Written By: Dr Anitha Anchan | Updated : June 13, 2014 2:34 PM IST
Have you noticed a sore in your mouth that won't go away? Is there a lump, or pain or numbness anywhere in your mouth or on your lips? If yes, do not neglect these. They could be signs of early oral cancer.
Most oral cancers begin in the tongue or in the floor of the mouth and are squamous cell carcinomas. They begin on the surface layer of the mouth and lips and if left untreated can spread to other parts of your body. Oral cancer includes cancers of the lips, cheeks, tongue, floor of the mouth, hard and soft palate, sinuses and throat (pharynx). It may originate in any of the tissues of the mouth or may be a result of metastasis from a different part of the body. If not diagnosed and treated early, they can be life threatening.
There are many risk factors for developing oral cancer. If you are a man, you are twice as likely to get oral cancer as a women and the risk increases with age. You are more likely to develop a head and neck cancer if you have a history of cancer. Precancerous (premalignant) lesions are those lesions, which precede the development of full-blown cancer. These lesions are changes in skin or lining of the mouth that are not cancer but could trigger it. Common pre-cancerous conditions that occur in the mouth are Leukoplakia,Erythroplakia and Oral Submucous fibrosis.
Most cases of oral cancer are linked to one or the other form of tobacco use (cigarettes, smokeless tobacco, chewing tobacco, dipping snuff, cigars, bidis, etc.). The longer the duration you use these, the higher the risk. Tobacco contains around 4,000 chemical constituents among which more than two dozen are known carcinogens (cancer causing chemicals). It is the single biggest culprit in the development of almost all pre-cancerous lesions. In India, the incidence of head and neck cancers is extremely high due to rampant tobacco-chewing habit in the form of gutka, quid, misri, snuff, etc.
Heavy alcohol use is another big culprit. Alcohol is known to irritate the lining inside the mouth or gums to a certain extent. And the risk increases if you use both alcohol and tobacco.
Sunlight helps the skin produce vitamin D and facilitates calcium absorption by the body. But did you know that sun exposure over long periods of time may increase the risk of lip cancer?
Some studies also suggest that not eating enough fruits and vegetables may increase the chance of getting oral cancer.
Chronic irritation from rough teeth, dentures, fillings, etc. has been considered to a risk factor for Leukoplakia (a premalignant lesion).
Human Papilloma Viruses (HPV 16 and HPV 18) which cause cervical cancer are also being linked to cancer of the oropharynx (throat, base of tongue, tonsils and soft palate). These viruses are passed from person to person through sexual contact. Cancer at the base of the tongue, at the back of the throat, in the tonsils or in the soft palate may be linked with HPV infection.
Oral cancer may present itself with many symptoms, some of the common ones are listed below. However, you should know that having any of these symptoms does not always mean cancer. A good doctor or dentist will be able to help diagnose it right.
Red (Erythroplakia) and white (Leukoplakia) patches on your lips or in your mouth
Non-healing sore on your lip or in your mouth
Swellings or lumps on the lips, gums, cheek, back of the throat etc.
Bleeding in the mouth
Numbness, loss of pain in any area of the mouth, neck or face
Difficulty in moving the jaw or tongue
Difficulty in chewing, swallowing or speaking
Loosening of teeth
A change in the fit of denture
Ear pain
Swollen lymph nodes in the neck
Unexplained weight loss
Early detection followed by appropriate treatment is very important for increasing survival rate and improving the quality of life. Hence a once a year screening for oral cancer is important. Most of the oral cancers can be diagnosed from lesions in the mouth. Your dentist will check for white or red patches, ulcerations, lumps and other signs in the mouth. If there is any area that is suspicious, he/she may use toluidine blue for vital staining which aids early recognition and hastens biopsy. However, Biopsy is the only definitive method of diagnosing oral cancer. Dental x-rays may show abnormalities in the bone. Other tests may include CT scan, Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET).
Read more about causes, symptoms, diagnosis and treatment of oral cancer.
Like all other cancers, treating oral cancers requires a multidisciplinary approach comprising of dental practitioners, surgeons, oncologists, nutritionists and rehabilitation specialists. If your tumour is small it is usually excised with surgery. The affected tissue is removed with minimal damage to other structures of the mouth. In advanced and extensive cancer a part of your mouth lining may be removed. If the cancer involves your tongue or jaw bone, they may need to be partially or completely removed. This may cause disfigurement of your face, head and neck which can be corrected with reconstructive surgery using bone grafts and surgical flaps. Depending on the stage of your cancer, radiotherapy and/or chemotherapy may be used along with surgery. You may find it difficult to chew, swallow and speak after your treatment. In such instances, rehabilitation may be necessary for you to return to normal activities as soon as possible. Dental or facial prostheses may be fabricated for cosmetic and functional reasons. They help in restoring speech and swallowing to normal. Prostheses also support the lip and cheek.
After the treatment it is very important to follow-up with your doctor who will monitor your recovery and check if there is any recurrence of cancer.
Read more about causes, symptoms, diagnosis and treatment of cancer.
Photo source: creativesmilesdentistry118.blogspot.in
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