Oral Cancer

Oral cancer on the side of the tongue, a common site along with the floor of the mouth

Source: Wikipedia

Mouth cancer, or oral cancer, can occur anywhere in the mouth, on the surface of the tongue, the lips, inside the cheek, in the gums, in the roof and floor of the mouth, in the tonsils, and in the salivary glands. It is a type of head and neck cancer and is often treated similarly to other head and neck cancers. Oral cancer can be life-threatening if not diagnosed and treated early. Mouth cancer mostly happens after the age of 40, and the risk is more than twice as high in men as it is in women.

Symptoms

The most common symptoms of oral cancer include:

• A sore that doesn't heal
• A sore that bleeds
• A growth, lump or thickening of the skin or lining of your mouth
• Loose teeth
• Poorly fitting dentures
• Tongue pain
• Jaw pain or stiffness
• Difficult or painful chewing
• Difficult or painful swallowing
• A sore throat

Make an appointment with your doctor or dentist if you have any persistent signs and symptoms that bother you and last more than two weeks. Your doctor will likely investigate other more common causes for your signs and symptoms first, such as an infection.

Causes

Cancer results when a genetic mutation instructs cells to grow without control. Untreated, oral cancer will start in one part of the mouth, then spread to other parts of the mouth, to the head and neck, and the rest of the body. Mouth cancers typically start in the squamous cells that line the lips and the inside of the mouth. This is called squamous cell carcinoma.

Risk Factors

Factors that can increase your risk of mouth cancer include:

• Smoking. 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.

• Excessive consumption of alcohol. Oral cancers are about six times more common in drinkers than in non-drinkers.

• Family history of cancer.

• Excessive sun exposure, especially at a young age.

• Human papillomavirus (HPV). Certain HPV strains are etiologic risk factors for Oropharyngeal Squamous Cell Carcinoma (OSCC)

Diagnosis

A biopsy may be carried out, where a small sample of tissue is taken to check for cancerous cells. Sometimes a "brush biopsy" is used initially; this where cells are painlessly collected by brushing them to one side.

If mouth cancer is diagnosed, the next task is to determine the stage of the cancer.

Tests include:

• Endoscopy, where a lighted scope is passed down the patient's throat to see how far the cancer has spread
• Imaging tests, such as X-ray, Computed Tomography (CT) scans, and Magnetic Resonance Imaging (MRI) Staging cancer will inform treatment options and help predict prognosis

Outlook

A person who is diagnosed with stage 1 oral or pharyngeal cancer has an 83 percent chance of surviving for longer than 5 years. Around 31 percent of cases are diagnosed at this stage.

For those whose cancer spreads to other parts of the body, the chance of surviving more than 5 years is 38 percent.

Treatment

Treatment depends on the location and stage of the cancer, and the patient's general health and personal preferences. A combination of treatments may be necessary.

·         Surgery: Surgical removal of the tumour involves taking out the tumour and a margin of healthy tissue around it. A small tumour will require minor surgery, but for larger tumours, surgery may involve removing some of the tongue or the jawbone.

·         Radiation Therapy: Oral cancers are especially sensitive to radiation therapy, which uses beams of high-energy X-rays or radiation particles to damage the DNA inside the tumour cells, destroying their ability to reproduce.A person with early-stage mouth cancer may only need radiation therapy, but it can also be combined with surgery, chemotherapy, or both, to prevent the cancer from returning.

·         Chemotherapy: Widespread cancer may be treated with chemotherapy as well as radiation therapy, especially if there is a significant chance of the cancer returning.Chemotherapy involves using powerful medicines that damage the DNA of the cancer cells, undermining their ability to reproduce.

·         Targeted Drug Therapy: Targeted drug therapy uses drugs known as monoclonal antibodies to change aspects of cancer cells that help them grow.Cetuximab, or Erbitux, is used for some head and neck cancers. Targeted drugs may be combined with radiotherapy or chemotherapy.

 

Prevention

A number of lifestyle changes can reduce the risk of mouth cancer.

• Stop using tobacco or don't start. If you use tobacco, stop. If you don't use tobacco, don't start. Using tobacco, whether smoked or chewed, exposes the cells in your mouth to dangerous cancer-causing chemicals.
• Drink alcohol only in moderation, if at all. Chronic excessive alcohol use can irritate the cells in your mouth, making them vulnerable to mouth cancer. If you choose to drink alcohol, limit yourself to one drink a day if you're a woman or two drinks a day if you're a man.
• Eat a variety of fruits and vegetables. Choose a diet rich in fruits and vegetables. The vitamins and antioxidants found in fruits and vegetables may help reduce your risk of mouth cancer.
• Avoid excessive sun exposure to your lips. Protect the skin on your lips from the sun by staying in the shade when possible. Wear a broad-brimmed hat that effectively shades your entire face, including your mouth. Apply a sunscreen lip product as part of your routine sun protection regimen.
• See your dentist regularly. As part of a routine dental exam, ask your dentist to inspect your entire mouth for abnormal areas that may indicate mouth cancer or precancerous changes.