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Rick Bender is sometimes called "the man without a face," a description he feels suitably describes his appearance. After 14 years of using spit (or smokeless) tobacco, he was diagnosed with oral cancer and underwent surgery that resulted in the loss of part of his tongue, half his jaw, and partial use of his right arm. Rick Bender is evidence of the damage oral cancer can do to a face, a person, a life.
ral or pharyngeal cancer will be diagnosed in an estimated
30,000 Americans this year, and will cause more than 8,000 deaths. The disease
kills one person every hour -- more people than cervical cancer, Hodgkin's
disease, or malignant melanoma. When the definition of oral cancer is expanded
to include laryngeal cancer, which shares risk factors with oral cancer,
the number of cases in the United States, per year, climbs to 41,000 and
the number of deaths to 12,500. Oral cancer is the sixth most common cancer
worldwide and the third most common in developing nations.
Some might say the old adage, "the cure is worse than the disease," applies to existing treatments for oral and pharyngeal cancers. Victims of oral cancer not only deal with the debilitating side-effects of radiation and chemotherapy but with the very visible evidence of surgery. Surgery to treat oral cancer is often extensive and disfiguring and may involve removing parts of the face, tongue, cheek, or lip -- causing changes in appearance that can be especially difficult to live with in a society that values physical beauty. Chemotherapy and radiation to the head and neck cause their own problems: jaw pain, mouth sores, and salivary glands that cease to function, resulting in difficulty chewing, swallowing, and talking. Recovering the ability to speak clearly and adjusting to new oral prostheses are additional challenges.
As with any cancer, the threat of death is an overriding fear. Most disturbing about oral and pharyngeal cancer is the survival rate. In the United States it is approximately 50 percent, a statistic that has not changed appreciably over the past 20 years. Oral cancer is unusual in that it carries a high risk of second primary tumors. Patients who survive a first cancer of the oral cavity have up to a 20-fold increased risk of developing a second primary oral cancer. The heightened risk can last 5-10 years, sometimes longer. Until researchers learn more about this phenomenon, second primary tumors will remain a specter faced by all oral cancer patients.
Additionally, oral cancer, like many diseases, continues to take a disproportionate toll on minorities. Incidence peaks in African Americans 10 years earlier than in the general population, in whom the disease is usually diagnosed between ages 65-74. The difference in survival rates between whites and African Americans is staggering -- 55 percent of whites survive five or more years, while only 34 percent of African Americans live that long. African American males suffer the highest incidence and lowest survival rates of any group. Oral cancer is the fourth most common cancer among African American men in the United States.