Oral carcinoma is one of the most prevalent cancers & is one of the 10 major cause of death. Majority of oral carcinomas are squamous cell carcinomas. it is disease of increasing age with 95%cases in people older then 40 years of age.
Cancer is a commonly used term for all malignant tumors. In Latin language, cancer means crab which has a fat main body and mass extention which springs and invade the surrounding tissues.
Tumor is an autonomous new growth of tissue or it is an abnormal mass of tissue the growth of which exceedds and is uncoordinated with that of normal tissue and persists in the same excessive manner even after the cessation of stimuli which evoked the changes.
Characteristic of malignant lesion
Lesion body- they exhibit ill defined borders which are very irregular and ragged
rapid growth- it increase in size very rapidly
Metastasis- they always metastasize either by direct spread, by lymphatics or through bloodstream
Adjacent cortical bone- grows by invasion & cause destruction of adjacent structures. bony cortex will be destroyed rather than expand.
Radiodensity-Radiolucent or may be mixed
Dental involvement- root intact & tooth in position
symptoms of oral cancer
Oral cancer may start as a sore or lump in the mouth that does not go away. Problems with eating, swallowing and talking may occur, and the sense of taste may be altered. Lymph nodes in the neck may be enlarged and unexplained weight loss may occur.
Common symptoms of oral cancer
Common symptoms of oral cancer include:
Altered sense of taste
Cracking of an area of the mouth
Difficulty eating or swallowing
Lump that does not go away
Nonhealing sore, which may be white, pale, red, dark, or otherwise discolored
Swollen lymph nodes in the neck
Thickened area in the mouth
Etiology and risk factors for oral cancer
some risk factors are
It is a minor etiologic factor in case of lip cancer.
lip cancer occurs more commonly in fair skinned people who are generally engaged in outdoor occupation, such as farming, fishing
Familial & genetic
there is little evidence
lip cancer is amongst the sites which show strongest cancer clustering with in families. but it also reflects the fact that families tend to have same occupation,i.e farming, which is related with ultraviolet exposure
it is more prevalent in black as compared to white
difference in incidence in part of rural & urban have been related to atmospheric pollution
SULPHUR DIOXIDE AND SMOKE CONCENTRATION IN THE ATMOSPHERE ARE POSITIVELY CORRELATED WITH SQUAMOUS CANCER OF LARYNX & PHARYNX
Blue collar workers exposed to dust or inhalation of organic agents are at increased risk of cancer of mouth
more prevalent in patients with poor oral hygiene,faulty restorations, sharp teeth, ill fitting dentures and those with syphilitic glossitis
Increasing incidence is age related, which may reflect declining immune surveillance with age
It may occur in immunosuppressed patients following organ & bone marrow transplantation.
HIV/AIDS patent are at increased risk of oral cancer
It contains potent carcinogens like nitrosamine, polycyclic hydrocarbons and polonium & metabolites of these constituents have been suggested etiologic factor in oral cancer
Common forms of oral smokeless tobacco
Pan/betel quid- it contains areca nut, betel nut, betel leaf, slaked lime, catechu, condiments with or with out tobacco
Tobacco smoke contains carbon monoxide.It ia an important factor in the development of oral cancer
smoking is strongly associated with soft palate cancer than anterior sites
All forms of alcohol
Beverage congeners include nitrosamines & impurities which can act as carcinogens.
it is associated with oral cancer
Diet Deficiency & Deficiency status
The relationship between sideropenic dysphagia & oral cancer is well established
Carcinoma of buccal mucosa may occur as complication of long term radiotherapy
Trauma in combination with other factors like chronic cheek biting, denture use & irregular teeth may act as as co-carcinogen & may promote transformation of epithelial cells
Chronic ulceration & fissure
Median rhomboid glossitis
Discoid Lupus erythematosus
Treatment of oral cancer begins with seeking regular medical care throughout your life, including regular dental care. Regular medical care allows a health care professional to provide early screening tests. Regular medical care also provides an opportunity for your health care professional to promptly evaluate symptoms and your risks for developing oral cancer.
The goal of oral cancer treatment is to permanently cure the cancer or to bring about a complete remission of the disease. Remission means that there is no longer any sign of the disease in the body, although it may recur or relapse later.
Common treatments for oral cancer
Common treatments for oral cancer include:
Chemotherapy to attack cancer cells
Participation in a clinical trial that is testing promising new therapies and treatments for oral cancer
Radiation therapy to attack cancer cells
Surgery to remove the cancer and evaluate how far it has spread
Other treatments for oral cancer
Other therapies may be added to help with your general state of health and any side effects of cancer treatment:
Antinausea medications if nausea occurs
Blood cell growth factors to increase the number of white blood cells if these get too low
Blood transfusions to temporarily replace blood components (such as red blood cells) that have dropped to low levels
Dietary counseling to help maintain strength and nutritional status
Reconstructive surgery to restore structures that have been removed
Occupational and physical therapy to help with eating, swallowing, or talking problems
Pain medications as needed to increase comfort
Some complementary treatments may help some people to better deal with oral cancer and its treatments. These treatments, sometimes referred to as alternative therapies, are used in conjunction with traditional medical treatments. Complementary treatments
Complementary treatments may include:
potential complications of oral cancer
Complications of untreated oral cancer can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of oral cancer include:
Decreased ability to eat, drink, talk or breathe
Hemorrhage (uncontrolled bleeding)
Recurring cancer after treatment
Spread of cancer into nearby structures
Spread of cancer to distant areas of the body
Spread of cancer to lymph nodes in the neck
In cases in which oral cancer has progressed to an advanced stage and has become unresponsive to treatment, the goal of treatment may shift away from curing the disease and focus on measures to keep a person comfortable and maximize the quality of life. Hospice care involves medically controlling pain and other symptoms while providing psychological and spiritual support as well as services to support the patient's family.