HPV now a major concern alongside smoking, say doctors

Cases of mouth cancer in the UK have increased by more than one-third in the last decade to hit a record high, according to a new report.

The number of cases has more than doubled within the last generation and previous common causes like smoking and drinking are being added to by other lifestyle factors.

According to the Oral Health Foundation, 8,864 people in the UK were diagnosed with the disease last year – up 36 per cent on a decade ago, with 3,034 people losing their life to it within the year.

This is an increase in deaths of 40 per cent in the last 10 years, and a 20-per-cent rise in the last five.

The findings are part of the Oral Health Foundation’s new State of Mouth Cancer UK Report 202, which has been released to coincide with November’s Mouth Cancer Action Month.

In the early stages, mouth cancer symptoms can be subtle and painless, making it easy to miss.

They could be a mouth ulcer that doesn’t heal within three weeks, white or red patches in the mouth, unusual lumps or swellings in the mouth, head or neck, or any persistent hoarseness in the voice.

One in three mouth cancers are found on the tongue and 23 per cent are discovered on the tonsil.

The other places to check for mouth cancer include the lips, gums, inside of the cheeks, as well as the floor and roof of the mouth.

Nearly two in three people have never checked their mouth for signs of mouth cancer, despite it taking less than a minute.

People are three times more likely to routinely check for testicular or breast cancer.

Survival rates for mouth cancer have barely improved in the last 20 years, partly because so many cases are diagnosed too late. Just over half of all mouth cancers are diagnosed at stage four – where the cancer is at its most advanced.

Dr Nigel Carter, the chief executive of the Oral Health Foundation, said: “While most cancers are on the decrease, cases of mouth cancer continue to rise at an alarming rate.

“Traditional causes like smoking and drinking alcohol to excess are quickly being caught up by emerging risk factors like the human papillomavirus (HPV).

“The stigma around mouth cancer has changed dramatically. It’s now a cancer that really can affect anybody.

“We have seen first-hand the devastating affect mouth cancer can have on a person’s life. It changes how somebody speaks, it makes eating and drinking more difficult, and often changes a person’s physical appearance.

“During mouth cancer action month, we will be raising greater awareness of mouth cancer.

“We urge everybody to become more ‘mouth aware’ by being able to recognise the early warning signs of mouth cancer and to be aware of the common causes.

“Most importantly, if you notice anything unusual, please don’t delay and seek help from a doctor or dentist.”

Charlotte Webster-Salter was given the life-changing news that she had mouth cancer when she was just 26. The ex-cabin crew member, who is now training to be a midwife, does not fit the typical mouth cancer patient – being an active young woman who does not smoke.

But Ms Webster-Salter represents a growing number of younger people who are being diagnosed with the disease.

Ms Webster-Salter, who lives in Petersfield, Hampshire, said: “I had some ulcers for about three to four years before I had my [mouth cancer] operation.

“I wasn’t worried about them at first because I do get run down. I was jet-lagged and flying all the time with my job and often ulcers are sign of celiac disease, which I have, so I put it down to that.

“They came and went but always in the same area, they never fully went but they used to flare up if I was run down.

“They felt like ulcers do, but just a bigger patch and they started to turn white, and they had red around them as well, so they looked quite inflamed. I thought maybe it was a bit of an infection or something.”

As a precaution Ms Webster-Salter went to the dentist and asked about them.

She said: “About a year before I had my operation I went to the dentist and they said, ‘Well, I don’t really know what it is, might be because your teeth are rubbing so we would advise maybe getting your teeth straightened and have your wisdom teeth taken out’.

“So, I did that. I paid for braces, got my wisdom tooth taken out and had really great teeth, but still had the ulcers.

“My mum kept telling me to go and get it checked so I went to my doctor who sent me for a biopsy.”

She finally had her biopsy in April 2021 after the ulcers got significantly worse. The biopsy showed that the ulcers were mouth cancer.

She added: “I went in for the results, and he asked, ‘Have you got anyone with you today?’ I looked at him and said, ‘It’s not good is it?’ He replied ‘No, it’s not. I’m really sorry, you’ve got cancer’.

“I remember saying to him ‘What do you mean? Surely not,’ and I think I almost laughed. It was such a shock because I’m otherwise a healthy person.”

Ms Webster-Salter had a nine-and-a-half-hour life-saving surgery where she had part of her tongue removed. The chunk taken out was replaced with muscle from her leg.

They also took a lymph node from her neck to check if the cancer had spread, which it had not.

As a result of swelling from the surgery she was fitted with a tracheostomy, where a tube is inserted in the neck to help with breathing.

Ms Webster-Salter said: “My tracheostomy was fitted for seven days so my body hadn’t swallowed or breathed through my mouth in so long that often your muscles take a while to get back to that.

“I remember the first time they tried to take it out. They covered this hole so I could then breathe through here and it wouldn’t, it just couldn’t, I think my body wasn’t ready because it was like being suffocated because I couldn’t breathe through my mouth.

“It was like I had a mouth full of like straw or hay. It was just so hard, so husky, so stuck. And I remember the panic, I was like no, I can’t, so they tried again the next day and then every day it just got a bit better and better.”

After the operation, Ms Webster-Salter had to learn how to talk, eat and walk again through speech and physiotherapy, but has not needed any further treatment.

Ms Webster-Salter added: “There is a stereotype for mouth cancer. I was told ‘oh, you’re too young’, ‘God it won’t be that’. But it really can happen to anyone, not just smokers.

“People think you have to be like a really old man that smokes 50 a day, but you don’t. It took this tiny little poster in the clinic for me to, to be like, ‘Oh my God, that’s mouth cancer’ and by then it was too late anyway.”

The goal of the Oral Health Foundation is to improve people’s lives by reducing the harm caused by oral diseases – many of which are entirely preventable.

Mouth Cancer Action Month runs throughout November.

Article by Alice Clifford