-related oral cancers are more difficult to detect because these cancers usually occur on the back of the tongue or on the tonsils, providing even more reasons to get screened regularly.

Two risk factors that greatly increase the risk of head and neck cancers are the use of tobacco products and frequent and heavy consumption of alcohol. According to Dr Akinmoladun, “tobacco is a singular risk factor for cancer in the neck and head region. But where an individual uses tobacco and also drinks alcohol, the chances of oral cancer goes further up.”

Dipping snuff, putting it inside the mouth, under the lip or between the cheek and gum, is especially popular among elderly women and artisans. But any form in which tobacco is used including this habit of dipping snuff, Dr Akinmoladun declared, significantly increases the risk of mouth cancer.

In fact, a study published in the New England Journal of Medicine suggested that longtime users of snuff are nearly 50 times more likely than nonusers to get some forms of oral cancer.

Dentists and dental hygienists play a front-line role in the battle against oral cancers, which kill many people all over the world even though these are diseases that are usually treated successfully when detected early. For instance, a week long free screening for oral cancers offered by the Oral, Head and Neck Awareness Initiative at the University College hospital (UCH), Ibadan, Oyo State, seeks to achieve this aim.

Many people do not recognize the symptoms of these cancers, which underscore the importance of everyone getting screened properly, not just those at a high risk such as tobacco and alcohol users.

But Dr Akinmoladun stated that a physical examination of the neck, oropharynx (the middle section of the throat that includes the soft palate, the base of the tongue, and the tonsils) and the mouth should be a routine dental examination which individuals should undergo at least once in a year to ensure early detection of these diseases and prompt treatment.

Nevertheless, he declared that when people notice red or white patches in the mouth that last more than two weeks, a change in voice or hoarseness that lasts more than two weeks, sore throat that does not subside or pain or swelling in the mouth or neck that does not subside, they should report such to the hospital.

In addition, he stated that sores in the mouth, difficulty in speaking or swallowing, difficulty breathing, ear pain and bleeding from the nose should be reported to the hospital to rule out oral cancers.

“For instance, a red or white patches that does not bleed or give pain should raise suspicion. Ordinarily, when a sore occurs, it heals in less than 10 days. But when it is not healing and it is not painful, then that is suspicious. A sample of it would have to be taken to ascertain that it is just an ordinary sore,” he said.

Although HPV-related oral cancers are more difficult to detect because these cancers usually occur on the back of the tongue or on the tonsils, however, there is hope. If it is diagnosed early, these cancers can be more easily treated without significant complications, and the chances of survival greatly increase.

Conversely, Dr Akinmoladun advocated increased intake of fruits and vegetables. ”Nutrition is very important in the prevention of cancers.

People who are nutritionally deficient, particularly in trace metals (such as selenium and zinc) and antioxidant vitamins such as Vitamin A, C and E, stand a higher chance of developing oral cancers. Fruits and vegetables are rich sources of fibre found to be protective against cancer, unlike the processed foods that many people eat,” he said.

Even though avoidance of risk factors for oral cancers such as tobacco and alcohol are protective, he declared: “This does not confer 100 per cent protection from these cancers. Currently, we do not know all the risk factor for the cancer, but at least avoiding the known ones will reduce one’s chances of coming down with these cancers.”

Source : tribune.com.ng