The seemingly innocuous, if uncomfortable, symptom is suffered by millions: a mouth ulcer. And when Sinead Marland noticed she had one, she thought little of it.
It had stubbornly refused to disappear after three weeks – so the mother-of-two, saw her GP. It was nothing to worry about, she was told.
The small, raised white lump on her tongue was irritating rather than painful. But reassured, Sinead, then 39, put it down to the stress of running around after her children.
Two months later, Sinead visited her dentist for a check up. She had learnt to live with the uncomfortable ulcer but the dentist was concerned, and referred her to a specialist.
A series of tests finally revealed the shocking truth: it was a mouth cancer.
When Sinead Marland noticed she had a mouth ulcer, she thought little of it, but a series of tests later revealed it was mouth cancer
‘I was a smoker so knew there was a risk, but the doctor had said I was fine,’ says Sinead. ‘I was incredibly lucky that it was caught.’
Sinead is now cancer-free after surgery. However, a large section of her tongue was removed in the procedure. For months she struggled to eat or speak. Her speech has still not fully returned to normal.
She says: ‘I had to relearn how to speak, but I sound different now. And I have scars on my arms and torso where skin grafts were taken to rebuild my tongue.’
Sinead is not alone – doctors, dentists and patients are all failing to spot early symptoms of the cancer, with the number of deaths soaring over the decade as a result.
Cases in the UK have reached a record high, surpassing 10,000 for the first time, according to data collected by the Oral Health Foundation. In the past 20 years, diagnoses have risen by 133 per cent.
As a result, the charity is holding Mouth Cancer Action Month throughout November, to raise awareness of the early signs and prevent thousands of deaths.
Symptoms include persistent ulcers, red or white patches in the mouth and lumps in the mouth, head or neck. Ulcers caused by cancer usually appear on or under the tongue, but may occasionally appear elsewhere in the mouth.
‘The issue is the early signs of mouth cancer are very similar to a lot of other conditions, and many people suffer from mouth ulcers,’ says Dr Ben Atkins, a dentist based in Manchester.
Dr Nigel Carter, chief executive of the Oral Health Foundation, adds: ‘The demographics of people with the cancer have changed – it used to be we would only be diagnosing heavy smokers and drinkers in their 70s but we are seeing a lot of younger cases.’
The disease is also being caught later. Over half of cases are diagnosed at stage three or four.
Five-year survival for the most advanced cases is 35 per cent – it’s 85 per cent at stage one. As a result, an estimated 3,637 people in the UK died of mouth cancer last year – 61 per cent more than a decade ago.
‘Catching the symptoms early is critical. So it is important that if you have a persistent ulcer you visit a dentist,’ says Dr Atkins.
However the data comes as people across the country struggle to get a dental appointment.
‘We are telling people to see either a GP or a dentist, as both can spot the signs of mouth cancer,’ says Dr Carter.
Research shows the surge in cases is mostly driven by sufferers in their 40s and 50s. Experts believe this is due to lifestyle.
In 2013, actor Michael Douglas revealed that he had developed mouth cancer as a result of an HPV infection. He is now cancer-free
‘Smoking and excessive alcohol consumption remain significant risk factors, but we are seeing a growing number of cases linked to the human papillomavirus (HPV),’ says Dr Carter. About 70 per cent of mouth and throat cancer cases are caused by HPV, says Cancer Research UK.
In 2013, actor Michael Douglas revealed that he had developed mouth cancer as a result of an HPV infection. Douglas, now 80, had a ‘walnut-sized’ tumour removed from the base of his tongue and intensive chemotherapy. He is now cancer-free.
There is an HPV vaccine but figures show that the number of children getting it is falling. The highly effective jab has been offered to all girls in Year 8 since 2008, and all boys since 2019, but nearly half of all eligible children are not getting it, which makes them vulnerable later in life.
For some, the introduction of the vaccine came too late.
‘My mouth was a mess, it was really sore, so when I found out I had cancer I was almost relieved to know what was wrong,’says Rachel Parsons
Mother-of-five Rachel Parsons, 53, visited her dentist and GP three times with a persistent mouth ulcer before she insisted on a referral and her cancer was diagnosed. Later tests showed that HPV was the likely cause.
‘My mouth was a mess, it was really sore, so when I found out I had cancer I was almost relieved to know what was wrong,’ Rachel says. ‘That first year, I was in and out of hospital. It also put a strain on my marriage.’
Luckily Rachel’s insistence on a test meant it was caught early enough to be removed with surgery. She is now cancer-free and has been able to repair the damage to her relationship.
But the care worker from Coventry says she has a scare almost every year, with an ulcer or pain in her mouth: ‘I am still concerned that it’s not getting picked up by doctors, but I’m not afraid to open my mouth now and ask for answers.’
With cases on the rise and early diagnosis key, if you have a mouth ulcer for more than three weeks, see a dentist or a doctor.