You may be surprised to hear that there’s a link between sleep apnea and any type of cancer, but here’s a study that shows that either directly or indirectly, many types of cancer treatments can cause obstructive sleep apnea. Researchers in this study found that 93% of patients with oral cancer that underwent surgery were found to have obstructive sleep apnea and 67% were found to have moderate to severe degrees of sleep apnea. One hundred percent of those that underwent radiation therapy or chemotherapy had obstructive sleep apnea.
These findings make sense, since after any type of oral cavity surgery and major reconstruction, there’s expected to be a great deal of swelling and bulkiness which takes up space inside the breathing passageways, leading to obstruction. Radiation and chemotherapy can also be expected to cause significant swelling, leading to the same problems.
What the study authors imply is that the treatment process (surgery, radiation or chemotherapy) is what can cause sleep apnea, but they never consider the possibility that most of these people had some degree of sleep apnea long before they developed their cancers.
Here are a few possible scenarios that may explain how untreated obstructive sleep apnea can lead to or promote oral and throat cancer:
1. A lowered or weak immune system can make you more prone to cancer, since your normal cancer fighting systems don’t work properly.
2. Hypoxia, where you have lowered levels of oxygen, has been shown in countless studies to promote tumor growth.
3. Hypoxia is a major feature of obstructive sleep apnea.
4. Smoking alone increases your risk of mouth, throat or esophagus cancers by 7X. If you drink alcohol heavily, your risk increases 6X but if used together, your risk increases synergistically by 38X!
5. Nicotine relaxes the lower esophageal sphincter, promoting acid reflux into the esophagus and the throat.
6. Obstructive sleep apnea is known to create vacuum pressures in the throat, literally suctioning up your normal stomach juices into your throat.
7. Acid, bile, digestive enzymes and bacteria can reach the throat, nose and lungs.
8. Alcohol relaxes all your muscles, leading to more obstructions and reflux into the throat.
9. Chronic long-term irritation of the voice box with acid has been shown to promote cancers in mice. A similar process happens with people with severe burns—as the body never stops trying to heal the burn, it loses control and squamous cell cancers (the same type for most head and neck cancers) can occur. This is called a Marjolin’s ulcer.
10. Many heavy smokers and drinkers have chronic cough, throat clearing, post-nasal drip, and hoarseness — all symptoms of laryngopharyngeal reflux disease (LPRD). LPRD is strongly linked with obstructive sleep apnea.
11. Imagine how chronic irritation of the throat with cigarette smoke and toxic chemicals, along with stomach juices, genetic susceptibility, lowered immune system, and hypoxia from sleep apnea can set up the “perfect storm” for oral and throat cancers.
My bet is that if you screened oral and throat cancer patients for sleep apnea before treatment, you’ll find a very high proportion that have undiagnosed sleep apnea. It’s also conceivable that people with sleep apnea are more prone to abusing alcohol or smoke, since they’re never able to get a good night’s sleep. As a result, they may feel stressed, anxious, or depressed. Resorting to smoking or drinking, while giving them temporary relief, may be making things much worse in the long term.
This may sound a bit far fetched, but an interesting perspective worth thinking about.
What’s your opinion on this theory? Write your comments below.