Oral cancer is divided into two categories – those occurring in the oral cavity (your lips, the inside of your lips and cheeks, teeth, gums, the front two-thirds of your tongue and the floor and roof of your mouth) and those occurring in the oropharynx (middle region of the throat, including the tonsils and base of the tongue).
About Iranian Surgery
Iranian surgery is an online medical tourism platform where you can find the best Surgeons to treat your Oral cancer in Iran. The price of an Oral cancer treatment in Iran can vary according to each individual’s case and will be determined based on an in-person assessment with the doctor and will depend on which part of the oral cavity is involved i.e. Tongue, Gum.
So if you are looking for the cost of Oral cancer treatment in Iran, you can contact us and get free consultation from Iranian surgery.
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Before Oral Cancer Treatment
Where Can Oral Cancer Appear?
The oral cavity includes your lips, cheek lining, gums, front part of your tongue, floor of the mouth beneath the tongue and the hard palate that makes up the roof of your mouth. The throat (pharynx) starts at the soft part of the roof of your mouth and continues back into your throat. It includes the back section of your tongue, as well as the base where the tongue attaches to the floor of your mouth.
Oral Cancer Symptoms
Symptoms of oral cancer include:
. A sore on your lip or mouth that won’t heal
. A mass or growth anywhere in your mouth
. Bleeding from your mouth
. Loose teeth
. Pain or difficulty swallowing
. Trouble wearing dentures
. A lump in your neck
. An earache that won’t go away
. Dramatic weight loss
. Lower lip, face, neck, or chin numbness
. White, red and white, or red patches in or on your mouth or lips
. A sore throat
. Jaw pain or stiffness
. Tongue pain
Some of these symptoms, such as a sore throat or an earache, may indicate other conditions. However, if you notice any of these symptoms, especially if they don’t go away or you have more than one at a time, visit your dentist or doctor as soon as possible. Find out what mouth cancer looks like here.
Oral Cancer Causes
Cancer happens when a genetic change in the body results in cells growing without control. As these unwanted cells continue to grow, they form a tumor. In time, the cells can migrate to other parts of the body.
Around 90% of mouth cancers are squamous cell carcinoma. They start in the squamous cells that line the lips and the inside of the mouth.
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Doctors do not know why these changes happen, but some risk factors seem to increase the chance of mouth cancer developing.
There is evidence that the following factors increase the risk:
. Smoking or chewing tobacco
. Using snuff, which comes from tobacco
. Regularly chewing betel nuts, a popular habit in parts of Southeast Asia
. Excessive alcohol consumption
. Human papillomavirus (HPV) infection, and especially HPV type 16
. A previous history of a head and neck cancer
Other factors that may increase the risk of mouth cancer include:
. Ultraviolet (UV) exposure to the lips from the sun, sunlamps, or sunbeds
. Gastroesophageal reflux disease (GERD)
. Previous radiation therapy in the head, neck, or both
. Exposure to certain chemicals, especially asbestos, sulfuric acid, and formaldehyde
. Having a long standing wound or chronic trauma, for example, from jagged teeth
. Drinking very hot mate tea, popular in South America
Following a healthful diet that contains plenty of fresh fruit and vegetables may reduce the risk.
Oral cancer Diagnosis
How is oral cancer diagnosed?
First, your doctor or dentist will perform a physical exam. 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 your doctor cannot determine why you’re having your symptoms, you may be referred to an ear, nose, and throat (ENT) specialist.
If your doctor finds any tumors, growths, or suspicious lesions, they’ll perform a brush biopsy or a tissue biopsy. A brush biopsy is a painless test that collects cells from the tumor 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, your doctor may perform one or more of the following tests:
. X-rays to see if cancer cells have spread to the jaw, chest, or lungs
. A CT scan to reveal any tumors in your mouth, throat, neck, lungs, or elsewhere in your body.
. A PET scan to determine if the cancer has traveled 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.
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Oral Cancer Screening
Oral cancer screening is an examination performed by a dentist or doctor to look for signs of cancer or precancerous conditions in your mouth.
The goal of oral cancer screening is to identify mouth cancer early, when there is a greater chance for a cure.
