Written By: Dr. Sara Solomon BSc Physical Therapy, DMD

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1 HEALTH & WELLNESS HPV LINKED TO Written By: Dr. Sara Solomon BSc Physical Therapy, DMD The CDC believes that nearly 80% of Americans will be infected with HPV at some point in their lifetime 1. Dr. Sara Solomon received her BSc in Physical Therapy and her DMD from McGill University in 2001 and 2005 respectively. She is a general dentist in Mississauga, Ontario, Canada. Sara is also a certified personal trainer, a SPINNING instructor, a physiotherapist, a certified jump rope specialist with the Jump Rope Institute, a university and continuing education lecturer and a WBFF fitness model. ORAL CANCER FACTS Perhaps you are wondering why a cancer that typically affects 50-something year old male smokers would be featured in a fitness magazine that targets nonsmokers in their 20 s and 30 s? Yes, it is true that oral cancer is historically associated with tobacco use. However, approximately 50-65% of oral cancer victims are nonsmokers and have no other lifestyle risk factors1. There is a new pathway by which people are being affected by this deadly cancer. Exposure to HPV 16 (Human Papilloma Virus 16) is the newly identified etiology 1. DEADLY FACTS 1 Every hour one American dies from oral cancer. Over Americans will be diagnosed with oral cancer this year. Only 57% will still be alive 5 years later. Approximately 50-65% of oral cancer victims are nonsmokers and have no other lifestyle risk factors. Oral cancer is most often discovered in the later stages of its development, the reason for its consistently high death rate. 114 Fit & Firm Magazine - Issue X - January 2011

2 Approximately 50-65% of oral cancer victims are non-smokers and have no other lifestyle risk factors. 1. HPV Virus WHAT IS HPV AND HOW IS IT LINKED TO ORAL CANCER? Human Papilloma Virus (HPV) is one of the most common viruses affecting the body s skin and mucosa. It is estimated there are over 130 HPV strains 1. Some cause warts, some cause cancers and some do not cause anything at all of which we are aware. Oral cancer does not always produce noticeable symptoms. This is why routine opportunistic screenings by your dental professional are so important. The strains that cause warts on the hands, arms, feet and other areas of the skin are common, non-cancerous, transmitted via skin contact and easily treatable. Many strains of HPV are contracted through sexual intercourse, oral sex and even French kissing. Genital warts are associated with HPV 6 and 111. HPV 16 and 18 are known to cause cervical cancer in women, and new studies show that HPV 16 is linked to oral cancer 1. Not only is the HPV positive oral cancer group the fastest growing segment of the oral cancer population, but they are also comprised of a younger group of individuals compared to tobacco related oral malignancies 1. At this time, 9 of the HPV strains are known to cause cancer. Even if you are infected with one of these 9, your immune system (if robust) will likely clear the infection before any damage occurs 1. Do not assume you are in the clear merely because you are asymptomatic: in its early stages, oral cancer does not always produce noticeable symptoms. This is why routine opportunistic screenings by your dental professional are so important. January Issue X - Fit & Firm Magazine 115

3 HEALTH & WELLNESS Anyone engaging in sexual behaviour is capable of contracting and transfering HPV 1.

4 Over 37,000 Americans will be diagnosed with oral cancer this year. Only 57% will still be alive 5 years later. 1 HPV Virus MINIMIZE RISK 1 1. Reduce likelihood of contact with the virus by limiting sexual partners, which reduces opportunity for exposure. 2. Visit your dentist for an oral cancer screening at least once a year. PREVENTION AND EARLY DETECTION Oral cancer is not a rare cancer, and will be newly diagnosed in approximately 100 new Americans per day 1. Dentists and hygienists are the best defense against oral cancer because they are able to identify oral abnormalities at their earliest and most easily treatable stages. Take responsibility for your own health. You are the most important factor in obtaining an early diagnosis. Early detection can tremendously improve life expectancy rates. In fact, oral cancer is 90% curable when detected in its early stages 1. Seventy percent of oral cancers; however, are typically detected in their later stages of development 1, and this accounts for high death rates of about 45% at 5 years from the diagnosis, as well as high treatment-related morbidity amongst survivors 1. At these later stages, metastasis to other locations worsens the prognosis. Late-stage oral cancer treatment not only causes disfigurement, but it also compromises quality of life. Annual oral cancer screening is crucial because you will unlikely notice any visible or painful symptoms in the cancer s early stages. Your dentist can see or feel precursor tissue changes or the actual cancer while it is still very small and treatable 1. Your dentist can perform a head and neck cancer examination in less than 5 minutes. It consists of both visual inspection and palpation. If any suspicious areas are detected, your dentist may recommend a biopsy. A biopsy involves taking a small portion of the suspicious January Issue X - Fit & Firm Magazine 117

5 HEALTH & WELLNESS The high death rate is not because oral cancer is difficult to detect, but rather because it is typically discovered later in its development 1. tissue for examination under a microscope by a pathologist. The pathologist will check for abnormal or malignant cells Palpation of the neck is extremely important. It is becoming increasingly more common to for the HPVpositive cancers to metastasize to the neck before it is even visible on oral soft tissues 1. A hard/firm, enlarged, PAINLESS, fixated node in the neck, if present for more than 3 weeks, should be biopsied 1. Your dentist will also assess your dentition and take radiographs to check for any abnormalities. Ensure you inform your dentist if you use or have used tobacco products. There are vaccines approved for use in PRE-sexual males and females that protect against HPV 6, 11, 16, 18 and the diseases they can cause (genital warts and cervical, vaginal and vulvar cancer). The vaccine must be NOTIFY YOUR DENTIST IMMEDIATELY IF 1 administered prior to becoming sexually active or the odds that you have already encountered one or more of these HPV strains may make it ineffective. These vaccines will likely positively impact oral cancers in the next couple of decades, as vaccinated individuals do not develop HPV-related malignancies in sites far removed from the cervix 1. CONCLUSION Oral cancer is a deadly unforgiving cancer. Any delay in its detection could cost you your life. It can go unnoticed, which is why it is critical to ask your dentist for annual oral cancer screening. Now that you are aware of the facts about oral cancer, spread the knowledge so the death rate associated with this ruthless disease can be dramatically reduced. You notice any of the abovementioned signs or symptoms. Any sore or discoloured area in your mouth does NOT HEAL within 14 days. ORAL CANCER SIGNS AND SYMPTOMS White or red patch. Ulcer (like a canker sore) that does not heal within 2 weeks. Lump or mass in the mouth or neck. Pain or difficulty swallowing, speaking or chewing. Wart-like masses. Chronic hoarseness. Sore throat. Numbness in the orofacial region. Difficulty moving the jaw or tongue. One-sided persistent ear ache. Swelling of the jaw. REFERENCES Fit & Firm Magazine - Issue X - January 2011

6 Photo By: Eva Simon