Maxillofacial Cancers

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20-20 Voice Cancer    

     Please also refer to: Facial cancers

     Welcome to a wh0le new world of cancers folks, a world that I was oblivious to….. until a few weeks ago. I attended a meeting with other head & neck cancer sufferers and was amazed to find so many different stories from so many different people! Welcome to the “maxillofacial” world of cancer! So, what are oral and/or facial cancers? (And yes, I do know that we have other headings along similar lines )

     Orofacial cancers are cancers of the mouth cavity or face. They can be classified by pathologists as different histological types and more than 80% of the cancers that we see   are squamous cell carcinomas (SCC) that have arisen from the skin (mucosa) of the mouth and lip.

     Mouth cancer is not one of the most common cancers but it is as common as cervical cancer, and it seems to be becoming more common (we don’t yet understand why this is).

     Please also refer to : Mouth cancers

Each year, there are over 2,500 new cases of orofacial cancer diagnosed in people living in the UK. This figure might be up to 25% higher because people don’t recognise that they have a small cancer and do not seek help at an early stage. Taken together, oral and facial (orofacial) cancers are the sixth most common cancers worldwide.

     Worryingly, the incidence of orofacial cancers has risen over the past 20 years in both the oral cavity and its adjacent structures such as the lips. Throat cancers have rocketted by 600% in the past decade!

Specialists are particularly concerned about the increase in incidence of cancer of the tongue, which tends to affect younger people, aged under 40 years old and more women than men.

How treatable are oral and facial cancers?

There has been much progress in the diagnosis and treatment of most cancers over the past few decades. Unfortunately, the prognosis of orofacial cancers has not yet benefited from these advances. Taken together, the 5-year survival rate remains at less than 55%, which is low for cancers in general. Despite our best efforts, at least 1,400 people will die each year in England and Wales as a result of their oral and facial cancer.

How can I keep a look-out for early oral and facial cancers?

     As with many cancers, we should be aware of what is normal for our body and keep an eye out for changes that might be early warning signals. The patients themselves are most likely to spot changes that might be early cancers of the mouth or face. The general rule is that if you see anything that is ‘new’ and doesn’t go away after three weeks of careful watching, go to see your dentist (if it is in your mouth) or doctor, who can refer you to a specialist oral and maxillofacial surgeonI have met people that have had some of these almost unbelievable forms of cancer:

under a tooth! in a gum! palate of the mouth! inside lower lip! tonsil cancer (our very own Ray Coates!), oral cavity & oralpharyngeal cancers, base of tongue cancer, cheek tissue (skin) cancers, nasal cancers, eye cancers, salivary gland cancers – and many more unfortunately.

AWARENESS: (Survey available here)

     However, the good news is that the majority of cancers of the head and neck are potentially curable if caught early enough and this is where the “20-20 Voice” Cancer “Awareness Survey”  will play a major part in people’s lives & survival. We have had our survey/questionnare sent in from all corners of the globe and the one major factor that stands out is the total LACK OF AWARENESS: we are addressing that situation with the inestimable help of our colleagues at the Leicester Royal Infirmary.

     Fortunately most head and neck cancers cause early symptoms.

 Some easy to recognise symptoms of head and neck cancer are:

  • a lump in the head and neck region.

  • ulcer in the mouth or a growth from the cheeks, tongue, palate or gums.
  • loosening or pain associated with teeth.
  • change in ability to swallow, chew or move the tongue
  • bleeding.

  • pain.

  • weight loss or change in diet.

  • changes in the skin or oral mucosa.
  • persistent earache, jaw ache, discomfort in the tongue or mouth.
  • unusual swelling, hard or soft.

      If any of these symptoms last more than two weeks you should be seen by your GP as soon as possible.

If your GP is concerned he or she will then refer you to see one of the ENT Consultants at your local hospital and they will quickly determine what is going on in the affected area.

     Of course not all lumps in the jaw, neck or mouth are cancerous so it is best to seek the advice of your GP before you become concerned. Equally so these days, dentists are moving into the front line as they are being trained to spot ‘offending sites’ that may be the start of a small cancer. This is great news as they can then recommend you see your Dr immediately who will then start the whole hospital referral proceedure  for you!

     Again, it is speed & awareness that saves the day! If the problem is is deemed to be worthy of an ENT visit do NOT go into instant panic mode! Keep calm, present yourself at the earliest opportunity and let your ENT specialists do what they do best.

A note from a head & neck cancer sufferer: (“Jim”)

While you think you are both physically and mentally prepared for head and neck surgery, nothing hits you harder than waking up and not being able to talk. Buying a note book and pen prior to admission is a useful diversion (takes you back to school days) but does not give you the means to convey true feelings. In my case (I was unable to speak for just over 2 weeks – tracheotomy) I quickly became dependent on texting as the main means of keeping in touch. This was fine for friends and family but was still reliant on pen and paper for communicating on the ward.

Your initative to provide I-pads with speech software will make an enormous difference to head and neck patients unable to communicate either in the short or long terms. We underestimate the power of speech and only begin to appreciate it when we lose it.

best wishes “Jim”

(thank you most kindly for allowing us your thoughts Jim)


(we will add further info as we get it folks….. thank you)