Oral cancer, also known as mouth cancer, is cancer of the lining of the lips, mouth, or upper throat. In the mouth, it most commonly starts as a painless white patch that thickens, develops red patches, an ulcer, and continues to grow. When on the lips, it commonly looks like a persistent crusting ulcer that does not heal, and slowly grows. Other symptoms may include difficult or painful swallowing, new lumps or bumps in the neck, a swelling in the mouth, or a feeling of numbness in the mouth or lips.
It belongs to a larger group of cancers called head and neck cancers. Most develop in the squamous cells found in your mouth, tongue, and lips.
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.
. One of the biggest risk factors for oral cancer is tobacco use. This includes smoking cigarettes, cigars, and pipes, as well as chewing tobacco.
. People who consume large amounts of alcohol and tobacco are at an even greater risk, especially when both products are used on a regular basis.
Other risk factors include:
. Human papillomavirus (HPV) infection
. Chronic facial sun exposure
. A previous diagnosis of oral cancer
. A family history of oral or other types of cancer
. A weakened immune system
. Poor nutrition
. Genetic syndromes
. Being male
Men are twice as likely to get oral cancer as women are.
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.
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.
Mouth cancer can complicate, affecting the outlook of the condition.
Dysphagia, or difficulty swallowing, is the main complication of mouth cancer. Swallowing is normally an automatic process, but surgery or radiotherapy may affect the action of the tongue, mouth, or throat.
Dysphagia can lead to malnutrition and food going down the wrong way, leading to choking, lung infections, or aspiration pneumonia.
If tests show that particles of food are entering the patients' lungs, a short-term feeding tube may be directly connected to the stomach, while the patient learns exercises that improve their swallowing. A person who continues to have problems may need to follow a special diet.
Speaking problems are common, but a speech therapist can teach some exercises that develop vocal movements.
Depression, irritability, frustration, and anxiety may also occur. Joining a support group or online forum can be helpful, providing an opportunity to meet people with similar experiences.
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.
. 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.
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.
How is oral cancer treated?
Treatment for oral cancer will vary depending on the type, location, and stage of the cancer at diagnosis.
Treatment for early stages usually involves surgery to remove the tumor and cancerous lymph nodes. In addition, other tissue around the mouth and neck may be taken out.
Radiation therapy is another option. This involves a doctor aiming radiation beams at the tumor once or twice a day, five days a week, for two to eight weeks. Treatment for advanced stages will usually involve a combination of chemotherapy and radiation therapy.
Chemotherapy is a treatment with drugs that kill cancer cells. The medicine is given to you either orally or through an intravenous (IV) line. Most people get chemotherapy on an outpatient basis, although some require hospitalization.
Targeted therapy is another form of treatment. It can be effective in both early and advanced stages of cancer. Targeted therapy drugs will bind to specific proteins on cancer cells and interfere with their growth.
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.
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.
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.