Cancer is an abnormal disorganized growth of cells in the tissues of a person. Cancer cells keep on multiplying without paying heed to the body’s command to stop. This abnormal growth of cells destroys the normal structure and the function of the affected tissue and the body in general.
Any cancerous growth occurring within the the oral cavity is known as Oral Cancer. The oral cavity includes the mouth and all the structures within it, such as the tongue, teeth, gums, etc
Among cancers, oral cancer is one of the most common causes of death. In males, oral cancer constitutes 4% of total body cancers and in females; it is 2% of all cancers. A majority of the oral cancers affect the outer layer of mucous membrane covering the oral cavity.
Cancer in the mouth does not occur overnight. It occurs as a series changes within the tissue, which eventually promote the development of cancer.
The factors involved are:
3. Syphilis (a sexually transmitted disease caused by bacteria)
4. Nutritional deficiencies.
5. Virus infection
7. Other miscellaneous factors such as trauma, heat, and irritation from sharp teeth, poorly restored fillings and ill-fitting dentures.
SIGNS & SYMPTOMS
Oral cancer may initially present without any symptoms. Patients are most often identified only after a significant progression of the disease. Discomfort is the most common symptom that compels a patient to seek medical care. A cancer patient may present with any of the following symptoms:
· Awareness of a mass present or growing within the oral cavity.
· Difficulty in swallowing.
· Pain in the ear.
· Limited mouth opening.
· Excessive bleeding which is not seen that commonly.
· A non-healing ulcer in the oral cavity.
· Swelling on the gums interfering with the seating of the dentures in the mouth.
A majority of oral cancers involve the tongue, the posterior region of the oral cavity and the floor of the mouth. The lips, gums, the under surface of the tongue and the palate (bones separating the mouth from the floor of the nose) are less frequently involved.
Certain pre-cancerous lesions occurring in the oral cavity may indicate the person’s susceptibility to cancer. These lesions can be in the form of
· White patches in the mucous membrane covering the oral cavity and along the lateral border of the tongue, which cannot be removed by rubbing the affected area.
· Red patches seen on the mucous membrane lining the mouth and the tongue.
· Increase in fibrous content of the mucous membrane lining the cheek, which presents itself as thick fibrous bands running along the inner aspect of the cheek. Commonly seen in betel chewers this condition results in inability to open the mouth.
All the above lesions will cause a burning sensation when consuming spicy food.
1. Thorough examination of the oral cavity and the neck region conducted without neglecting any area may show hard lumps of tissues, which may indicate cancer. The patient is assessed for any suspicious tissue changes, which may include a white, red or a mixed white or red lesion.
2. Imaging the lesion using x-ray films, CT scan and advanced diagnostic techniques such as MRI helps in defining the location and extent of the cancerous growth.
3. Microscopic examination of a tissue specimen from the suspected lesion is the best method to confirm or rule out oral cancer. It gives the exact type and nature of cancer.
[ CT Scan: is an advanced diagnostic technique using x-rays to three-dimensionally identify the site and extent of a lesion.
MRI: It is more advanced technique, which uses magnetic force to diagnose both bony and soft tissue lesions.]
The principle objective is to cure the patient of cancer. The choice of treatment depends upon factors such as cancer cell type, amount of changes in the cell-size and location of the cancerous growth.
Surgery or radiation is used with curative intent in treatment of cancer. Chemotherapy (Medicines) is used as an additional form of treatment. In an early lesion either surgery or radiation as a form of treatment would suffice. But in an advanced condition, a combination of both surgery and radiation is required.
There is rarely a second chance available for cure. Hence the initial approach of treatment is critical. The survival rates after early detection and treatment of cancer have been noted to be 70%. Chemotherapy (Medicines) is a weak substitute for the above-mentioned treatment.
Tobacco utilization either in the form of smoking or chewing is an important factor in the development of oral cancer. About 97% of oral cancer victims are known to be associated with tobacco either in the form of smoking or chewing. Pipe smoking and cigar smoking have been known to increase the risk levels by a few folds. Among the various habits associated with tobacco, tobacco chewing is known to cause oral cancer more rapidly than any of the other habits. This is because of the direct and repeated contact of the tobacco with the mucous membrane of the oral cavity.
FREQUENTLY ASKED QUESTIONS
Do all betel nut or tobacco chewers get oral cancer?
Betel nut and tobacco chewers are definitely more prone to oral cancer than those who do not have this habit, but there are also other factors such as genetics, diet, environment and the person’s immune system.
Will stopping the habit improve the condition?
There are certain lesions seen frequently in the mouth of betel nut and tobacco chewers. These lesions precede oral cancer. If these preceding lesions are identified in time, then stopping the habit will definitely improve the lesion or maybe even cure it.
Is pain an early sign of cancer?
Not always. Pain is usually a late symptom of cancer. People often think that persistent pain such as headache or constant pain in the region of the face means cancer, but this is rarely the case. However pain should not be ignored.
What are the side effects of treatment?
There are side effects to all forms of treatments involving oral cancer.
If the lesion is small then there are usually no side effects, but if the lesion is large then it may require the removal of the affected structures resulting in the speech defects, difficulty in swallowing and also facial deformities. These conditions can rehabilitated by speech therapy and by physiotherapy.
During and after radiation therapy the patient develops mouth sores. The patient also suffers from reduced secretion of saliva, which causes difficulty in swallowing and makes the patient more prone to tooth decay and other forms of infection.
Side effects depend on the kind of drug used. The usual side effects are loss of hair, ulcers in the mouth and in the stomach, reduced resistance to infection, loss of appetite, nausea, vomitting, and lack of energy.