Most dentists perform an examination of your mouth during a routine dental visit to screen for oral cancer. Some dentists may use additional tests to aid in identifying areas of abnormal cells in your mouth.
Preparing for the treatment
Radiotherapy makes the teeth more sensitive and vulnerable to infection, so you'll be given a full dental examination and any necessary work will be carried out before you begin your treatment.
If you smoke or drink, stopping will increase the chances of your treatment being successful.
Your GP and specialist nurse can give you help and support if you're finding it difficult to quit smoking and give up drinking.
Oral Cancer Complications
Mouth cancer and its treatment can lead to a range of complications.
Complications after surgery include the risk of:
. Difficulty eating and swallowing
Long term problems may include the following:
. Narrowing of the carotid artery: This can result from radiation therapy and may lead to cardiovascular problems.
. Dental problems: These can develop if surgery changes the shape of the mouth and jaw.
. Dysphagia, or difficulty swallowing: This can make it hard to eat and may increase the risk of inhaling food, and subsequent infections.
. Speech problems: Changes to the tongue, lips, and other oral features can affect speech.
. Mental health issues: Depression, irritability, frustration, and anxiety may arise.
Oral Cancer Prevention
There's no proven way to prevent mouth cancer. However, you can reduce your risk of mouth cancer if you:
. 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, do so in moderation. For healthy adults, that means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger.
. 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.
During Oral Cancer Treatment
Oral Cancer Types
It includes cancers of the:
. Inner lining of the cheek
. Floor of the mouth
. Hard and soft palate
Your dentist is often the first healthcare provider to notice signs of oral cancer. Getting biannual dental checkups can keep your dentist up to date on the health of your mouth.
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Oral cancer Stages
There are four stages of oral cancer.
. Stage 1: The tumor is 2 centimeters (cm) or smaller, and the cancer hasn’t spread to the lymph nodes.
. Stage 2: The tumor is between 2-4 cm, and cancer cells haven’t spread to the lymph nodes.
. Stage 3: The tumor is either larger than 4 cm and hasn’t spread to the lymph nodes, or is any size and has spread to one lymph node, but not to other parts of the body.
. Stage 4: Tumors are any size and the cancer cells have spread to nearby tissues, the lymph nodes, or other parts of the body.
According to the National Cancer Institute, the five-year survival rates for oral cavity and pharynx cancers are as follows:
. 83 percent, for localized cancer (that hasn’t spread)
. 64 percent, for cancer that’s spread to nearby lymph nodes
. 38 percent, for cancer that’s spread to other parts of the body
Overall, 60 percent of all people with oral cancer will survive for five years or more. The earlier the stage at diagnosis, the higher the chance of survival after treatment. In fact, the five-year overall survival rate in those with stage 1 and 2 oral cancers is typically 70 to 90 percent. This makes timely diagnosis and treatment all the more important.
Oral Cancer Treatment options
Treatment for mouth cancer depends on your cancer's location and stage, as well as your overall health and personal preferences. You may have just one type of treatment, or you may undergo a combination of cancer treatments. Treatment options include surgery, radiation and chemotherapy. Discuss your options with your doctor.
Surgery for mouth cancer may include:
. Surgery to remove the tumor. Your surgeon may cut away the tumor and a margin of healthy tissue that surrounds it to ensure all of the cancer cells have been removed. Smaller cancers may be removed through minor surgery. Larger tumors may require more-extensive procedures. For instance, removing a larger tumor may involve removing a section of your jawbone or a portion of your tongue.
. Surgery to remove cancer that has spread to the neck. If cancer cells have spread to the lymph nodes in your neck or if there's a high risk that this has happened based on the size or depth of your cancer, your surgeon may recommend a procedure to remove lymph nodes and related tissue in your neck (neck dissection). Neck dissection removes any cancer cells that may have spread to your lymph nodes. It's also useful for determining whether you will need additional treatment after surgery.
. Surgery to reconstruct the mouth. After an operation to remove your cancer, your surgeon may recommend reconstructive surgery to rebuild your mouth to help you regain the ability to talk and eat. Your surgeon may transplant grafts of skin, muscle or bone from other parts of your body to reconstruct your mouth. Dental implants also may be used to replace your natural teeth.
