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Southern Ocean County Hospital would like to thank everyone who e-mailed questions for this edition of Ask-The-Expert and would like to especially thank Dr. Engle for taking part in the program.

July : Oral, Head and Neck Cancer

Question 1
I have a white spot on the side of my tongue that has been there for about two weeks. I didn’t think it was anything to worry about but now I’m not sure. It doesn’t hurt or anything, and I don’t smoke or use chewing tobacco. Do you think it might be oral cancer?

If the white Spot (leukoplakia) on your tongue has only been there for two weeks it can possibly represent irritation for traumatic rubbing of your tongue against your teeth. If the white spot has been there 4 weeks or more you should get it checked to rule out a squamous cell cancer. Smokers are not the only people that get oral cavity cancers; there has been an association with poor dentation, diet and employment in textile industries. Verrucous leukoplaki-warty type surface has the greater tendency toward malignant transformation. The majority of these white tongue lesions in non-tobacco users DO NOT turn out to be cancers but if it has been present for over 4 weeks you should get it looked at.

Question 2
Whenever I go to the dentist he checks me for oral cancer. What is he looking for? Is a dentist a good way to get an oral cancer screening, or should I see an ear, nose and throat specialist?

Certainly dentists are more than capable of evaluating for oral cancers. You can check routinely yourself; look far white spots or plaques (leukoplakia), severely red areas (erythroplakia), or ulcers that never completely heal. If these are painless and have been present for over one month get it checked. Certainly a second opinion would not hurt.

Question 3
Can oral cancer spread throughout the body? Is it fatal like some other cancers?

Absolutely! Oral cancers can spread throughout the body. Base of tongue cancers have one of the highest rates of metastases (spread) – approximately 70%

Dr. Engle's answers are informational only and should not be used as a diagnosis or for treatment. Please talk to your physician about official diagnosis of your condition and treatment.