Oral Cancer is the uncontrollable growth of cells that invade and cause damage to surrounding tissue. They can occur anywhere in the oral cavity:
- Tongue
- Lips
- Cheeks
- Salivary glands
- Floor of the mouth
- Roof of the mouth (hard palate)
- Tonsils
- Uvula
Causes of Oral Cancer
The exact cause of the mutations is unknown, but there is evidence that certain risk factors increase the chance of mouth cancer developing.
- Smokeless and Smoking Tobacco Use
- Areca Nut Chewing
- Alcohol
- Poor nutrition
- HPV virus
- Genetic factors
- Chronic trauma
RISK FACTORS ASSOCIATED WITH ORAL CANCER
- Chewing or smoking tobacco
- Drinking excess alcohol
- Exposure to sunlight for long periods of time
- Exposure to certain chemicals, especially asbestos / sulfuric acid
- Human papillomavirus (HPV) infection
- Weakened immunity due to certain medications
- Consumption of diet rich in processed meat, and fried foods
- Have the skin disease lichen planus, graft-versus-host disease (GVHD) or certain inherited conditions of the blood.
CLINICAL SYMPTOMS OF ORAL CANCER
If you do notice any of the following symptoms, talk with your health care professional.
- White or red patches on lips, gum, tongue or buccal mucosa
- Pain or difficulty chewing, swallowing or speaking
- Hoarseness of voice
- Numbness or pain in any area of the mouth that do not subsides
- Loosening of teeth without significant reason
- Bleeding in the mouth
- A lump which can be felt inside the mouth or on the neck
- Jaw pain or stiffness
- Sore throat
- Difficulty wearing dentures
- A sore on the lips or in the mouth that does not heal
- An earache that doesn’t go away
CAN ORAL CANCER BE PREVENTED?
- Quit tobacco of all forms
- Limit alcohol consumption
- Protect yourself from ultraviolet light exposure, use sunscreen whenever you go out
- Prevent HPV infection
- Have a healthy diet, avoid spicy, junk food
- Have dentures fitted properly, remove any sharp projection from crowns, dentures, restorations.
- Visit a dentist at least once a year for a complete oral examination.
DIAGNOSIOS OF ORAL CANCER
- CLINICAL EXAMINATION
Oral cavity is easily accessible for examination. The dentist may be the first person to spot signs of mouth cancer. A thorough physical examination of the oral cavity, is the most essential and basic procedure that provides valuable insight into a person’s overall state of health. - BIOPSY
If a suspicious area is found, your doctor or dentist may remove a small piece of tissue for laboratory testing (biopsy). The doctor might use a scalpel to cut away a sample of tissue or use a needle to remove a sample. In the laboratory, the cells are analyzed for cancer or precancerous changes that indicate a risk of cancer.
A biopsy may be carried out, where a small sample of tissue is taken to check for cancerous cells. Sometimes a “brush biopsy” is used initially; this where cells are painlessly collected by brushing them to one side. - ENDOSCOPY
Endoscopy, where a lighted scope is passed down the patient’s throat to see how far the cancer has spread - IMAGING TECHNIQUES
X-ray, Computed Tomography (CT) scans, and Magnetic Resonance Imaging (MRI), PET scans help in staging the cancer, which will inform treatment options and help predict prognosis
TREATMENT OF ORAL CANCER
Treatment depends on the location and stage of the cancer, and the patient’s general health and personal preferences.
SURGERY
It involves resection of the tumor and a margin of healthy tissue around it. A small tumor will require minor surgery, but for larger tumors, surgery may involve removing some of the tongue or the jawbone.
If the cancer has spread to the lymph nodes in the neck, the cancerous lymph nodes and related tissue in the neck will be surgically removed.
Reconstruction may be required for major surgery cases. This involves using transplanted grafts of skin, muscle, or bone from other parts of the body. Dental implants may be needed.
RADIATION THERAPY
It may be used alone or in combination with chemotherapy or surgery.
It involves beams of high-energy X-rays or radiation particles to damage the DNA inside the tumor cells, destroying their ability to reproduce.External beam radiation delivers radiation from outside, while in brachytherapy, radioactive seeds and wires can be placed near the cancer inside the body.
It is useful for the patients in the early stages of oral cancer.
Radiotherapy cobined with other treatment options may also increase the adverse effects . Adverse effects of radiation therapy in the mouth include:
- tooth decay
- mouth sores
- bleeding gums
- jaw stiffness
- fatigue
- skin reactions / burns
A dentist can also help you understand how best to care for your teeth during and after radiation therapy to reduce your risk of complications
CHEMOTHERAPY
Chemotherapy involves using medications that damage the DNA of the cancer cells, preventing them from replicating but at the expense of healthy tissue.
The following adverse effects may occur:
- Fatigue
- Nausea/vomiting
- Hair loss
- Weakened immune system, increasing the risk of infection
Although, these effects usually subsides after finishing treatment.
TARGETED DRUG THERAPY
Targeted drug therapy uses drugs known as monoclonal antibodies to change aspects of cancer cells that help them grow and may be combined with radiotherapy or chemotherapy. For example – Cetuximab or Erbitux .
The following mild adverse effects are possible:
- Nausea/vomiting
- Breathlessness
- Diarrhea
- Conjunctivitis
- Allergy to Cetuximab
HOW TO COPE PSYCHOLOGICALLY WITH ORAL CANCER
It is rightfully said that Cancer affects not only a person but his entire family. Many people feel depressed and stressed while dealing with cancer. To help yourself stay healthier, try to:
- Speak with a counselor or your healthcare team professional
- Take time for yourself
- Go for spiritual advisory
- You can opt for medications for depression or anxiety.
- Be socially and physically active.
- Eat a healthy diet, with as many healthy foods
- Drink plenty of water, fruit juices, and other liquids.
- Rest as much as needed.
- Talk with your healthcare team about ways to manage treatment side effects.
- Take your medicines as directed by your team.
