Oral Cavity Cancers: Symptoms, Diagnosis, and Treatments

What is oral cavity?

The oral cavity includes the lips, the inside lining of the lips and cheeks (buccal mucosa), the
teeth, the gums, the front two-thirds of the tongue, the floor of the mouth below the tongue, the
bony roof of the mouth (hard palate) and the area behind the wisdom teeth (called the retromolar
trigone)

What are the types of oral cavity cancers?

  • Squamous cell carcinoma – -Almost all of the cancers in the oral cavity are squamous cell
    carcinomas, also called squamous cell cancers. These cancers start in squamous cells, which are
    flat, thin cells that form the lining of the mouth. Verrucous carcinoma is a rare type of squamous
    cell cancer that is most often found in the gums and cheeks. It's a low-grade (slow growing)
    cancer that hardly ever spreads to other parts of the body.
  • Minor salivary gland cancers-These cancers can start in the glands in the lining of the mouth.

What are pre-cancer conditions of oral cavity?

  • Leukoplakia-an oral mucosal white lesion that cannot be considered as any other definable
    lesion
  • Erythroplakia-Erythroplakia (pronounced eh-RITH-roh-PLAY-kee-uh) appears as abnormal red
    lesions on the mucous membranes in your mouth.
  • Lichen planus-lacy-white lesions in the mouth, which may be painful or cause a burning
    sensation
  • Oral submucosal Fibrosis-Oral submucous fibrosis is a chronic, progressive, irreversible and yet avoidable collagen metabolic disorder of the mouth caused by chewing areca nut in betel quid or its variants.burning sensation in the mouth especially when eating spicy food, sometimes also with small blister formation. The mouth may feel dry with  ulcers .On examination, even at an early stage, the oral mucosa looks white in a marble-like pattern, either diffusely throughout the mouth or in localised areas, or in a netlike pattern.n later stages fibrosis develops and hence mouth cannot be opened as wide as normal, affecting eating and swallowing, speaking and dental hygiene.tongue becomes smooth, white and cannot move easily.

What are the risk factors for oral cavity cancers?

  • Smoking
  • Tobacco
  • Chewing betel quid or paan
  • Drinking excessive alcohol
  • Age more than 45
  • Male gender
  • Persistent viral infections such as HPV
  • Excessive exposure to sun
  • Genetic inheritance

What are the symptoms of Oral cavity cancers?

  • A lip or mouth sore that doesn't heal within 2 weeks
  • A white or reddish patch on the inside of your mouth
  • Loose teeth
  • A growth or lump inside your mouth
  • Mouth pain
  • Ear pain
  • Difficult or painful swallowing

How is oral cavity cancer evaluated and diagnosed?

  • Biopsy-A procedure in which tissue samples are removed from the lesion and under a
    microscope to determine if cancer or other abnormal cells are present
  •  Endoscopy-A small fiber-optic scope can be used to examine the throat for signs of cancer
    beyond the mouth area.
  • Computerized tomography (CT) scan or magnetic resonance imaging (MRI).
  • Ultrasonography
  • Positron emission tomography (PET)/CT scan.-A noninvasive procedure that uses special
    radioactive dyes that may help detect cancer in the body.

What are the Treatment Options available for oral cavity cancers?

Surgery- Surgery may be needed to remove the cancer from oral cavity as well as to repair
(reconstruct) the defect once the cancer is removed. Surgery may also be needed to remove the
lymph nodes from the neck if there is concern that the cancer may have spread there.

Radiation therapy– Radiation therapy uses high-energy rays that damage cancer cells and halt the
spread of the disease.
Chemotherapy- Chemotherapy uses medications that go throughout the entire body to kill cancer
cells. Chemotherapy may be given alone, or it can be used in combination with surgery or radiation
therapy.
Immunotherapy- Immunotherapy uses medications that help your body’s immune system fight the
cancer.
Targeted therapies- For some patients, drugs that target specific cancer cells are an option

What are the lifestyle modifications needed for prevention of Oral cavity cancer and its recurrence?

  • avoiding tobacco products
  • avoidance of paan
  • limiting alcohol use
  • sun protection
  • HPV vaccination
  • Periodical oral cancer screening

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