ORAL CANCER

 

Oral cancer has the potential to manifest in various regions of the mouth, including the inner cheeks and gums. This particular form of cancer falls under the broader category of head and neck cancer. Specifically, it is classified as oral and oropharyngeal cancer, with oropharyngeal cancer primarily impacting the posterior region of the mouth and the lining of the throat.

As per the statistics provided by the American Cancer Society (ACS), approximately 53,000 individuals from the United States are expected to receive a diagnosis of oral or oropharyngeal cancer in the year 2019. While the average age of diagnosis tends to be around 62 years old, the ACS reports that roughly 25% of cases occur before the age of 55. Furthermore, this disease demonstrates a higher likelihood of affecting males as compared to females.

SYMPTOMS

In the early stages of oral cancer, it is often difficult to detect any noticeable signs or symptoms. Individuals who smoke or consume alcohol heavily should make it a priority to undergo regular checkups with their dentist, as these habits increase the risk of developing mouth cancer. Dentists possess the ability to identify any potential signs of oral cancer at an early stage. Certain indications suggest the possibility of future cancer development. Leukoplakia, characterized by white patches in the mouth that do not disappear when rubbed, is one such sign.

Oral lichen planus, which presents as white lines with a reddish border, potentially accompanied by ulceration, is another indicator. Numerous oral lesions may serve as precursors to cancer. It is important to note that the presence of these lesions does not necessarily indicate the presence of cancer. However, any changes occurring in the mouth should be discussed with a doctor. Vigilantly monitoring for changes can aid in the early detection of mouth cancer, which in turn facilitates easier treatment.

If cancer develops, a person may notice:

• Patches on the mouth lining or tongue, typically appearing reddish in color or reddish and white.
• The mouth becomes numb, the person experiences mouth bleeds and painful discomfort in the mouth
• Sores grow in the mouth and refuse to heal even after several treatments. One might refer to it as a mouth ulcer.
• The gum becomes thick as a result of a lump in the mouth lining.
• Teeth in the mouth suddenly become loose
• The Jaws in the mouth begin to swell
• The victim develops a hardness in the throat often leading to a soaring throat which usually feels like something is stuck down there. As a result, the individual would have a hoarse voice
• In addition to that the individual will find it difficult to eat food and swallow, followed by pains and challenges in moving the jaws and tongue while talking or eating.
• Experiencing any of these symptoms does not necessarily indicate the presence of mouth cancer, but it is advisable to consult a doctor for further evaluation.

TREATMENT

1.1 SURGERY:

Surgical intervention may be recommended by the doctor to eliminate the tumor and adjacent healthy tissue, depending on the severity of the cancer. The extent of the surgery will be determined by the specific circumstances, potentially involving the removal of sections of the tongue, jawbone, or lymph nodes. It's important to note that this type of surgery can impact appearance, speech, and eating. When necessary, doctors may suggest reconstructive surgery to address these concerns.

1.2 RADIATION THERAPY

Radiation therapy proves highly effective for oral cancer treatment, utilizing high-energy X-rays, or radiation particles, to precisely target and immobilize tumor cells within the DNA, preventing their replication.

1.3 THERE ARE TWO PRIMARY METHODS OF RADIATION THERAPY:

1. External beam radiation: A specialized machine precisely directs radiation beams towards the affected area.
2. Brachytherapy: Radioactive needles are utilized by the surgeon to deliver radiation internally to the tumor. This option may be recommended for individuals with early-stage tongue cancer.

Adverse effects in the mouth resulting from radiation therapy may include tooth decay, mouth sores, bleeding gums, jaw stiffness, fatigue, and skin reactions, such as burns. It is worth noting that treatment tends to be more successful in individuals who are non-smokers or have already quit. While radiation therapy alone may be sufficient for individuals with early-stage mouth cancer, combining it with other treatments may be advised by a doctor to minimize the risk of cancer progression or recurrence.

1.4 CHEMOTHERAPY

In cases of widespread cancer, combining chemotherapy with radiation therapy may be recommended by medical professionals. Chemotherapy employs potent medications that harm the DNA of cancer cells, impairing their ability to proliferate and metastasize. While chemotherapy effectively destroys cancer cells, it can also cause significant damage to healthy tissues, resulting in adverse effects. Such effects may include fatigue, nausea, vomiting, hair loss, and a weakened immune system with an increased susceptibility to infections. Fortunately, these effects typically subside once the treatment is completed.

