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Oral cancers are various diseases that concern both the course and the location as well as the clinical course. The most common are squamous cell tumors, which are located in the mobile area of the tongue and within the floor of the mouth. The prognosis depends primarily on early cancer diagnosis and effective treatment.
What is oral cancer?
Tumors attacking the oral cavity constitute a diverse group of diseases concerning their course, location and structure. The symptoms of cancer are not very specific, and the first symptoms may be similar to an ordinary infection, such as aphthae. The most common cancer diagnosed in the mouth is squamous cell carcinoma, affecting the floor of the mouth and the front of the tongue. However, cancers of the oral cavity do not only concern it strictly, they can also occur in other areas (e.g. cancer of the cheek, hard palate or alveolar process). It is also worth mentioning adenomas, which in turn develop in the small salivary glands located around the entire mouth.
Often the symptoms of throat cancer resemble an upper respiratory infection, which unfortunately makes diagnosis and healing difficult.
Is oral cancer common?
No, it is a quite rare group of cancer, and the number of these diagnosed in Poland each year minimally exceeds a thousand cases. As for the number of deaths in this type of cancer, it is about 2/3 of that number. Women get sick much less often than men!
Oral cancer – causes
Among the factors that increase the risk of developing oral cavity cancer:
- smoking (tobacco smoke contains carcinogenic substances),
- frequent consumption of strong alcohol,
- poor oral hygiene, which leads to frequent inflammation and changes in cells that can transform into malignant cells,
- poorly selected dental prostheses that irritate the oral mucosa and increase the risk of cancer,
- HPV (human papillomavirus) infection.
Oral cancer symptoms
Unfortunately, the symptoms of mouth cancers are not specific and the first symptoms may resemble an ordinary infection of the mucosa. For this reason, symptoms in the initial stage of the disease are rarely recognized. Any kind of changes in the tongue or throat are treated indulgently by the patient and raise no suspicions. Patients often limit themselves to antiseptics or medications for hoarseness and sore throats, instead of going to the doctor for a consultation. Any lesion in the mouth that lasts more than two weeks should be seen promptly by a specialist.
The most characteristic and common symptoms of oral cancer include: white / red spots, lumps or ulcerations located on the side of the tongue or on the lower labial red. The cheek tumor is usually located at the mouth of the salivary gland, while the tumor of the bottom of the mouth is visible in the lateral part of the cavity. A lump may develop on the hard palate or gum and the patient develops:
- excess production of saliva
- numbness in the mouth
- trismus,
- bad smell from the mouth,
- pain,
- hoarseness and sore throat also appear at the beginning,
- breathing difficulties,
- shortness of breath in advanced stages of cancer,
- bleeding from the mouth.
Oral cancer diagnosis
Oral cancer diagnosis is not a major problem, because cancer can be noticed very quickly during normal hygiene procedures. Any changes in the oral cavity should not be underestimated, as this type of tumor quite often metastasizes to the surrounding lymph nodes. Then an enlarged tumor is palpable on the patient’s neck.
In order to make a proper diagnosis, it is important to take a sample of the lesion in the oral cavity. Subsequently collected material is examined under a microscope, thanks to which it is possible to determine the nature of the tumor, its type and the degree of aggressiveness. In addition, standard tests are ordered:
- Neck ultrasound – assessing lymph nodes, sometimes performed together with a fine-needle aspiration biopsy, which indicates the presence of metastases;
- computed tomography,
- MRI of the head or neck
- X-ray of the curved structures of the maxilla and mandible – performed when there is a suspicion of infiltration of the mandible,
- chest radiograph – allows you to assess the stage of the disease,
- Abdominal ultrasound.
Treatment of oral cancer
The choice of the type of treatment depends on where the tumor is located and how advanced it is. Small tumors that have not yet had time to attack the lymph nodes – the tumor is excised with a margin. However, if the tumor is aggressive (without lymph node metastases), excision of the lymph nodes located in the upper neck area or their irradiation is recommended. In the case of a very advanced local tumor without metastases, the tumor with a certain group of cervical lymph nodes is usually excised, and then radiotherapy is recommended.
The situation is different in the case of changes that infiltrate the surrounding structures, then the surgery is more complicated and consists in removing even bone fragments and a certain group of lymph nodes. After these types of surgery, chemotherapy or radiation therapy is usually recommended.
If the presence of lymph node metastases is revealed before the procedure, the nodes on both sides of the neck are removed and the treatment is supplemented with chemotherapy or radiotherapy.
What if the tumor cannot be removed?
Then, radiotherapy and chemotherapy are ordered, and sometimes even these two methods at the same time. If these methods cause the tumor to shrink to a size that can be removed – surgery is performed. It should be emphasized that surgery only makes sense when the tumor is completely removed, as partial removal of the lesion exposes the patient to the risks associated with the procedure, with no benefit.
When metastases to distant body regions, chemotherapy is usually prescribed.
How can I prevent oral cancer?
Among the methods used in the prevention of oral cavity cancer, the following are recommended:
- taking care of oral hygiene,
- regular, semi-annual oral checkups at the dentist,
- treatment of teeth and, if necessary, their removal,
- quitting cigarettes,
- reducing the amount of alcoholic beverages consumed,
- visits to the dentist in case of lesions in the oral cavity,
- in the event of a lump or ulcer, seek immediate advice.
See also: Innocent beginnings of a dangerous disease