. Surgery carries a risk of bleeding and infection. Surgery for mouth cancer often affects your appearance, as well as your ability to speak, eat and swallow.
You may need a tube to help you eat, drink and take medicine. For short-term use, the tube may be inserted through your nose and into your stomach. Longer term, a tube may be inserted through your skin and into your stomach.
Your doctor may refer you to specialists who can help you cope with these changes.
. Radiation therapy
Radiation therapy uses high-energy beams, such as X-rays and protons, to kill cancer cells. Radiation therapy is most often delivered from a machine outside of your body (external beam radiation), though it can also come from radioactive seeds and wires placed near your cancer (brachytherapy).
Radiation therapy is often used after surgery. But sometimes it might be used alone if you have an early-stage mouth cancer. In other situations, radiation therapy may be combined with chemotherapy. This combination increases the effectiveness of radiation therapy, but it also increases the side effects, you may experience. In cases of advanced mouth cancer, radiation therapy may help relieve signs and symptoms caused by the cancer, such as pain.
The side effects of radiation therapy to your mouth may include dry mouth, tooth decay and damage to your jawbone.
Your doctor will recommend that you visit a dentist before beginning radiation therapy to be sure your teeth are as healthy as possible. Any unhealthy teeth may need treatment or removal. A dentist can also help you understand how best to care for your teeth during and after radiation therapy to reduce your risk of complications.
Chemotherapy is a treatment that uses chemicals to kill cancer cells. Chemotherapy drugs can be given alone, in combination with other chemotherapy drugs or in combination with other cancer treatments. Chemotherapy may increase the effectiveness of radiation therapy, so the two are often combined.
The side effects of chemotherapy depend on which drugs you receive. Common side effects include nausea, vomiting and hair loss. Ask your doctor which side effects are likely for the chemotherapy drugs you'll receive.
. Targeted drug therapy
Targeted drugs treat mouth cancer by altering specific aspects of cancer cells that fuel their growth. Targeted drugs can be used alone or in combination with chemotherapy or radiation therapy.
Cetuximab (Erbitux) is one targeted therapy used to treat mouth cancer in certain situations. Cetuximab stops the action of a protein that's found in many types of healthy cells, but is more prevalent in certain types of cancer cells. Side effects include skin rash, itching, headache, diarrhea and infections.
Other targeted drugs might be an option if standard treatments aren't working.
Immunotherapy uses your immune system to fight cancer. Your body's disease-fighting immune system may not attack your cancer because the cancer cells produce proteins that blind the immune system cells. Immunotherapy works by interfering with that process.
Immunotherapy treatments are generally reserved for people with advanced mouth cancer that's not responding to standard treatments.
Nutrition is also an important part of your oral cancer treatment. Many treatments make it difficult or painful to eat and swallow, and poor appetite and weight loss are common. Make sure you discuss your diet with your doctor.
Getting the advice of a nutritionist can help you plan a food menu that will be gentle on your mouth and throat, and will provide your body with the calories, vitamins, and minerals it needs to heal.
. Keeping your mouth healthy
Finally, keeping your mouth healthy during cancer treatments is a crucial part of treatment. Make sure to keep your mouth moist and your teeth and gums clean.
No complementary or alternative medicine treatments can cure mouth cancer. But complementary and alternative medicine treatments may help you cope with mouth cancer and the side effects of cancer treatment, such as fatigue.
Many people undergoing cancer treatment experience fatigue. Your doctor can treat underlying causes of fatigue, but the feeling of being utterly worn out may persist despite treatments. Complementary therapies can help you cope with fatigue.
Ask your doctor about trying:
. Exercise. Try gentle exercise for 30 minutes on most days of the week. Moderate exercise, such as brisk walking, during and after cancer treatment reduces fatigue. Talk to your doctor before you begin exercising, to make sure it's safe for you.
. Massage therapy. During a massage, a massage therapist uses his or her hands to apply pressure to your skin and muscles. Some massage therapists are specially trained to work with people who have cancer. Ask your doctor for names of massage therapists in your community.
. Relaxation. Activities that help you feel relaxed may help you cope. Try listening to music or writing in a journal.
