Tuesday, April 16, 2013

6 Steps to a Thorough Oral Cancer Screening & Early Detection

Last week we brought you the inspiring story of Eva Grayzel, who was diagnosed with late stage oral cancer at age 33, and had about a 15% survival rate. After her amazing defeat of the disease, she has become a champion for early detection, and started Six-Step Screening, a foundation to raise public awareness about the existence and early signs of oral cancer, to inspire oral health professionals to perform thorough and regular oral cancer screenings on every patient, and to provide guidance, support and hope to newly diagnosed oral cancer patients.

This week, we're going to cover the signs of early oral cancer, and how to know if you've gotten a thorough oral cancer screening.

Watch out for the following signs:

  • Changes to the oral tissue such as a red or a white patch, or changes to the texture
  • Persistent sore throat 
  • Difficulty swallowing
  • Chronic sore throat
  • Lump in neck - especially if it doesn't bother you
  • Mouth or ear pain
Six Steps to a Thorough Oral Cancer Screening
Your dentist or hygienist will:

Step 1 - Tongue 'n Gauze: Extend your tongue as far as it can go, examining the sides and underside for white and red patches, and feels your tongue for lumps. NOTE: This is the most common site oral cancers in non-smokers.






Step 2 - Lip & Cheek Roll: Feel for lumps or bumps, looking for white or red areas that should not be there.







Step 3 - Double-Digit Probe: Examine the floor of your mouth from the top and bottom simultaneously for lumps, looking for red and white patches.





Step 4 - Palate Tickle: Check the roof of your mouth for lumps and areas of softness on the hard palette, looking for red and white patches.







Step 5 - Neck Caress: Palpate your neck for enlarged lymph nodes - a possible sign of infection or something more serious.







Step 6 - Tonsil Ahhhhh: Depress your tongue with a dental mirror, examining your tonsils for symmetry, enlargement, redness, or unusual bumps.









Self Exam
Know your mouth. We are told to do self-exams for the breasts and prostate. We are told to check our skin for spots with irregular borders. Now, it's time to check your mouth! Click here to download the self-exam sheet.

Friday, April 12, 2013

A Survivor's Story

In honor of Oral Cancer Awareness month, we're bringing you a story from Eva Grayzel, who is a nationally recognized professional storyteller and performance artist who was diagnosed with Stage 4 oral cancer at age 33. She was never a smoker, and a nondrinker. This is her story.


What Mom puts herself before her kids? I had a canker sore on the left side of my tongue for a month. Everything else seemed more important. Finally, I took the time to see an oral surgeon. "You have two choices - keep an eye on it and hope it heals, or have it removed with a scalpel." I had it out, and the biopsy was negative. 

I had no symptoms for two years. Then the sore returned right over the biopsy site. Once again, it was present for about a month. I returned to the oral surgeon, who reviewed my pathology report and said it was probably the same thing. 
"The results of your biopsy show a hyperkeratotic lesion, a hardening of the skin, like a callus. Nothing to be concerned about."
"Yeah, but this sore won't go away and it really hurts. It's uncomfortable to eat and talk."
"Rinse with salt water, use this gel, and if it doesn't get better, come back."

Now you tell me why the oral surgeon was suggesting that I monitor the health of my tongue! What do I know? I believed it was getting better. I was a good patient, rinsing and using the analgesic gel to relieve the pain from the sore. It didn't hurt quite as much. But, after four weeks I took a good look at the sore and realized it might be getting worse, so I made another appointment with the oral surgeon. 

"Hmm. This has to be caused by constant irritation. Make an appointment with your dentist to have your back molars shaved down They are sharp and may be preventing the healing process. And be sure to come back if it doesn't get better."

I had my molars shaved down.

I really believed it was getting better. It didn't look as red. The white center seemed to be a little smaller. Until one day, I was feeling the gnawing pain in my tongue, took a look under a bright light and realized that it was definitely not getting better. If anything, it looked worse. I called the next day for another appointment a week later. I asked to see a different oral surgeon in the practice who might have a different opinion. 
"Shaving the teeth didn't seem to be enough. You must be biting or gnawing on your tongue at night."

Once again, I really believed the sore was getting better. After another couple of weeks, I developed an earache on the same side as my tongue sore. It was the worse earache I ever had, and actually brought me to tears, even in the middle of the night. So, I saw an ENT who told me I had water on my eardrum. 
"Whenever my tongue hurts, my ear hurts," I told him.
He looked at my tongue. "I don't know what's on your tongue. Has an oral surgeon seen this?"
"Sure," I replied. "I just thought you might have another idea."
"Not really. That is his field. But I will take care of the water on your eardrum."

Time went on and after I had seen two oral surgeons, two dentists, a periodontist, and an ENT, a friend suggested Dr. Mark Urken, a specialist in lumps and bumps in the head and neck region. I didn't know he was an oral oncologist.

