Oral Cancer
Oral Cancer
What Is Oral Cancer?
Oral cancer, a malignancy that develops in the mouth, encompasses a wide range of areas, including the lips, gums, cheeks, tongue, soft and hard palate, the floor of the mouth, sinuses, and throat. Typically, it affects individuals over the age of 40 and is more commonly diagnosed in men than women. Several factors contribute to the development of oral cancer, such as tobacco use (both smoking and smokeless forms), excessive alcohol consumption, infection with the human papillomavirus (HPV), and other related factors.
In India, oral cancer ranks as the second most prevalent type of cancer, and it stands as the sixth leading cause of cancer-related deaths globally. Each year in India, approximately 1 lakh new cases of oral cancer are diagnosed. Unfortunately, the prognosis for many of these cases is grim, with half of the affected individuals succumbing to the disease within one year of detection. This alarming statistic can be attributed to the fact that a significant majority of these cases, around 60-70 percent, are detected in advanced stages, underscoring the urgent need for early detection and intervention to combat this deadly disease.
Types Of Oral Cancer
Identifying the specific type of oral cancer is crucial for determining the most appropriate treatment options and understanding the potential for cancer progression. Here are the primary types of oral cancers:
1. Squamous Cell Carcinoma: This is the most common type of oral cancer and typically originates in the mouth. However, it can also occur in other areas of the body, such as the skin or the inner ear. Squamous cell carcinoma can affect various parts, including the vocal cords.
2. Adenocarcinomas: This is a less common form of oral cancer that develops within the salivary glands. It may manifest with visible symptoms like a lump in the cheek or beneath the tongue, non-healing sores on the lips, or ulcers on the gums.
3. Oral Malignant Melanoma: This rare type of mouth cancer begins in melanocytes, which are responsible for skin pigmentation. It often doesn’t present symptoms until it has grown substantially, potentially spreading to nearby lymph nodes or metastasizing to other parts of the body.
Understanding the specific type of oral cancer is critical for tailoring treatment approaches and assessing the likelihood of cancer progression.
Symptoms Of Oral Cancer
The symptoms of oral cancer can vary from person to person, but it’s important to remember that if any of the below occur, visit your physician immediately.
- Tongue pain
- Sore throat
- Loosened teeth
- A lump in the neck
- Bleeding from the mouth
- Ear pain or hearing loss
- Pain or stiffness in the jaw
- Problems in wearing dentures
- Speech problems/change in voice
- Pain or difficulty in swallowing
- A persisting earache Dramatic weight loss
- Lip or mouth sore that doesn’t heal with time
- If a growth or mass is seen anywhere in the mouth
- Numbness on the lower lip, face, neck, or chin White, red, or red and white-colored patches in or around the mouth or lips
Causes Of Oral Cancer
Preventing oral cancer is not foolproof, but certain factors have been pinpointed as elevating the risk of its onset. The subsequent factors are recognized as influencing the likelihood of developing oral cancer:
Alcohol has been identified as a contributing factor to oral cancer. Research shows that individuals who consume alcohol in combination with tobacco face a heightened risk of developing floor-of-mouth cancers compared to those who abstain from both alcohol and tobacco.
Additional risk factors associated with oral cancer include:
1. Certain genetic disorders.
2. A previous history of oral cancer.
3. Family history of cancer, whether oral or other types.
4. Gender: Men have double the likelihood of developing oral cancer compared to women.
5. Age: The risk of oral cancer increases with age.
6. Exposure to Human papillomavirus (HPV): HPV exposure raises the risk of oral cancer.
7. Chronic sun exposure, particularly to the face, which can lead to lip cancer when exposed to UV light over extended periods.
8. Weakened immune system and malnutrition: Poor nutrition and obesity can diminish the body’s ability to defend against oral cancer, increasing the likelihood of developing the disease.
Oral Cancer Diagnosis And Tests
Oral cancers are often difficult to detect and diagnose since they don’t always cause signs or symptoms. There are various tests used to detect and diagnose oral cancers, and your dentist can help determine if you should undergo any of these options. The most common tests for oral cancer include:
Biopsy is an additional diagnostic method employed in cancer detection, serving the purpose of both diagnosis and confirmation of cancer’s presence. The chosen treatment plan hinges on the cancer’s type, extent, and tumor size. This procedure is typically painless, involving the collection of tumor cells by gently brushing them onto a slide. Subsequently, the results are examined under a microscope, allowing your physician to determine the presence of cancer and its degree of advancement.
This diagnostic procedure entails the patient consuming a barium-infused beverage. Subsequent X-ray imaging will reveal any irregular growths within the digestive system, extending down to the stomach. Additionally, this examination can identify potential leaks within the intestines or rectum, which could impede the absorption of essential nutrients.
This procedure enables an internal view of the body. It involves the use of an endoscope, which is a slender and flexible tube equipped with a telescopic camera. A specialized endoscopic tool, known as a gastroscope, is gently passed through the esophagus, stomach, and duodenum to assess the condition of these organs.
Imaging is performed to comprehensively assess the extent of a tumor in all dimensions, including its depth within the tissues. The choice between CT scan, MRI, or PET CT is made based on the tumor’s location, size, and characteristics. These imaging techniques aid medical professionals in identifying the specific cancer type in a patient and provide valuable guidance for tailoring appropriate treatment strategies.
X-rays represent a swift, painless, and straightforward diagnostic tool for assessing issues in the oral and jaw areas. They serve to identify tooth decay, concealed tooth infections, as well as the presence of fractures resulting from injuries, such as those affecting the jaw.