. Acupuncture. During an acupuncture session, a trained practitioner inserts thin needles into precise points on your body. Some acupuncturists are specially trained to work with people with cancer. Ask your doctor to recommend someone in your community.
After Oral Cancer Treatment
Recovering from oral cancer treatment
The recovery from each type of treatment will vary. Post-surgery symptoms can include pain and swelling, but removing small tumors usually has no associated long-term problems.
The removal of larger tumors could possibly affect your ability to chew, swallow, or talk as well as you did before the surgery. You might also need reconstructive surgery to rebuild the bones and tissues in your face removed during surgery.
Radiation therapy can have a negative effect on the body. Some of the side effects of radiation include:
. A sore throat or mouth
. Dry mouth and loss of salivary gland function
. Tooth decay
. Nausea and vomiting
. Sore or bleeding gums
. Skin and mouth infections
. Jaw stiffness and pain
. Problems wearing dentures
. A change in your ability to taste and smell
. Changes in your skin, including dryness and burning
. Weight loss
. Thyroid changes
Chemotherapy drugs can be toxic to rapidly growing noncancerous cells. This can cause side effects such as:
. Hair loss
. Painful mouth and gums
. Bleeding in the mouth
. Severe anemia
. Poor appetite
. Mouth and lip sores
. Numbness in the hands and feet
Recovering from targeted therapies is usually minimal. The side effects of this treatment can include:
. An allergic reaction
. Skin rashes
Although these treatments do have side effects, they’re often necessary in beating the cancer. Your doctor will discuss the side effects and help you weigh the pros and cons of your treatment options.
Reconstruction and rehabilitation after oral cancer treatment
People who are diagnosed with advanced oral cancer will likely need reconstructive surgery and some rehabilitation to assist with eating and speaking during recovery.
Reconstruction can involve dental implants or grafts to repair the missing bones and tissues in the mouth or face. Artificial palates are used to replace any missing tissue or teeth.
Rehabilitation is also necessary for cases of advanced cancer. Speech therapy can be provided from the time you get out of surgery until you reach the maximum level of improvement.
Lifestyle and home remedies
. Quit using tobacco
Mouth cancers are closely linked to tobacco use, including cigarettes, cigars, pipes, chewing tobacco and snuff, among others. Not everyone who is diagnosed with mouth cancer uses tobacco. But if you do, now is the time to stop because:
Tobacco use makes treatment less effective.
Tobacco use makes it harder for your body to heal after surgery.
Tobacco use increases your risk of a cancer recurrence and of getting another cancer in the future.
Quitting smoking or chewing can be very difficult. And it's that much harder when you're trying to cope with a stressful situation, such as a cancer diagnosis and treatment. Your doctor can discuss all of your options, including medications, nicotine replacement products and counseling.
. Quit drinking alcohol
Alcohol, particularly when combined with tobacco use, greatly increases the risk of mouth cancer. If you drink alcohol, stop drinking all types of alcohol. This may help reduce your risk of a second cancer.
The outlook for oral cancers depends on the specific type and stage of cancer at diagnosis. It also depends on your general health, your age, and your tolerance and response to treatment. Early diagnosis is critical because treating stage 1 and stage 2 cancers may be less involved and have a higher chance of successful treatment.
After treatment, your doctor will want you to get frequent checkups to make sure that you’re recovering. Your checkups will usually consist of physical exams, blood tests, X-rays, and CT scans. Make sure to follow up with your dentist or oncologist if you notice anything out of the ordinary.
Oral Cancer treatment cost
Diagnosis of Oral cancer is hard enough without considering the direct and indirect costs associated with Oral cancer treatment. Beating your cancer is your first priority, but financial worries are often not far behind. Most Oral cancer patients fail to understand, why package cost for Oral Cancer treatment cannot be predetermined.
The answer is simple; cost of treating oral cancer can vary. The cost variation will depend on which part of the oral cavity is involved i.e. Tongue, Gum, Cheek, Jaw (Upper/Lower), Palate, Base of the Tongue, Uvella and Stage of the Disease (Early / locally advanced / metastatic) and modality of treatment required as per National / International treatment guidelines to achieve best treatment outcomes.
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