Oral Cancer: Signs, risk factors & prevention!

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
  • Bleeding
  • Loose teeth
  • Earache
  • Numbness & swelling in the lip & chin.

COMPLICATIONS

  • Extension or spreading of the cancer to the throat
  • Difficulty in swallowing
  • Painful swallowing
  • Change or hoarseness in voice
  • Mucositis
  • 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.
  • Death.

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

  1. Initially tissue biopsy by scalpel or needle method done by taking a tissue sample from the affected/suspected region in the oral cavity.
  2. 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.
  3. MRI or PET scan done for assessment of the size of the lesion/cancer.
  4. Various types of endoscopy are done for detection of spread of cancer to the pharynx, larynx, bronchus, esophagus, etc.
  5. Chest X-ray & nuclear medicine for detection of spread of cancer to other parts of the body.
  6. CT scan for the assessment of the cancer in lymph nodes.
  7. 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.
  8. 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.

PREVENTION

  • 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.