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types of cancer

Oral Cancer

Overview

Oral cancer is the uncontrolled multiplication of cancerous cells in the mouth and surrounding regions. This type of cancer may affect the tongue, lips, palate, floor of the mouth or even the pharynx and sinuses. Oral cancers are most often discovered after they’ve spread to the lymph nodes of the neck. If not treated at an early stage, it can potentially be life threatening. One of the biggest risk factors for oral cancer is tobacco use. This includes smoking cigarettes, cigars, and pipes, as well as chewing tobacco. People who consume large amounts of alcohol and tobacco are at an even greater risk, especially when both products are used on a regular basis.

Symptoms

Some of the symptoms of oral cancer depends on the location of the tumour. Some common warnings are persistent rough patches in the oral cavity with ulceration and raised border that is mildly painful. Crusting and dry ulcers on the lip and a mass in the pharynx could be symptoms of oral cancer as well. Below are some of the symptoms of oral cancer:

  • Ulcers in the oral cavity
  • White patches
  • Loose teeth and bleeding gums
  • Persistent ear ache
  • A feeling of numbness and/or swelling in the lip and chin
  • Pain while drinking, eating, speaking
  • Difficulty in swallowing
  • Change in voice
  • Swelling in the neck

    • Causes

    Study suggests that men face twice the amount of risk of developing oral cancer as compared to women, and the risk is even greater in men who are over age 50. Though the causes are unclear, the various risk factors for the development of oral cancer include:

  • Smoking, be it cigarette, cigar, or pipe. Smokers are six times more likely than non-smokers to develop oral cancers.
  • Smokeless tobacco users. Users of dip, snuff or chewing tobacco products are 50 times more likely to develop cancers of the cheek, gums, and lining of the lips.
  • Consumption of alcohol in excessive quantities. Oral cancers are about six times more common in drinkers than in non-drinkers.
  • Family history of cancer.
  • Excessive exposure to sun rays, especially at a young age.
  • Human papillomavirus (HPV). Certain HPV strains are etiologic risk factors for Oropharyngeal Squamous Cell Carcinoma (OSCC)
    • While smoking and drinking greatly increases the risk of oral cancer, it is important to note that over 25% of all oral cancers occur in people who are non-smokers and who only drink alcohol occasionally.

    Diagnosis

    As a first step, a physical exam is done. This includes closely examining the roof and floor of your mouth, the back of your throat, tongue, and cheeks, and the lymph nodes in your neck. If the doctor cannot determine why these symptoms are present, the patient maybe referred to an ear, nose, and throat (ENT) specialist. If any tumours, growths, or suspicious lesions are found, a brush biopsy or a tissue biopsy is performed. A brush biopsy is a painless test that collects cells from the tumour by brushing them onto a slide. A tissue biopsy involves removing a piece of the tissue so it can be examined under a microscope for cancerous cells. In addition, one or more of the following tests maybe recommended:

  • X-rays to see if cancer cells have spread to the jaw, chest, or lungs
  • a CT scan to reveal any tumours in your mouth, throat, neck, lungs, or elsewhere in your body
  • a PET scan to determine if the cancer has travelled to lymph nodes or other organs
  • a MRI scan to show a more accurate image of the head and neck, and determine the extent or stage of the cancer
  • an endoscopy to examine the nasal passages, sinuses, inner throat, windpipe, and trachea
    • Basis the above tests, the staging of oral cancer can be arrived at. There are four stages of oral cancer:
  • Stage 1: The tumour is 2cm or smaller and it has not spread to the lymph nodes.
  • Stage 2: The tumour is between 2-4 cm, and it has not spread to the lymph nodes.
  • Stage 3: The tumour is either larger than 4 cm and has not spread to the lymph nodes, or is of any size and has spread to one lymph node, but not to the other parts of the body.
  • Stage 4: Tumours are of any size and the cancer cells have spread to nearby tissues, the lymph nodes, or to the other parts of the body.
    • The chances at better quality of life is higher if the diagnosis of oral cancer is done at an early stage.

    Treatment

    Treatment for oral cancer varies depending on the type, location, and stage of the cancer at diagnosis: Surgery Surgery is usually sought for early stage treatment to remove the tumour and cancerous lymph node(s). In addition, other tissue around the mouth and neck may be taken out depending on the stage of the cancer. Radiation therapy Radiation therapy is another option. This involves radiation once or twice a day, five days a week, for two to eight weeks. Treatment for advanced stages will usually involve a combination of chemotherapy and radiation therapy. Chemotherapy Chemotherapy is a treatment with drugs that kill cancerous cells. The medicine is given to either orally or through an intravenous (IV) line. Most people get chemotherapy as an outpatient, however depending on the stage of cancer and the patient’s overall health, some may require hospitalization. Targeted therapy Targeted therapy as treatment can be effective in both early and advanced stages of cancer. Targeted therapy drugs will bind to specific proteins found on the cancer cells and interfere with their growth. Nutrition Nutrition is crucial to oral cancer treatment. Many treatments make it difficult or painful to eat and swallow, and poor appetite and weight loss are common. Getting the right diet, that is gentle on the mouth and throat, from a nutritionist can help provide the body with the calories, vitamins, and minerals it needs to heal quickly. Here is an illustration on how to self examine your Oral Cavity for any symptoms of Cancer

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