Three years ago at this time I was lying on the couch, watching St. Elmo's Fire with Friend Pens The Lotion Slut, feeling rather giddy from a combination of red wine and Vicodin. I had just had the majority of my hard palate and all of my soft palate removed due to a case of oral cancer. If you want to read the whole story, go back to September of 2010 in the archives.
(St. Elmo's Fire is a good movie filled with terrible people. Skip it; that way, you won't have to wish for that two hours of your Vicodin- and red-wine-soaked life back.)
Let's talk about oral cancers. There are a lot of them, some of them frightening, some of them less so. All of them are on, as they say, the rise, due to a number of factors. Here are some interesting things about OC that you may not know:
1. A large number of oral cancers are due to the human papilloma virus. In different forms, HPV can cause warts on your fingers, genital warts, cervical dysplasia and cancer, or lumps in your mouth, or oral cancer. There are innumerable strains of HPV. Most of them are harmless. Some are really a bitch to get and to treat.
2. Oral cancer, which used to be the province of men over the age of 60, is increasing in young women. Part of this has to do with the near-ubiquity of HPV in the population. A lot of it has to do with the fact that young women now smoke more and drink more than young men. Alcohol or smoking predisposes you to oral cancer; doing both at once is a great way to lose chunks of your tongue or jaw.
3. Oral cancer is underdiagnosed in young people. Part of this has to do with the fact that the thinking on OC hasn't caught up with the reality. Part of it has to do with how often young people visit the dentist. I go to the dentist twice a year; my OC was found by The Fantastic Hygienist at my dentist's office. It had grown from nothing to a two-centimeter lump that I had not noticed in half a year.
4. Oral cancer has a huge impact on your life, no matter how minor it is. I got lucky: all I have to do for the rest of my life is wear a metal-and-plastic prosthetic that protects my airway and allows me to speak, and get yearly checkups (complete with MRI and CT scans and all the associated radiation) to make sure that I still have no evidence of disease. Some people, like my pal Mary, have lost much, much more than that to this disease, and the consequences are ongoing.
5. Oral cancer can hit you even if you don't smoke, or drink, or have sex. Mary, for instance, had a stage III squamous cell carcinoma of the tongue that was HPV negative. She is a lifelong nonsmoker and nondrinker. OC doesn't play favorites.
6. Which leads me to THE MOST IMPORTANT POINT OF ALL: If you see or feel a weird bump in your mouth, get it checked out. If you've got a gut feeling about it, don't stop asking for answers until you know what's really going on. OC is still one of those things that docs don't expect to see in people my age (forties) without other risk factors. I was incredibly lucky in that I had a dentist who was paranoid as fuck about the thing on my palate. Other people have not been so fortunate; as a result, they've had to undergo things like feeding tube placements and the loss of all of their teeth.
My cancer, polymorphous adenocarcinoma, doesn't have known risk factors. The article in Wikipedia on it is still only a stub. It's rare, it's non-invasive (usually), and can normally be treated with what's called "wide excision," also known as "taking out most of your mouth and changing your life forever." The type of cancer I had was indolent, meaning that it didn't spread or grow very quickly. It could happen to anybody. It happened to me.
So, on this third, give or take, anniversary, I have this one request: think about oral cancer. Go to the fucking dentist. It doesn't matter if you haven't been in fifteen years; they get off on that stuff. Get your mouth checked out. Avoid what I went through.