Oral Cancer: Risk Factors, Symptoms, Diagnosis, Causes, Treatments

Cancer is the most deadliest disease in this world with Oral Cancer being the most common and fatal. Cancer is the uncontrolled growth of cells that causes damage to the surrounding tissues.

Mouth is the most predominant site in the head and neck region for oral cancer, it is the leading cause of death among all cancer in India.

Of all oral cancer, Squamous cell carcinoma is the most common one, seen in almost 92% of the cases.

Annually there are around 300,000 new cases reported worldwide, of which two-thirds is seen in the developing countries and the majority cases are seen in India.

There are 145,000 deaths worldwide and 45,000 deaths are seen in India.

Common Sites In ORAL CAVITY For ORAL CANCER

  • Lip
  • Buccal Mucosa
  • Lower alveolar ridge
  • Upper alveolar ridge
  • Retromolar gingival
  • Floor of the mouth
  • Hard Palate
  • Anterior two third of the tongue

Causes of ORAL CANCER

  • Tobacco (Chewing and smoking)
  • Alcohol
  • Viruses (example Human Papilloma Virus HPV-16, HPV 18 )
  • Poor dental hygiene
  • Constant Chronic trauma to the oral cavity
  • Family History
  • Sun Exposure
  • Age- 95% of oral cancers occurs above 40 years of age with male predominance.

Sign And Symptoms Of ORAL CANCER

  • Generally, they are present as a non-healing ulcer with varying degree of pain and occasional bleeding from the ulcer OR outward growth is present which looks like the shape of a cauliflower.

 

  • Lesions of long term causes pain, bleeding, and fixation of the involved area.

 

  • Lesion in Buccal mucosa can lead to reduced mouth opening.
  • Long term tongue cancer can cause reduce movement of the tongue, speech, saliva and surface bleeding.
  • Soreness, tenderness in the affected region.
  • Difficulty in chewing and swallowing.
  • Difficulty in speaking( throat cancer).
  • Ear pain and tongue pain.
  • Swelling, lumps, rough spots in the mouth that doesn’t heal.
  • Lesion around a non-healing tooth extraction can cause loosening of the involved tooth.

STAGES OF ORAL CANCER

Stage 1

  • Tumor Size is 2 cm or less.
  • Doesn’t spread to lymph nodes

Stage 2

  • Tumor size 2-4 cm.
  • Not involving lymph nodes.

Stage 3

  • Tumor larger than 4 cm.
  • May or may not be involving more than one lymph nodes but doesn’t spread to any other body part.

Stage 4

  • Tumors of any size that has spread to the surrounding tissues, lymph nodes and other body parts.

DIAGNOSIS

If u have any above mentioned symptoms, take an immediate vist to your doctor.

  • Clinical examination
  • OPG is use to identify the lesions involving bone.
  • Xrays if it involves jaws, chest or lungs
  • CT- scan is use to examine lesion involvement of mandible and para-nasal sinuses.
  • PET SCAN ( if cancer involves lymph nodes or other organs)
  • MRI scan for determining extent or stage of cancer.
  • Biopsy
  • FNAC – Fine needle aspiration cytology
  • HOME EXAMINATION to detect Oral Cancer by using a flashlight. Look for any lumps and discoloration at the floor of mouth, inside of cheeks, red or white patches on tongue or any part of oral cavity.

PREVENTION of ORAL CANCER

An early diagnosis can reduce the higher risks of this deadly disease and gives the best chance to beat it.

  • A big NO to tobacco and alcohol consumption.
  • BALANCED DIET that includes fruits, cereals, vegetables, vitamin C, zinc, folate.
  • Use of SUNSCREENS with SPF against harmful UV RADIATIONS especially sunscreen lip balms.
  • A REGULAR VISIT to DENTIST(every 6 months)
  • Maintain good ORAL HYGIENE

MANAGEMENT / TREATMENT

Oral cancer can be treated with Surgery or Radiotherapy or With a combination of both.

Surgery

Surgery is performed to remove tumor or cancerous lymph nodes.

  • It is simple and fast.
  • No cosmetic and functional defects after surgery.
  • Surgery is less expensive.

Radiotherapy

  • Treatment time is longer as compared to surgery.
  • There are many side effects like Dry mouth, caries and cancer of the bone at the site of radiotherapy.
  • Can usually be given only once.
  • Not suitably for treatment if lesion is near the bone.

Brachytherapy

  • In this form of radiotherapy, radiation is administrated through catheters surgically at the site of lesion.
  • Brachytherapy does not damage the normal tissues surrounding the lesion such as bone,  salivary glands, and spinal cord.
  • Lymph nodes are damaged by Brachytherapy alone so external beam radiotherapy is used in combination with Brachytherapy.

Chemotherapy

  • Here anti-cancer drugs are used to treat oral cancer of early stages, in which the drugs are given into the vein or taken directly into the mouth,  which later allows them to reach into the bloodstream and reach to the site.
  • Chemotherapy is also given with radiation therapy and is also given after surgery.

Drugs

Most commonly used Drugs are.

  • Carboplatin
  • Hydroxyurea
  • Cisplatin
  • Dicetaxel

After treatment, there would be frequent checkups. There are always some PROS and CONS associated with the treatment method depending upon its severity and stage. Stage 1 and 2 are easily curable with very good prognosis.

CONCLUSION

WILL POWER, HOPE and POSITIVE MINDSET are the keys to beat any disease. Here’s a story of positive attitude-
There was a cancer warrior with stage 4. One day he decides to grow some DAFFODILS in the belief that he will visualize their blooms the next spring. And at worst, if he wouldn’t be there to see them, he has made a small part of MOTHER EARTH beautiful because of them.
“ DO THE BEST YOU CAN WITH WHAT YOU HAVE”
We can win our battle with this life threatening disease by following a healthy routine

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Dr Deepak Kansal

Dr Deepak Kansal is a dentist, who is currently working in Sri Ganganagar. He did his Bachelor of Dental Surgery from Rajasthan University of Health Science.

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