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Watch For Warning Signs Of Oral Cancer

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By IRENE MAHER, Channel 8 Medical Editor

Published: December 7, 2007

I rang the doorbell and a tiny platinum blonde with a big laugh announced, "Welcome to the Poore house!"

Annette Poore, 63, of Wesley Chapel, seemed as bright and cheerful as the Christmas decorations that grace her home year-round.

You get the idea that it would take a lot to get this woman down. But something nearly did over the summer, when Annette learned she had mouth cancer. She wanted to share her story because few people give this type of cancer a thought, and like her, may ignore the earliest warning signs.

It all started last April with a little mouth ulcer, Annette remembers. "It was just a sore spot on the back of my tongue. It was very small. You could hardly see it."

But by May she was having trouble talking and eating, so she went to see an ear, nose and throat specialist, who took a tissue biopsy. About a week later she got the news.

"They said it looked like cancer," she says.

Mouth and throat cancer, or simply oral cancer, get lumped together under the banner of head and neck cancer. Oral cancer doesn't get the attention of breast, colon, lung and prostate cancers, but 50,000 new cases will be diagnosed in the United States this year, says Tapan Padhya, director of USF's Division of Head and Neck Oncology at the H. Lee Moffitt Cancer and Research Institute.

The usual targets are hard-core, longtime smokers and drinkers. But, Padhya says, in the last 10 to 15 years a new group of patients has emerged.

"Now we have probably 20 percent or more that are like Annette," he says, "that don't smoke, don't drink, very healthy lifestyle, yet get mouth and throat cancer." Padhya says the prevailing theory about healthy-lifestyle people is that the cancer might be linked to a virus or some environmental cause.

The tiny ulcer on the back of Annette's tongue eventually grew to the size of a silver dollar. Padhya, Annette's surgeon, removed 20 percent of her tongue. She was forced to take medical leave from her job as a first grade teacher at R.B. Cox Elementary School in Dade City. "The children couldn't understand me," she says.

Swallowing and eating are still challenging, and she has to work at keeping her weight up. She makes a batch of pureed soup in a blender every day for lunch and drinks a milkshake in the morning. Her evening meal is solid food.

As oral cancer patients go, Annette is one of the lucky ones. The only evidence of her ordeal is that her tongue (she'll stick it out if you ask) looks like it has an indentation on one side. Many people diagnosed with oral cancer must undergo disfiguring operations to remove the entire tongue or part of the jaw — even the voice box.

Early diagnosis can often prevent such radical surgery if the patient pays attention to early warning signs and gets medical attention at the first sign that something isn't normal. Those signs include a sore in the mouth that gets progressively larger, more swollen or more painful; a persistent sore throat; difficulty speaking clearly; a hoarse or raspy voice; and difficult or painful swallowing. Some patients even develop ear discomfort or ear pain.

"Generally, any symptom that lasts more than a month, you definitely want to have it checked out," Padhya says.

Annette hopes others will learn from her experience and won't ignore something as seemingly inconsequential as a mouth ulcer.

"It was very tempting to let it go," she says. "Because I thought, 'Oh, I've had these before.'"

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