When Wayne Eisman was being trained as a physician in the early 1980s, 99.1 percent of people diagnosed with oral cancer had it because of alcohol, cigarettes, or both.
There has been a “complete flip-flop.”
Substances still account for many cases of throat and tongue cancer, but there is a new offender in the fight against oral cancer.
“Now, in head, neck and throat offices, 60 percent of these patients they”™re seeing have causes related to HPV (human papillomavirus),” said the president of ENT and Allergy Associates, a Tarrytown-based medical practice with 37 offices throughout New York and New Jersey. “What may be the problem is, there are 200 strains of HPV and only a couple cause cancer of the cervix. A couple of those cause cancer of the tongue or tonsil and for some reason, some people just don”™t have the immunity that gets rid of this virus.”
It”™s estimated nearly 37,000 Americans will be diagnosed with oral cancer this year; it will cause more than 8,000 deaths.
Of the 37,000 diagnosed, 57 percent will be alive in five years.
“In its early stages, oral cancer is unremarkable in appearance and it looks like a million other nonsignificant findings in the mouth,” said dentist Kenneth Magid, co-owner of Advanced Dentistry of Westchester in Harrison and clinical associate professor at New York University College of Dentistry. “That”™s why it”™s deadly. Some doctors say you can look in the mouth and find it. No, you can”™t. That”™s why it”™s usually diagnosed in stage three or four.”
ENT and Allergy Associates integrated its community-based office system into an advanced surgical program at Mount Sinai Medical Center for treatment of head, neck and esophageal cancer.
Both ENT and Advanced Dentistry invested in technology for screening these types of cancer; one method is the OralCDx Brushtest for the biopsy of cells and the VELscope Vx, a device that emits a green light when viewing healthy cells and a lack of fluorescence in problem areas.
“It becomes oral cancer prevention and not oral cancer diagnosis,” Magid said of screening patients the recommended one-time each year and every six months for smokers and drinkers. “In my private practice, we found men and women (with tissue cell abnormalities). In the early stages, the survival rate is over 90 to 95 percent if found early.”
Eisman said the HPV vaccine Gardasil, primarily administered to young people, will protect against the most common strains of HPV.
However, if an individual has already come in contact with the virus, the vaccine does little to protect against any side effects.
For some, symptoms or signs of cancer may take 10 to 20 years to develop.
“I had someone come in whose husband had this problem in his throat, she did some reading and she wondered ”˜who”™ it was,” Eisman said. “When she had married him, she said she was a virgin. But, he may have come across this many years beforehand”¦ We”™re on the cusp of a pandemic. A lot of people out there have this. The incidents are startling.”
