Oral Cancer

Oral cancer or mouth cancer is any cancerous tissue growth located in the oral cavity.

Signs & Symptoms:

• Persistent mouth sore
• Pain: Persistent mouth pain is another common oral cancer sign
• A lump or thickening in the cheek
• A white or red patch on the gums, tongue, tonsil, or lining of the mouth
• A sore throat or feeling that something is caught in the throat that does not go away
• Difficulty swallowing or chewing
• Difficulty moving the jaw or tongue
• Numbness of the tongue or elsewhere in the mouth
• Jaw swelling that makes dentures hurt or fit poorly
• Loosening of the teeth
• Pain in the teeth or jaw
• Voice changes
• A lump in the neck
• Weight loss
• Persistent bad breath

Risk Factors

• Gender: Oral cancer and oropharyngeal cancer are twice as common in men as in women
• Age: Two-thirds of individuals with this disease are over age 55
• Ultraviolet Light
• Genetic syndromes: Fanconi anemia & Dyskeratosis congenita:
• Tobacco Use
• Alcohol
• Betel quid
• Human Papillomavirus (HPV) Infection
• Immune system suppression
• Lichen planus
• Graft-versus-host disease (GVHD)

Common Types:

• Lip cancer
• Mouth cancer
• Tongue cancer

Diagnosis:

• Physical examination
• Endoscopy
• Biopsy
• Oral brush biopsy
• X-ray
• Barium Swallow
• Computed Tomography (CT or CAT) Scan
• Magnetic Resonance Imaging (MRI)
• Ultrasound
• Positron emission tomography (PET) scan

Stages:

Prevention:

• Always brush and floss your teeth regularly
• Do not smoke (or chew) any type of tobacco product
• Drink alcohol in moderation
• Limit your exposure to the sun
• Exercise regularly
• Choose cancer-fighting foods in your diet
• How you prepare those foods is also important in the prevention of cancer
• See your dentist or dental hygienist regularly
• Conduct a self exam at least once a month

Management

• Surgery
  Surgery is the removal of the tumor and some surrounding healthy tissue, known as a margin, during an operation. Sometimes surgery is followed by radiation therapy and/or chemotherapy. Depending on the location, stage, and pathology of the cancer, some people may need more than one operation to remove the cancer and to help restore the appearance and function of the affected tissues. The most common surgical procedures for the removal of oral and oropharyngeal cancer include:
  • Primary tumor surgery: The tumor and a margin of healthy tissue are removed to decrease the chance that any cancerous cells will be left behind. The tumor can be removed through the mouth or through an incision in the neck. A mandibulotomy, in which the jawbone is split to access the tumor, may also be required.
  • Glossectomy: This is the partial or total removal of the tongue
  • Mandibulectomy: If the tumor has entered a jawbone but not spread into the bone, then a piece of the jawbone or the whole jawbone will be removed. If there is evidence of destruction of the jawbone on an x-ray, then the entire bone may need to be removed.
  • Maxillectomy: This surgery removes part or all of the hard palate, which is the bony roof of the mouth. Prostheses (artificial devices), or more recently, the use of flaps of soft tissue with and without bone can be placed to fill gaps created during this operation
  • Neck dissection: Cancer of the oral cavity and oropharynx often spreads to lymph nodes in the neck. It may be necessary to remove some or all of these lymph nodes using a surgical procedure called a neck dissection.
  • Laryngectomy: A laryngectomy is the complete or partial removal of the larynx or voice box. The larynx is critical to swallowing because it protects the airway from food and liquid entering the trachea or windpipe and reaching the lungs, which can cause pneumonia. A laryngectomy is rarely needed to treat oral or oropharyngeal cancer.

• Radiation Therapy:
  Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. External-beam radiation therapy is the most common type of radiation treatment for oral and oropharyngeal cancer. During external-beam radiation therapy, a radiation beam produced by a machine outside the body is aimed at the tumor. This is generally done as an outpatient procedure. Internal radiation therapy is given using implants. Internal radiation therapy involves tiny pellets or rods containing radioactive materials that are surgically implanted in or near the cancer site. The implant is left in place for several days while the person stays in the hospital.
• Chemotherapy
  Chemotherapy is the use of drugs to destroy cancer cells, usually by stopping the cancer cells’ ability to grow and divide.
• Immunotherapy
  Immunotherapy, also called biologic therapy, is designed to boost the body’s natural defenses to fight cancer. It uses materials made either by the body or in a laboratory to improve, target, or restore immune system function..
• Targeted therapy
  Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells while limiting damage to healthy cells.