VELSCOPE- ORAL CANCER SCREENING

Every hour of every day, one American dies of oral cancer. The mortality rate associated with oral cancer has not improved significantly in the last 40 years. The death rate in the United States for oral cancer is higher than that of cervical cancer, Hodgkin's disease, cancer of the brain, liver, testes, kidney, or ovary.

More than 30,000 Americans will receive an oral cancer diagnosis this year. In five years, only 57% will still be alive. 27% of oral cancer victims do not use tobacco or alcohol and have no other lifestyle risk factors.

Oral cancer is one of the most curable diseases when it's caught early. That's why the VELSCOPE exam has been developed. VELSCOPE uses technology that has proven successful in identifying soft tissue abnormalities in other areas of the body. An VELSCOPE exam is particularly important if you are at increased risk for developing oral cancer.

An annual VELSCOPE exam, in combination with a regular visual examination, provides a comprehensive oral screening procedure for patients at increased risk for oral cancer. The VELSCOPE exam is painless and fast, and could help save your life.

Benefits and Expectations:
When oral cancer is found at the earliest stage, treatment is quicker, simpler, less involved, and more then 90% successful! When oral cancer is diagnosed in late stage, treatment is expensive, disfiguring and has a poor survival rate.

VELSCOPE is a technology used by us to assist in the early detection of abnormal tissue in your mouth. VELSCOPE helps us see abnormal tissue that is not visible during a regular exam. At the conclusion of a VELSCOPE exam, following a standard visual exam, you can be confident you have received the most comprehensive oral cancer screening available

Who is at Risk?
Oral Cancer Risk by Patient Profile:

Increased Risk: Patients age 18-39 with no lifestyle risk factors

High Risk: Patients age 40 and older with no risk factors OR patients age 18-39 with lifestyle risk factors

Highest Risk: Patients age 40 and older with lifestyle risk factors or patients with a history of oral cancer.

Risk Factors:
Lifestyle risk factors for oral cancer include:

1. Tobacco use (any type, any age, within 10 years).
2. Alcohol consumption of at least 1 drink per day (3 ounces of hard liquor, 4 ounces of wine, or 12 ounces of beer).
3. Immune deficiencies such as HIV & AIDS
4. Human Papilloma Virus, particularly HPV 16/18

Oral cancer most commonly involves:

1. The front 2/3 of the tongue
2. The lining of the cheeks and lips (the buccal mucosa).
3. The floor of mouth under the tongue.
4. The roof of the mouth (hard palate).
5. The gums (gingiva).
6. The small area behind the wisdom teeth (the retromolar trigone).
7. The minor salivary glands.

Most oral cancers look very similar under the microscope and are called "squamous cell" carcinomas. These are malignant and tend to spread rapidly.

 Squamous Cell Carcinoma:
Squamous epithelium is the tissue that lines the mouth, throat, tongue and tonsils. These tissue cells are irregularly shaped and very flat. Squamous epithelium also lines other body cavities and capillaries to reduce friction, as well as lining the lungs to facilitate gas exchange.

Carcinoma is any malignant cancer that arises from epithelial cells. Carcinomas invade surrounding tissues and organs and may "metastasize"., or spread, to lymph nodes and other sites.

 Metastasis, is the spread of a disease from one organ or body part to another non-adjacent organ or body part. Only malignant tumor cells and infections have the capacity to metastasize. Cancer cells can "break away", "leak", or "spill" from a primary tumor, enter lymphatic and blood vessels, circulate through the bloodstream, and settle down to grow within normal tissues elsewhere in the body.

Oral Cancer is often detected late in development, when the possibility of metastasis is much greater. Like most cancers, cancer of the lip and oral cavity is best treated when found early - when cure rates are greater than 80%.

Determination of the stage of cancer in the lip or oral cavity is important in order to plan the best course of treatment.

There are a number of stages:

• Stage I. The cancer is no more than 2 centimeters and has not spread to lymph nodes in the area

• Stage II. The cancer is more than 2 centimeters but less than 4 centimeters and has not spread to lymph nodes in the area.
• Stage III. Either of the following may be true - the cancer is more than 4 centimeters; the cancer is any size but has spread to only one lymph node on the same side of the neck as the cancer.
  
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• Stage IV. Any of the following may be true - the cancer has spread to tissues around the lip or oral cavity; the lymph nodes in the area may or may not contain cancer; the cancer is any size and has spread to more than one lymph node on the same side of the neck as the cancer, to lymph nodes on one or both sides of the neck, or to any lymph node that measures more than 6 centimeters.
• Recurrent. The cancer has returned after it has been treated. It may come back in the lip and oral cavity or in another part of the body.