Exam 3-Oral Cancer Lecture 1 Flashcards
Squamous Cell Carcinoma accounts for __% of cancers in the oral cavity
90% (could be as high as 95%)
What are three types of cancers that make up the other 10% of oral cancer (since SCC makes up 90%)
1.Sarcomas 2.Leukimias/Lymphomas 3.Other carcinomas/adenocarcinomas
In the US about how many NEW cases of OC are diagnosed every year?
30,000
In the US, about how many people will die this year from OC?
9,000
If you practice dentistry for 25 years, how many cases of OC are you likely to see?
2-3
What is the average survival rate from OC after 5 years?
50%
The American Cancer Society groups OC with what type of cancer? What is the survival rate of that cancer alone?
Pharyngeal Cancer…90%
Oral Cancer has the ____ LOWEST SURVIVAL RATE OF ANY CANCER
6th
OC is the _____ most common cancer in BLACK MALES
4th
OC is the ____ most common cancer in WHITE MALES
6th
OC has a higher death rate than these THREE BIG PUBLICIZED CANCERS:
Melanoma, Cervical Cancer, and Breast Cancer
The number of cases and the number of DEATHS attributable to the disease are relatively ________ over the last 5-6 decades
constant
What is the peak age range for incidence of OC?
50-70 years old
OC is Increasing incidence OVER age ___
70
OC increasing incidence UNDER age ___
40
Males out number females in a __:___ ratio
2:1
The overall INCIDENCE rate of the disease is actually _______ slightly
falling
In ___% of cases of oral cancer, the patient was/is a smoker
75% BOOM.
Ummm no shit Sherlock: Longer duration of smoking = _______ incidence of cancer…._________ usage of tobacco = increased incidence of cancer
INCREASED…..INCREASED
Interesting….Risk for ______ and ________ essentially = risk for cigarettes (for intraoral squamous
cell carcinoma)
cigars, pipe smoking
Smokeless Tobacco- A much ______ incidence of development of carcinoma when compared with smoked tobacco
LOWER
Smokeless Tobacco- usually asociated with prolonged use like ___ cans/week and for about ____ to ____ years of usage.
2-3 cans/wk…for 20-30 years of usage
Smokeless Tobacco- What is the major determinant in carcinogenicity? Which form is less carcinogenic?
Moist vs dry snuff….moist has a very low incidence of malignant transformation
Which type of abuse has a statistically GREATER risk for OC than Tobacco?
ALCOHOL ABUSE
The risk for EtOH abuse to develop into OC is greater than a smoker who smokes ___ packs per day!
2
What is the most prominent effect of EtOH on the oral tissue that makes it a carcinogen?
its a DRYING AGENT (alters epithelial metabolism)
What two side kicks (other consequences of abuse) does EtOH abuse have that cause cancer?
1.Nutritional deficiency 2. Detox limited c/o liver disease
What constitutes EtOH abuse?
6 EtOH equivalents/day
What has more of a risk for developing OC: Heavy Smoking and Minimum EtOH or Minimum Smoking and Heavy EtOH?
Minimum Smoking and heavy EtOH has a MUCH greater risk of OC development
What are the 4 factors that degrade the immune system and therefor open the door for cancer?
1.Aging 2.Chronic Nutritional Deficiency 3.Disease States 4.Theraputic intervention
What are the 4 types of Chronic Nutritional Deficiency that can contribute to cancer?
1.Iron deficiency anemia 2.Vit A Def. 3.Vit C Def 4.Vit E deficiency
What is another name for an Iron deficiency anemia?
Plummer-Vinson Syndrome
MUY INTERESTING….Iron deficiency anemia (plummer-vinson syn) can lead to cancer for which two reasons?
1.Increase susceptibility to carcinogens 2.Increased permeability of epithelium
What does having a Vitamin A deficiency do with getting oral cancer? you lose “protective role against ________” whatever the f that means…
precancer
What does having a Vitamin CCC deficiency do with getting oral cancer? Decreased _________/________ of compounds leads to persistence of noxious stimuli
oxidation/reduction
What does having a Vitamin E deficiency do with getting oral cancer? Decreased _______ leads to persistence of _______ substances
anti-oxidant… ionized
What are three main chronic disease states/infections that could lead to Oral Cancer?
1.Candida 2.HPV 3.HHV
Why in the hell would a candida infection lead to OC? Epithelial __________ with disruption of maturation…Persistent/continuous ________ cell presence
hyperplasia…inflammatory
HPV and OC: Produces ________ of cell cycle regulation that compromise immune system surveillance
inhibitors
There is a significant increase in __________ carcinoma today due to HPV
oropharyngeal
Thirty years ago, 15% of the throat cancer was due to HPV, today it is ___%
80%
What are the two main areas of the oral cavity that are affected by HPV caused Oral Cancer?
oropharynx and base of tongue
What are the two main forms of HHV (please give # and nickname) that are closely associated with oral canceR?
1.HHV4 (Ebstein Barr) 2.HHV8 (kaposi’s sarcoma-assoc herp)
Much like HPV, HHV Produces ________ of cell cycle regulation that compromise immune system surveillance
inhibitors
Any chronic disease state that results in persistent/continuous stimulation of the immune system can result in a gradual accumulation of ________ in the affected cells…What are three typical, everyday dental conditions that could theoretically lead to OC?
genetic defects…1.Diabetes 2.Periodontal Disease 3.Lichen Planus
Whats an example of a disease that lowers immune response and therefore can progress to oc?
AIDS
What are three examples of therapeutic interventions that can lead to oral cancer?
1.Chemo 2.radiaiton 3.Organ transplant meds
What are two examples of syndromes (genetic defects) that are risk factors for SOME cancers?? Has there been a specific syndrome that has a risk for ORAL cancer?
1.Basal Cell Nervus Syndrome 2.Gardner’s Syndrome….NOT a specific syndrome assoc with OC
Family history of oral cancer _______ risk of acquiring oral cancer.
increases
DID YOU KNOW: Only ___% of US adults can correctly identify an early warning sign of oral cancer
25%
DID YOU KNOW: Only ___% of US adults know the risk of alcohol abuse
13%
HOLY S! Only ___% of US adults have had an oral cancer exam
14%
Some disturbing news, In ___% of new cases, the patients have absolutely no evident risk factors
25%
WHAT DOES SCC LOOK LIKE?? The white or red plaques called ________ and ________
leukoplakia or erythroplakia
WHAT DOES SCC LOOK LIKE?? Erythroplakia-Often with a smooth _______ appearing surface
velvety
WHAT DOES SCC LOOK LIKE?? Erythroplakia-May have slightly ______ margin
raised
WHAT DOES SCC LOOK LIKE?? Erythroplakia-May have _____ areas speckled over the surface
white
WHAT DOES SCC LOOK LIKE?? Ulcer-often with a raised, ______ border
rolled
WHAT DOES SCC LOOK LIKE?? Ulcer-ften with a very deep, central ______
crater
WHAT DOES SCC LOOK LIKE?? An _________ mass…Often with an irregular ________
Exophytic….surface texture