After nine months of trying to heal the sore on my tongue, I was finally going to get an answer. I took the bus into NYC for my biopsy on April 1, 1998. Why the bus, when this could be serious? Well, I had no idea, not an inkling that my condition was even remotely serious. My mother met me at the hospital to take me home. She knew something was up when the doctor waited for her to be at my side when he spoke to me. April Fool's jokes were rampant all around, yet the news I heard was no joke.
At first, Dr. Urken used some enigmatic words to describe my condition. I was still a little out of it from the anesthesia. Maybe that was a good thing. He said my lymph nodes were enlarged, and he used the word "carcinoma," but I did not know if that meant benign or malignant. When he looked down and answered in the affirmative, "You are in an advanced stage of oral cancer," I knew had to get home, face my family, and prepare for the invasive reconstructive surgery that lay ahead of me. Twenty-four hours later, I pulled myself up and forged on. I was a cancer survivor now. I had to live up to the title.

At age 33, I was diagnosed with stage 4, squamous cell carcinoma on the lateral tongue. I never smoked, rarely drank alcohol, and never used mouthwashes containing alcohol. I had no risk factors. But, no one is at "no risk for cancer." I endured a modified radical neck dissection, and one-third of my tongue  was reconstructed, followed by 6,000 rads of IMRT.
I'm now a 10-year survivor! Three negative biopsies, a vocal cord polyp, but no recurrence! Lucky me! Due to my talented surgeon and a local radiation oncologist, who was up on the latest and had an operating IMRT when tehre were only 12 of them up and running in the country, and my support network, and my own strength, I pulled through a most debilitating and public disease that you cannot hide under clothing. My work is cut out for me.





With an extraordinarily successful tongue reconstruction and neck dissection, she branched into motivation speaking, telling her story in a way only a professional storyteller can. From the profound insight she gained, she inspires audiences to embrace life. Please visit her website at http://www.evagrayzel.com/

Friday, April 5, 2013

Oral Cancer Awareness Month & FREE Oral Cancer Screenings

The month of April is Oral Cancer Awareness Month, and to help raise awareness, Dr. Lee is teaming up with the Oral Cancer Foundation & is offering FREE Oral Cancer Screenings on Thursday, April 18th from 2 - 5 p.m. and on Monday, April 22nd from 9 a.m. - 12 p.m. The screenings will be on a first-come-first-serve basis.Oral Cancer is not a rare disease, it kills one person every hour of every day, and over 100 new individuals will be diagnosed with it each day. The good news is that if can often be found early in its development though a simple, painless and quick screening. 

Who should get screened?
Every adult! Oral cancer can often be caught early, even as a pre-cancer. With early detection, survival rates are high. Like other screenings routinely given such as cervical, skin, prostate, colon and breast examinations; oral cancer screenings are an effective means of finding cancer in its early, highly curable stages. Make them a part of your annual check up. 

What are the risk factors?
There are two distinct pathways by which most people come to oral cancer. One is through the use of tobacco and alcohol, and the other is through the exposure to the HPV 16 virus; or the Human Papilloma Virus Version 16; which is now the leading cause of oral cancers in the US. It is also the same virus that is responsible for the majority of cervical cancers in women. The quickest growing segment of the oral cancer population is now young, healthy, non-smokers due to the connection to this virus. 

Early indications of oral cancer include: red and/or white discolorations of the soft tissues of the mouth, hoarseness that lasts for a prolonged period of time, and any sore which does not heal within 14 days. Advanced indicators of this disease include: the sensation that something is stuck in  your throat, numbness in the oral region, difficulty in swallowing, moving the jaw or tongue, and a lump or thickening that develops in your mouth or on your neck. 

What is the screening process?
A visual exam of all the tissues in your mouth will be conducted by Dr. Treva Lee, and she will feel the floor of the mouth and portions of the back of the throat to search for any abnormalities. She will also conduct an indirect examination of the nasopharynx and larynx, which involves her feeling the neck for swollen lymph nodes and other abnormalities such as hardened masses. She will also check the inside of the mouth for white patches, red patches, ulcerations, lumps, loose teeth.



We also use a great new technology called the VELscope Vx. The blue light stimulates the natural fluorescence in the soft tissues of your mouth which helps us see disease not visible with the naked eye. The VELscope Vx helps us discover oral disease before it can be seen under ordinary light, and helps us identify oral disease early on while it is still easy to treat. Pictured on the left, you can see the lesion that is difficult to see with the naked eye, but when illuminated by the VELscope Vx, it helps us easily identify the lesion. Our staff could barely wait to try out our new gadget, you can see our hygienist Niki conducting a screening on our marketing assistant Alexis.

Please visit us on Thursday, April 18th from 2 - 5 p.m. and on Monday, April 22nd from 9 a.m. - 12 p.m. to receive your FREE oral cancer screening! Please remember this is by a first come first serve basis, so please arrive early - and bring your friends and family!!
If you have any questions please call our office at: 559-226-3010