Oral Cancer

Cancer of oral cavity

Age-adjusted incidence rates of oral cancer in India is, 20 per 100,000 population and accounts forover 30% of all cancers in the country. Majority of cases present to ahealthcare facility at later stages, therebyreducing chances of survival due to delays in diagnosis. Earlierdetection of oral cancer offers the best chance for longterm survival and has the potential to improve treatmentoutcome.

Oral cavity is divided into following subsites:
  • The front two thirds of the tongue.
  • The gingiva (gums).
  • The buccal mucosa (the lining of the inside of the cheeks).
  • The floor (bottom) of the mouth under the tongue.
  • The hard palate (the roof of the mouth).
  • The retromolar trigone (the small area behind the wisdom teeth).

Risk factors for oral cancer:
Tobacco consumption either by chewing or smoking, alcohol and betel quid are main predisposing factor for oral cancer. Poor oral hygiene, poor dental status (sharp/fractured teeth due to caries/trauma), and chronic ulceration from an ill-fitting denture has been suggested to promote neoplasm in the presence of other risk factors.

Symptoms of oral cancer:

Check with your doctor if you have any of the following:
  • A sore on the lip or in the mouth that does not heal.
  • A lump or thickening on the lips or gums or in the mouth.
  • A white or red patch on the gums, tongue, or lining of the mouth.
  • Bleeding, pain, or numbness in the lip or mouth.
  • Change in voice.
  • Loose teeth or dentures that no longer fit well.
  • Trouble chewing or swallowing or moving the tongue or jaw..
  • Swelling of jaw.
  • Sore throat or feeling that something is caught in the throat.

Tests used to detect and stage oral cancer:
  • Physical examination of lip, oral cavity and neck.
  • Biopsy
  • Exfoliative cytology
  • CT Scan
  • MRI
  • Chest radiograph

Treatment of oral cancer:

Surgery is mainstay of treatment in resectable oral cancer. In early cancers surgery alone is sufficient whereas in large tumours with high risk of recurrence, postoperative radiation or chemo-radiation is required. In Unresectable tumours chemo-radiation is given.Borderline resectable tumours can undergo surgery after giving chemotherapy. In metastatic tumours chemotherapy and targeted therapy is used to prolong the survival of patient and decrease the suffering.

What after treatment of oral cancer?

After completing treatment for oral cancer you have to come for regular follow up at interval of 3 months for initial 3 years and then 6 monthly up to five years. Despite adequate treatment of oral cancer chances of recurrence exist. Purpose of follow up is to pick up recurrence at early stage so that adequate salvage treatment can be implemented timely.