1.5 HYPERTHERMIA THERAPY

An innovative approach, hyperthermia therapy involves elevating the temperature above normal levels to induce damage and eliminate cancer cells. This technique can also enhance the sensitivity of cancer cells to radiation therapy, maximizing treatment efficacy.

STAGES

The stage of cancer denotes the extent of its spread throughout the body. In its earliest stages, there may be the presence of precancerous cells that have the potential to develop into cancerous cells. This initial stage is often referred to as stage 0 cancer or carcinoma in situ. It is advised by medical professionals for individuals to cease smoking and carefully monitor any further changes. Localized cancer is confined to a specific area and has not invaded nearby tissues.

Regional cancer indicates that the cancer has spread to adjacent tissues. Distant cancer signifies the spread of cancer to distant parts of the body, including potentially the lungs or liver. Without treatment, oral cancer can initiate in one area of the mouth and subsequently metastasize to other regions of the mouth, as well as the head, neck, and other body parts. The available treatment options and prognosis are dependent, to some extent, on the stage of the cancer.

COMPLICATIONS

Mouth cancer and its treatment can give rise to various complications. Surgical procedures carry the risk of complications such as bleeding, infection, pain, and difficulties with eating and swallowing.

1.6 LONG-TERM COMPLICATIONS MAY INCLUDE THE FOLLOWING:

• Narrowing of the carotid artery: This can occur as a consequence of radiation therapy and may result in cardiovascular issues.
• Dental problems: Changes to the shape of the mouth and jaw due to surgery can lead to dental complications.
• Dysphagia, or difficulty swallowing: This can make eating challenging and increase the risk of food aspiration and subsequent infections.
• Speech impairments: Alterations to the tongue, lips, and other oral structures can impact speech.

Your mental state can be affected, one might go into depression, Irritation, fear, panic, and frustration may manifest. Visiting an online support group can be beneficial as it provides an opportunity to connect with individuals who share similar experiences.

CAUSES

The occurrence of cancer stems from genetic alterations within the body, leading to uncontrolled cell growth. These aberrant cells proliferate, forming a tumor, and can eventually spread to other areas of the body. Approximately 90% of mouth cancers are classified as squamous cell carcinoma, originating from the squamous cells lining the lips and the interior of the mouth.

RISK FACTORS

• The exact reasons for these genetic changes remain unknown, but certain risk factors have been associated with an increased likelihood of developing mouth cancer.
• Evidence suggests that the following factors elevate the risk:
• Regular smoking in addition to eating tobacco can be a contributing factor.
• Regular consumption of snuff, a tobacco-derived product
• Habitual chewing of betel nuts, is prevalent in some regions of Southeast Asia.
• Frequent consumption of Alcoholic drinks
• Infection with human papillomavirus (HPV), particularly HPV type 16
• Family history associated with facial cancer, head, and neck cancer type.
• Other factors that may heighten the risk of mouth cancer include:
• Exposure to sunlight's UV rays can impact the mouth.
• Gastroesophageal reflux disease (GERD) has been linked to the development of oral cancer.
• Prior radiation therapy in the neck, head, or both areas can be a contributing factor.
• Exposure to specific acidic chemicals like Formaldehyde may play a role.
• Persistent non-healing mouth wounds, particularly in jagged teeth or from chronic trauma, can be concerning.
• Consuming certain hot mate tea substances, commonly found in South America, can be a factor.
• Maintaining a balanced and healthy routine with a diet abundant in fresh fruits and vegetables may help reduce the risk of mouth cancer.

DIAGNOSIS

To determine the nature of the ailment, the doctor will inquire about the patient's symptoms. The doctor is responsible for conducting a thorough examination while the patient is lying on the bed. By questioning the patient about their parents or grandparents, the doctor aims to gather information about their medical history. If mouth cancer is suspected, a biopsy may be recommended. During a biopsy, a small tissue sample is taken to examine for cancer cells. This can be done through a painless brush biopsy, using a specialized brush.

Once the doctor confirms the presence of mouth cancer, the next step is to determine its stage using the following approaches:

• Endoscopy: The doctor inserts a small tube equipped with a light and camera into the patient's throat to assess the severity and stage of the mouth cancer.
• Imaging tests: This involves utilizing X-rays to examine the lungs and determine the extent of the disease, including whether cancer has spread to other areas of the body.