Oral cancer also known as mouth cancer is the cancer of the lining of the lips, mouth or upper throat.
It can start as a white patch that develops in a red patch or a growing ulcer.
SIGNS & SYMPTOMS OF ORAL CANCER
- Thin irregular white patches in the mouth
- Mix of red & white patches
- Persistent rough patch with ulcer
- Raised border
- Dry & crusting ulcer on the lip
- Mass or growth in the pharynx
- Loss of taste
- Loose teeth
- Numbness & swelling in the lip & chin.
- Extension or spreading of the cancer to the throat
- Difficulty in swallowing
- Painful swallowing
- Change or hoarseness in voice
- Oral thrush
- Lesions that are initially painless but after they grow larger, a burning sensation if produced.
- Spread of cancer to lymph nodes which results in the formation of a painless hard mass.
- Swelling in the neck
- Spread of tumor to the bone
- Surgery to remove cancer when it is severely spread to the neck can lead to loss of structure of the face.
CAUSES & RISK FACTORS
- Smoking or chewing tobacco
- Alcohol consumption
- Infection with human papillomavirus (HPV), particularly type 16, is a known risk factor and independent causative factor for oral cancer.
- Chewing betel leaf & betel nut which is common in India.
- People after hematopoietic stem cell transplantation (HSCT) are at a higher risk for oral squamous cell carcinoma.
- Precancerous lesions present in the mouth that have greater chances of malignant transformation like white or red patches & ulcers in the mouth.
- Oral submucus fibrosis
- Actinic cheilitis.
DIAGNOSIS OF ORAL CANCER
- Initially tissue biopsy by scalpel or needle method done by taking a tissue sample from the affected/suspected region in the oral cavity.
- Histopathological study of the tissue is establish & the diagnosis is done for the type of cancer, classification on the basis of stages & other features like growth rate.
- MRI or PET scan done for assessment of the size of the lesion/cancer.
- Various types of endoscopy are done for detection of spread of cancer to the pharynx, larynx, bronchus, esophagus, etc.
- Chest X-ray & nuclear medicine for detection of spread of cancer to other parts of the body.
- CT scan for the assessment of the cancer in lymph nodes.
- Needle biopsy of the lymph nodes to assess the spread & damage done by the cancer which is essential in listing a treatment regimen for the patient.
- Staging of the cancer on the basis of tumor, node & metastasis.
TREATMENT OF ORAL CANCER
- Surgery to remove squamous cell carcinoma
- In small to medium lesions when the cancer is restricted to the mouth, access is made through the oral cavity or the jaw.
- When the cancer spreads to the lymph nodes in the neck, dissection of the neck follows.
- Radiation therapy proves effective in treatment of small lesions and used in conjunction with surgery in case of larger lesions.
- Monoclonal antibodies like cetuximab have been shown to be effective in management of carcinoma of the head & neck.
- Following treatment, rehabilitation may be necessary to improve movement, chewing, swallowing, and speech.
- Oral/facial reconstruction surgery which utilizes skin grafts & fascia for restructuring of the mouth & neck.
- Cessation of smoking
- Limiting alcohol consumption
- Not chewing tobacco, betel leaves & areca nut
- Getting vaccinated for HPV & practicing safe sex
- Using sun screen gels & cream for the lips.