SUNBURY - Pamela Dixon is on a mission to warn people of the dangers of oral cancer.
As one of the 57 percent of people who have survived oral cancer beyond the five-year mark, Dixon feels she's lucky to still be alive.
But she also feels a responsibility to teach others about oral cancer, one of the deadliest cancers.
Pamela Dixon, of Selinsgrove, is working to bring awareness to oral cancer.
"I think people need to know," she said.
Dixon, of Selinsgrove, was just 28 when she was diagnosed with oral cancer seven years ago.
That's what makes her somewhat unique. Most people who have oral cancer are past 40.
Statistics show oral cancer cases are growing, yet another reason Dixon feels a need to get out the word about the disease.
"I'm willing to do whatever I can do to save lives," said Dixon, a medical assistant for Sunbury Clinic Company.
Oral cancer, she added, can happen to anybody.
For Dixon, it started with intermittent pain on her tongue.
She spent a lot of time studying her tongue in the mirror, but perhaps a year went by before a lesion appeared - a small white area with a dark hole in the center.
Two weeks later an oral surgeon gave her the news that she had cancer of the tongue.
Oral cancer is cancer of the tongue, lips or mouth.
Dixon underwent radiation treatments for almost two months.
But ten months after she finished with radiation, she woke up with a swollen neck and subsequently learned she had a recurrence.
The cancer had spread to her neck, and she underwent surgery to remove it.
She didn't accept news from an oncologist that she had a 50 percent chance of having yet another recurrence, that it could spread to her lungs, liver or bones.
Dixon went ahead and sought a second opinion, subsequently began chemotherapy and went on the drug, Erbitux.
She's now cancer free, but her battles with oral cancer have left more than scars.
Part of her tongue was cut away.
Although she can speak fairly clearly, it can be a challenge for her to talk. She has difficulty swallowing and is unable to open her mouth very wide.
The second surgery, Dixon noted, combined with radiation left her with a "leaking hole from my mouth to my neck and a portion of my jawbone was dead."
Hyperbaric oxygen treatments to heal the jawbone didn't work, and eventually a part of Dixon's lower leg bone (tibia) along with tissue were removed and used to close the hole.
A long scar now runs along the one side of her neck.
Dixon said she sometimes is asked about it, but doesn't mind because it offers her the chance to talk about and bring awareness to oral cancer. She said she really didn't become pro-active about educating others about oral cancer until after her second surgery.
One reason that cancer is deadly is because it often is not discovered until its later stages, she noted.
"It's not uncommon at all to have a recurrence," she added.
Dixon noted that oral cancer often results from smoking, chewing tobacco or heavy use of alcohol.
Interestingly enough, the rate of oral cancer is rising, despite a decline in the use of tobacco.
"I was a smoker but I didn't smoke very long," Dixon said.
She said had no genetic predisposition to the disease either.
Dixon noted that lifestyle plays a big part in oral cancer.
For example, a study in the "New England Journal of Medicine" revealed that those infected with HPV, or human papillomarvirus, were 32 times more likely to develop oral or throat cancer.
HPV is the most common sexually transmitted infection in the world, according to the National Cancer Institute.
The rate of HPV-related oral cancer has risen from 0.8 cases per 100,000 people in the 1980s to 2.6 cases per 100,000 people in the 2000s - an increase of 225 percent.
Dixon is getting out the word to people, including health care professionals of the need for people to be screened for oral cancer.
She feels that's most important because oral cancer in its early stages is often painless.
Signs of oral cancer may include red or white patches in the soft tissues of the mouth, a sore that lasts more than two weeks, a lump or thickening in the mouth or neck, difficulty swallowing or moving the tongue or jaw, and pain in one ear.