Stages Of Oral Cancer
Staging is a very important part of the treatment process. It helps in choosing the right treatment option depending on the extent of the spread of cancer. If a biopsy is indicative of cancer, imaging studies are the next step. Imaging studies help in staging and planning treatment accordingly. Various stages of oral cancer include:
Biopsy is an additional diagnostic method employed in cancer detection, serving the purpose of both diagnosis and confirmation of cancer’s presence. The chosen treatment plan hinges on the cancer’s type, extent, and tumor size. This procedure is typically painless, involving the collection of tumor cells by gently brushing them onto a slide. Subsequently, the results are examined under a microscope, allowing your physician to determine the presence of cancer and its degree of advancement.
In this stage, the following conditions are observed:
1. The tumor may vary in size but has extended to involve at least one lymph node on the same side of the neck.
2. The cancer measures more than 4 cm in size but has not spread to distant parts of the body or affected any other lymph nodes.
The advanced stage of oral cancer is characterized by the tumor’s extensive spread and severe functional impairment. This stage is further divided into three categories:
1. Stage 4A: In this stage, the cancer has extended into the tissues surrounding the mouth and lips. The involvement of lymph nodes may or may not be present.
2. Stage 4B: At this stage, the cancer has spread to lymph nodes, and these affected lymph nodes are larger than 6 cm. Alternatively, cancer may have spread to lymph nodes on both sides of the neck, or there may be involvement of more than one lymph node on the same side of the neck.
3. Stage 4C: In this advanced stage, cancer has spread to other parts of the body, including bones and lungs.
Treatment Options For Oral Cancer
The approach to treating oral cancer is contingent on several factors, which encompass the cancer’s stage, its specific location, and the patient’s overall medical condition. In general, a combination of diverse treatment modalities is typically required. These can encompass an array of surgical and non-surgical interventions, which may include:
Cancer cells within the body exhibit rapid growth, posing a significant threat to an individual’s well-being. The behavior of these cancer cells can be altered through the application of biological therapy. One such form of biological therapy is Cetuximab, recognized as a monoclonal antibody. Cetuximab serves to block the cancer cells’ surface, thus impeding the triggering of their growth and progression.
Radiation therapy harnesses high-energy radiation to reduce the size of tumors or eliminate cancer cells, directing radiation beams towards the affected region. This is achieved using a machine that emits rays from a radioactive source. The various machines employed in radiotherapy differ in terms of the dosage, intensity, and type of radiation utilized during treatment. In certain cases, radiotherapy may serve as an alternative to other treatment modalities, such as surgery, chemotherapy, or targeted therapy, particularly in the treatment of specific cancer types.
Oral cancer surgery encompasses various types of procedures, including:
1. Primary Closure: When the tumor is small and the tissue loss is minimal, sutures are used to bring the remaining tissues together, facilitating wound closure.
2. Local Flap: In cases where primary closure is not possible due to a larger defect, adjacent tissue from areas like the tongue, buccal mucosa, or palate is utilized to repair the defect.
3. Regional Flap: For more extensive defects where adjacent tissue is insufficient, tissue from distant sites, such as the chest, arm, or neck, is employed to cover the defect. This method typically involves more extensive surgery.
4. Microvascular Free Flap Reconstruction: This represents an advanced technique in flap surgery. It involves taking tissue from a distant site like the forearm, thigh, or leg, along with its blood supply, and surgically attaching it to the remaining oral tissue to cover the defect. The flap can be used immediately after surgery or preserved in a freezer for future use.
Follow-Ups After The Treatment
For cancer survivors, maintaining regular follow-up care post-treatment is of paramount importance. These check-ups are essential for the early detection of potential cancer recurrences. During each follow-up appointment, your oncologist will conduct a thorough examination and review your medical and surgical history. The need for imaging will be determined based on factors like tumor stage, symptoms, and your response to treatment. Initially, follow-up visits are scheduled every 2-3 months for the first 2 years, followed by 3-6 monthly check-ups for the subsequent 3 years, and thereafter, an annual schedule.
To further safeguard your health, you can take certain precautions:
1. Refrain from exposure to passive smoking.
2. Abstain from tobacco and alcohol consumption.
3. Schedule regular check-ups, especially if you have a history of smoking or alcohol use.
Best Hospital For Oral Cancer Treatment In India
There are many hospitals across India. But some places provide the best treatment for oral cancer. You should choose a hospital that has a reputation for treating all types of cancer. A well-known cancer hospital will employ the best and most experienced doctors. Some of them are listed below:
- HCG Manavata, Nashik
- Fortis BG Road, Bangalore
- Fortis Hospital, Vadapalani
- Kokilaben Ambani Hospital
- Manipal Hospital, Whitefield
- Fortis C-DOC, Chirag Enclave
- Fortis La Femme, Greater Kailash
- Manipal Hospital, Old Airport Road
- BKL Superspeciality Hospital, New Delhi
- Fortis Escorts Heart Institute, Okhla Road
FAQs
It ranks as the fourth most prevalent cause of cancer among women, but in certain regions of our country, it stands as one of the most frequently diagnosed cancers in women.
The indicators of oral cancer encompass:
1. A persistent ulcer that lingers for over three weeks.
2. The presence of a growth or rough area within the mouth.
3. The appearance of white or red patches.
4. Unexplained loss of teeth.
5. Altered speech.
6. Difficulty in eating.
7. Pain at the back of the throat that extends to the ear.
8. Swelling in the neck.
The main common type of cancer is squamous cell carcinoma as it covers more than 90 percent of cancers that occur in the oral cavity.
Identifying oral cancer is of paramount importance as it plays a crucial role in extending life and enhancing the likelihood of successful treatment. Detecting oral cancer at an early stage and commencing treatment promptly can substantially reduce the mortality rate associated with this disease.
It is important to know the location of cancer, and its first or second stage before you start treatment. Early diagnosis of oral cancer has a higher chance of survival. The 5-year survival rate for localized oral cancer is approximately 80 percent.
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