Journal of Cancer Science and Research
Open Access

Diagnosis and Treatment of Oral Cancer

Dipen Mistry^{* *}Correspondence: Dr. Dipen Mistry, Department of Medical Oncology, Max Super Specialty Hospital, Shalimar Bagh, New Delhi, India, Tel: (31) 98836-5128, Email:

Author info »

About the Study

Oral cancer, a disease characterized by the growth of cancer cells in the mouth, including the lips. Oral cavity cancer is often associated with cancer of the cavity behind the tonsils and the back of the throat (oropharyngeal cancer). Most cases arise from the flat cells that line the mouth (squamous cell carcinoma). Oral cavity cancer spreads to the jaw and can occur at the same time as cancer of the larynx, esophagus, or lungs.

Causes and symptoms

Several factors has been identified the risk of developing oral cancer. Tobacco and alcohol use are the main contributing factors, and when taken in large amounts in combination and used heavily, this causes the increase in risk eventually. Tobacco is mainly used in the preparation of cigarettes, cigars, pipes and chewing tobacco. Oral cancer affects men at twice the rate of women, probably because men are generally more likely to use tobacco and alcohol. Vitamin A deficiency is also a risk factor, as some strains of the human papillomavirus can infect the mouth and increase the risk of oral cancer. Exposure to the sun's UV rays can cause lip cancer.

The most common symptom is mouth ulcers. Early visual signs include white or red spots inside the mouth. White spots (leukoplakia) have about a 5% chance of progressing to cancer. Red spots (erythroplakia) bleed easily, and about half of them become cancerous. Other symptoms of oral cavity or oropharyngeal cancer include lumps or swelling in the cheeks, throat, or jaw, difficulty swallowing or moving the tongue or jaw, and pain in the jaw or teeth. Almost any type of persistent mouth soreness can indicate oral cancer and should be evaluated by a doctor.

Diagnosis

If cancer is suspected, more tests are done to determine the type and stage of cancer. Suspicious tumors are analyzed by biopsy, and the mouth, throat, and larynx are visually examined using a small speculum or laryngoscope (a flexible tube containing a light and lens at the end). In some cases, a more comprehensive examination of the head and neck can be done under general anesthesia. Multiple imaging techniques can also be used, such as x-ray, Computed Tomography (CT) scan, or Magnetic Resonance Imaging (MRI) of his chest and head. Barium may need to be swallowed prior to x-rays to improve image contrast. Once oral cancer is diagnosed, it is staged to indicate how far the cancer has progressed. A stage of oropharyngeal cancers is confined to the epithelial cells lining the mouth or pharynx and is sometimes called carcinoma. Stage I and II cancers are less than 2 cm (about 3/4 inch) and 2 cm to 4 cm in size, respectively and have not spread to nearby lymph nodes. A stage III tumor is cancer larger than or smaller than 4 cm that has spread to lymph nodes on the same side of the neck as the tumor. Stage IV tumors have spread to other areas of the neck, lymph nodes, or other organs in the body.

Conclusion

Treatment

Like most cancers, oral cavity and oropharyngeal cancer can be treated with surgery, radiation or chemotherapy. Surgery is often the first treatment. To minimize tissue loss, superficial lip cancer can be scraped off layer by layer until no cancer is found. Small early-stage tumors can be removed along with the surrounding tissue with minimal side effects. If the cancer has spread to the surrounding bone, part or all of the jaw (mandibular resection) may need to be removed, or a maxillary resection may be done to remove the hard palate. Both procedures require subsequent reconstructive surgery. If cancer has spread to lymph nodes in the neck, those lymph nodes are also removed.

Oral cavity and oropharyngeal cancer can be treated with radiation using an external beam or surgically implanted radioactive pellets. External radiation is the most common approach to oral cancer. Radiation is usually used in combination with surgery to destroy the small amount of cancer tissue that remains.

Prevention

Oral cancer is almost completely preventable by avoiding smoking and drinking alcohol, which are the main risk factors. A healthy diet with sufficient vitamin A is also recommended. Regular dental checkups can detect oral cancer early. Dentures should be removed and cleaned at night to prevent cancer causing substances from sticking to the gums.