Oral Cancer Exams and Biopsies
Any visit to our office includes an oral cancer exam. However, you are the most important factor in an early diagnosis of a change you notice in or around your mouth. You should look for: A sore or lesion in the mouth that does not heal within two weeks.
- A lump or thickening in the cheek
- A white or red patch on the gums, tongue, tonsil, or lining of the mouth
- A sore throat or a feeling that something is caught in the throat
- Difficulty chewing or swallowing
- Difficulty moving the jaw or tongue
- Numbness of the tongue or other area of the mouth
- Swelling of the jaw that causes dentures to fit poorly or become uncomfortable
These symptoms may be caused by other, less serious problems, but they also indicate the possible presence of oral cancer. After the physical examination of your mouth, if we find any areas that are suspicious, we may recommend a biopsy. This is simply taking a small portion of the suspicious tissue that is sent to an oral pathologist for examination under a microscope.
Types of Biopsies
Incisional
The most traditional type of biopsy is incisional. In an incisional biopsy, we will remove part or the entire lesion depending on its size and our ability to define the extent of it at this early stage. The sample of tissue is then sent to a pathologist who examines the tissue under a microscope to check for abnormal or malignant cells.
Fine Needle Biopsy
When dealing with an area of significant mass, such as an enlarged lymph node, fine needle aspiration cytology (fine needle biopsy or FNB) is reliable and relatively inexpensive. A small needle attached to a syringe is inserted into the questionable mass, and cells are aspirated, or pulled out into the syringe.
Punch Biopsy
In this case, a very small circular blade is pressed down into the suspect area cutting a round border and removing a perfect plug of cells from the sampled area. The area where the plug was removed will not bleed much, and heals normally without the need for any stitches since it is so small.
OralCDx
Another new way to test for oral cancer is a system called OralCDx. Using a special, hand-held brush, we take a small sample of tissue from the suspicious lesion. The sample is put on a slide and sent to the CDx Laboratories. At the lab, computers use advanced robotics, scanning and imaging techniques technology originally developed for the defense industry to accurately examine the thousands of cells on the sample. The computer is able to look at every cell, compare them to libraries of normal and abnormal cells and determine which cells are potentially problematic. A summary report is returned to us for our files or for further discussion with you. If the OralCDx test is positive or atypical, we will then confirm it with a standard incisional biopsy. If the OralCDx test turns out to be negative, but the lesion persists, it should receive a follow-up evaluation.
Velscope : It Could Save Your Life
Did you know that oral cancer steals the life of one American every hour? We don't hear much about oral cancer, but 34,000 patients were diagnosed in 2007. Only half of patients diagnosed with oral cancer will survive longer than five years. Because it is often detected in the later stages, oral cancer's mortality rate is higher than that of cervical cancer, Hodgkin’s disease, brain, liver, kidney, or ovarian cancer. Treatment for oral cancer often causes disfiguration and lessens the patient’s quality of life.
Thanks to an amazing new technology, VELscope, dentists and hygienists can quickly and painlessly screen for oral cancer. VELscope is a fluorescence-based identification system that detects tissue abnormalities and is used in combination with traditional visual exams.
All adults should have an annual VELscope exam because a quarter of oral cancer victims are non-smokers, don't drink, and have no lifestyle factors to heighten their oral cancer risk. Men over 40 and women between the ages of 20 and 40 are the most prone to the disease. Patients with lifestyle risks, including any tobacco use, daily alcohol consumption, viral infections, autoimmune deficiencies like HIV, and diabetes may need more frequent evaluations.
The screening involves use of a special light to illuminate abnormal cells so that they appear distinctly different from the surrounding normal tissue.
While the statistics on oral cancer are discouraging, when the disease is found and treated in the early stages it has an 80 to 90-percent cure rate. Ask your dentist about whether you could benefit from a VELscope oral cancer screening.
