Oral cancers are basically tumours of the oral cavity. Oral cancer is a broad term referring to a range of varied cancers that initiate in the oral or the mouth area or of the body. This includes the oral cavity, the tongue, the palate and the upper & lower jaws. Oral cancer can be either benign or malignant.
What are the types of oral cancers ?
There are several types of cancer that can initiate in the oral cavity. These include the following.
- Squamous Cell Carcinomas : Most oral cancers initiate in the squamous cells that line the mouth and are called squamous cell carcinomas. The majority of malignant tumours of the oral cavity are squamous cell carcinomas.
- Adenocarcinomas : The cancers that initiate in glandular cells of the lining of the oral cavity are called adenocarcinomas.
Based on the region of the head and neck where they occur, oral cancer can be divided into ;
- Cancer of the lips- The clinical behaviour of lip cancer is akin to skin cancer.
- Cancer of the gums or the inside of the cheeks
- Cancer of the tongue
- Cancer of the floor of the mouth and
- Cancer of the jaws.
What are the causes for oral cancer ?
The development of oral cancer is the consequence of both environmental factors and genetic factors acting together and is hence, multifactorial.
Smoking and chewing tobacco & alcohol abuse are key risk factors for oral cancer. It is important to know that not all smokers and alcohol users develop Oral Cancer, which suggests that individual variation in genetic susceptibility also plays an important role.
While tobacco and alcohol are the main carcinogens implicated in oral cavity cancer, a small but significant role for human papilloma virus is recognised. High risk types of Human Papillomavirus (HPV) and Epstein-Barr virus (EBV), both oncogenic viruses are also considered risk factors. HPV infection has an identified role in carcinogenesis, especially in cancer of the posterior oral cavity.
What are the clinical features of oral cancer ?
The clinical features can vary from asymptomatic to painful lesions, a persistent sore or swelling that does not subside, unusual bleeding or numbness, white patches (leukoplakia) or red patches (erythroplakia), change in tone of voice, difficulty in chewing or swallowing food, loss of appetite or weight loss.
How are oral cancers diagnosed ?
- A complete physical examination of the body is mandatory.
- Imaging Tests: To determine what the tumour is and its exact extent, imaging tests may need to be performed so doctors can view, assess and judge the cancer and determine how far it has progressed or spread. These important diagnostic tests include the following such as X- rays, CT Scans, MRI Scans or PET Scans.
- Biopsy: Removed tissue examined under a microscope by a pathologist is the only sure-shot way to make a definitive oral cancer diagnosis.
How are oral cancers staged ?
Physical examination is most definitive if carried out when the patient is under general anaesthesia. There is a local & distant staging.
Grade and Stage describe the head and neck tumour, helping to provide guidance for the doctors in choosing the best treatment option(s). Staging is a careful attempt to find out the exact extent and spread of the cancer. The higher the stage the further the cancer has grown away from its original site in the oral cavity.
Grade refers to what the cancer cells look like, and how much they resemble their cell of origin or differentiation. The higher the grade, the more aggressive the tumour is.
Staging : TNM system
T (Tumour) 1–4: Refers to the size of the primary tumour. The higher the “T” number, the bigger the cancer is.
N (Nodes) 0–3: Shows whether the cancer has spread to the regional lymph nodes of the neck. 0 means zero nodal involvement; and 1, 2 or 3 indicates increasing or more nodal involvement.
M (Metastasis) 0–1: Cancer has spread (undergone metastasis) to other sites & organs (1) or it has not (0).
How are oral cancers treated ?
Treatment options for Oral Cancers depend on the type of cancer, staging of the cancer, and its location. The best therapeutic approach usually consists of surgery with either or both chemotherapy and radiotherapy.
Patients with the early-stage (I and II) cancer are subjected to single modality treatment (that is either surgery or radiotherapy), while patients with advanced disease (stages III and IV) are subjected to the combined approach such as radical surgery with radiotherapy or combined chemo-radiation.
The treatments for oral cancer include the following.
- Surgery : The aim of surgery is to remove the tumour tissue and preserve the oral cavity’s functions, like breathing, swallowing and speech. The type of surgery depends on the part of the oral cavity affected. If tumour is small, surgery is localized. If it has spread to local lymph nodes, your surgeon has to remove the nodes, in an operation called a neck dissection or lymphadenectomy.Several reconstructive options exist to repair soft tissue and bony defects after tumour resection. However, disease factors such as tumour thickness, positive margins, extra-capsular spread of nodal metastasis and pattern of invasion have been shown to determine success of treatment. Post-operative adjuvant radiation or chemo-radiation should be considered in the presence of unfavourable disease factors.
- Radiation Therapy : A cancer treatment that utilizes high-energy x-rays or basically radiation to eradicate cancer cells. Radiation can be used on select patients that are sensitive to radiation or can be used post surgery to kill any remaining cancer cells.
- Chemotherapy : another kind of cancer treatment that uses either drugs or chemical substances (hence the name chemotherapy) to kill cancer cells and prevent them from dividing.
What is the care to be taken after the removal of an oral cancer ?
Metastatic diagnostic workup and monitoring post-treatment has to include imaging and scanning of the neck, thorax, lungs, chest, and the abdomen with radiography, MRI or CT scans because of the risk of recurrence of Oral Cancers.
Adjuvant chemotherapy or radiotherapy may be required in cases wherein excision cannot be done completely.
How to find and reach cancer specialists for oral cancer treatment ?
Now you can find and reach oral cancer specialists from different cancer hospitals and destinations on a single platform, Hinfoways. You can avail opinions and information from multiple cancer specialists, cost estimates for oral cancer treatment from different cancer hospitals, compare things and then choose a cancer specialist or a cancer hospital for oral cancer treatment.
Find, reach and choose a cancer specialist for oral cancer treatment on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
