While mouth ulcers are a common ailment, we should all be aware that they can also be the early signs of oral cancer.

Dedes Husriani used to be of the mind that mouth ulcers were a common ailment, one that would clear up in time. So when she got one, she took it easy, believing she would get better after a few days.  

However, the mouth ulcer remained even after three weeks, so she went to see a doctor at a public hospital near her house in Tangerang. After two months, the affliction still persisted. Concerned, Dedes decided to visit a bigger hospital in Jakarta where she was diagnosed with oral cancer.  

“It all began with a small ulcer I had in my mouth,” Dedes told The Jakarta Post, adding that previously, she was not familiar with oral cancer.   

“I learned about the disease in November 2017. My advice to all people out there is to never underestimate any small abnormalities in your body. When something is not right, you need to be aware and go to the doctor because every minute counts,” she said.

Yuniardini S. Wimardhani, a lecturer at the department of oral disease research within the school of dentistry at the University of Indonesia, said oral cancer was often defined as an uncontrolled growth of abnormal cells in the soft tissue inside the mouth, especially in parts of the cheeks, tongue and lining of the gums. 

“The first symptom is often a mouth ulcer that appears on the tongue or in the walls of cheeks that lasts more than three weeks. As the ulcer itself does not cause any irritating pain, people often miss the earliest chance to catch the disease,” she said.

She said the most common risk factors that triggered oral cancer were excessive smoking, drinking of alcohol and irresponsible sexual behavior, which increased one’s exposure to Human Papilloma Virus type 16 and 18, also known as HPV. The common habit in Asia of chewing betel nuts also increases one’s vulnerability to contracting oral cancer, as it contains nicotine, one of the most deadly carcinogens, which activates cancer cells. Direct exposure to UV rays and an unbalanced diet can also increase one’s risk of contracting oral cancer.

“The risk factors are actually modifiable as long as a person maintains a healthy lifestyle. Nonetheless, people with a family history of cancer could have been passed down the genetics that increase one’s likelihood of contracting cancer,” she said.

According to the Oral Cancer Foundation, people over the age of 40 have a higher chance of getting oral cancer, but Yuniardini believed the disease knew no age. She said the survival rate for oral cancer was still very low.

“According to scientific literature journals, on average, within five years, only 50 percent of patients with oral cancer survive,” she said.  

A study published by the WHO in 2014, found that oral cancer ranked fifth as the most lethal cancer in Indonesia, and that it was highly likely to impact men of all ages with unhealthy habits.

“The life expectancy for people with oral cancer in Indonesia is still very low because it tends to be diagnosed at a later stage. Usually, it is found in the third or fourth stage. This is crucial because the later the cancer is diagnosed, the lower the chance of survival, even with advanced medication,” Yuniardini said.

Here, knowledgeable dentists play an important role in detecting the earliest symptoms of oral cancer during examinations of their patients’ mouths.

“This can be done by carefully examining the inner part of the lips, lateral borders of the tongue and lymph nodes located in the neck.

“Ideally, a person should visit a dentist every six months to check for any changes to the health of their mouth,” Yuniardini explained. 

In Dedes’ case, she was diagnosed early, so was able to receive timely and adequate medical treatment.

“I need to take antioxidants and regularly rinse my mouth with mouthwash,” Dedes explained.

— The writer is an intern at The Jakarta Post.

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