Why do cancer patients have difficulty swallowing

Detect and treat cancer : "It starts with a sore throat"

Mr. Bloching, where can the cancer be located in the mouth and throat?

Oral and pharyngeal cancers occur on the tongue and floor of the mouth, mostly on the tonsils, which many do not know, and on the roof of the mouth. What is difficult to see is a carcinoma that grows towards the base of the tongue.

How aggressive are the tumors?

These are tumors that grow relatively quickly. They start small and develop through transitional stages, the so-called pre-malignant preliminary stages. But you can recognize this early on. White spots on the lining of the mouth or throat, for example, can already be such precursors. They can turn into cancer and grow relatively quickly once they become cancerous.

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In the 1980s the number of new cases was much higher before it decreased in the 1990s. Stagnation can now be observed ...

You can't quite say that. There was an increase, yes. This was related to smoking behavior. Oral and throat cancer is caused by smoking and alcohol consumption. Smoking behavior has changed: there are now fewer smokers, although this varies greatly from region to region. In Brandenburg, for example, up to 40 percent of men still smoke, in Hesse it is only 18 to 20 percent. In the meantime, however, new risk factors have emerged, such as the HP virus, which can also be transmitted through oral sex. This even leads to an increase again.

The HP virus is known from uterine cancer ...

There it was first identified as a risk factor. For this there was also a Nobel Prize for Harald zur Hausen, a German researcher. We now know that the rate of carcinomas caused by HP viruses is increasing - in throat cancer it is up to 40 percent. The viruses are a very big risk factor.

The Standing Vaccination Commission (STIKO) has been recommending a vaccination for girls for a long time. How is the situation with the boys?

The STIKO has had an official recommendation for boys from nine to 14 years of age since 2018; they can also be re-vaccinated up to 17. The health insurance companies now cover the costs.

Are there any other risk factors?

Oral hygiene also plays a role. Gum and oral health and the number of carious teeth can play a role in tumor development. Chronic inflammation that occurs there are tumor risk factors. In addition, genetics also play a role. And there are certain risk factors from the world of work, some of which are not yet recognized, but for which we have indications that they increase the risk - chemicals and certain cold-cutting oils and solvents.

With typical symptoms such as coughing or difficulty swallowing, one hardly thinks of cancer. How do you recognize the disease?

It starts with a sore throat, like tonsillitis. These then radiate into the ear and it can burn when you drink juices with fruit acid. This is then a sharp, stabbing pain. Breathlessness or difficulty swallowing usually occurs relatively late, with pain coming first. If you have a sore throat that lasts more than two to four weeks, an ENT doctor should see if there is anything malicious.

Can the dentist also detect cancer?

In principle, dentists are also trained to recognize cancer. The dentist sees the patient regularly and therefore has the best opportunity to detect these tumors at an early stage.

In the early stages of the tumor, surgery is usually the first choice. What other procedures do you use?

Advanced tumors usually have to be treated multimodally - that is, both with surgery and with radio-chemotherapy. In individual cases, only radio chemotherapy can be used. However, individual treatment is important.

This interview and further information on cancer can be found in the “Tagesspiegel Oncology” health guide (12.80 euros, available at www.tagesspiegel.de / shop or Tel. 29021-520).

The interview was conducted by Hauke ​​Hohensee.

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