Risky Teen Behaviors Encourage Oral Cancer

Actor Yul Brynner, best known for his role in The King and I, died from lung cancer in 1985 after a life long addiction to smoking that began when he was 12.

Just months before his death, he looked into the television cameras on Good Morning America and said, "Now that I'm gone, I tell you, don't smoke, whatever you do, just don't smoke."

But not everyone was listening to that message. Today, 22 percent of high school students are smokers, according to the American Lung Association.

Although Brynner died of lung cancer, tobacco use also puts people at risk for oral and neck cancers. At the time of that interview Brynner had already established the Yul Brynner Head and Neck Cancer Foundation, Inc.

One way in which the foundation carries out its mission is through the annual Oral, Head and Neck Cancer Awareness Week, which runs from April 16th through the 22nd in 2007. The week is highlighted by a nationwide day of free screenings at more than 150 medical centers on Friday, April 20 (www.yulbrynnerfoundation.org/screenings/).

According to the American Cancer Society, over 40,000 Americans will be diagnosed with cancers of the head and neck in 2007, and 7,550 will die. Oral, head and neck cancer (OHNC) encompasses a variety of cancers that develop in the head and neck area, including the mouth, the throat, the paranasal sinuses and nasal cavity, the voice box, the thyroid and salivary glands, the skin of the face and neck, and the lymph nodes in the neck.

In a press release dated April 2, 2007, the Yul Brynner Head and Neck Cancer Foundation listed the common warning signs of OHNC:

• Red or white patch in the mouth that lasts more than two weeks

• Change in voice or hoarseness that lasts more than two weeks

• Sore throat that does not subside

• Pain or swelling in the mouth or neck that does not subside

• Lump in the neck

The foundation also noted in that same release that the "most effective prevention strategy remains the cessation of risky behaviors such as smoking, use of chewing tobacco and excessive alcohol consumption. More than 85 percent of head and neck cancers are related to tobacco use, while others may have a relationship to viral causes such as human papillomavirus (HPV) and Epstein-Barr Virus (EBV)."

For many teens, especially males, chewing tobacco is seen as an alternative to smoking. Chewing tobacco is less conspicuous than cigarettes since there is no smoke to permeate clothing. Also for athletes, many teens feel they can continue a nicotine habit without sacrificing performance on the field due to decreased lung capacity.

HPV and Oral Cancer

Although most Americans are aware of the part tobacco plays as a risk factor for oral cancer, few realize how serious a threat a virus such as the human papilloma virus (HPV) really is.

According to the Mouth Cancer Foundation, HPV is one of the most common virus groups in the world to affect the skin and mucosal regions of the body, which include areas such as the mouth, throat, tongue, tonsils, vagina, penis, and anus. More than 80 types of HPV have been identified.

A study from the May 3, 2000, issue of the Journal of the National Cancer Institute provided evidence that HPV is linked with certain types of oral cancer.

Twenty-five percent of those diagnosed with oral cancer were non-smokers while the other 75 percent of those diagnosed had used tobacco in some form during their lifetimes. Twenty-five percent of tissue samples from participants were HPV positive.

In addition, the investigators found that HPV-16 was present in 90 percent of the positive samples. The researchers concluded that the relationship of HPV and oral malignancies might provide clues as to the origin of cancer in those 25 percent who did not smoke.

What are the implications of this study for parents of teenagers? The answer to that question lies in the frequency with which oral sex is practiced by both homosexual and heterosexual teens.

A National Center for Health Statistics report issued in September 2005 surveyed over 12,000 Americans between the ages of 15 and 44, and found that over half the teenagers questioned had oral sex.

Oral sex can be especially popular in heterosexual relationships because teens see it as a form of contraception since pregnancy does not occur unless sperm enters the vagina. While oral sex may prevent unwanted births, it is not an effective method of preventing sexually transmitted diseases.

HPV, as well as chlamydia, gonorrhea, herpes, hepatitis, and HIV can be transmitted through oral sex. It is especially important to note that high-risk HPV-16 infections, which are common in the genital area, are increasingly being transmitted by oral sex, according to a study led by Dr. Eva Munck-Wikland, from the Karolinska Institute in Stockholm whose findings were published in the December 1, 2006 edition of the International Journal of Cancer.

If you are the parent of teenagers, have a serious talk with them about the dangers involved in practicing oral sex. If the thought of approaching the subject with your kids makes you uncomfortable, think about this: what’s a little embarrassment if it means protecting your child from oral cancer?

FoxNews.com health writer Maria Esposito contributed to this report.

For more great information on living healthy through every decade of life, click here to check out Dr. Manny's book The Check List (Harper Collins, 2007).

Dr. Manny Alvarez is the managing editor of health news at FOXNews.com, and is a regular medical contributor on the FOX News Channel. He is chairman of the Department of Obstetrics and Gynecology and Reproductive Science at Hackensack University Medical Center in New Jersey. Additionally, Alvarez is Adjunct Professor of Obstetrics and Gynecology at New York University School of Medicine in New York City.

Dr. Manny Alvarez serves as Fox News Channel's senior managing health editor. He also serves as chairman of the department of obstetrics/gynecology and reproductive science at Hackensack University Medical Center in New Jersey. For more information on Dr. Manny's work, visit AskDrManny.com.