Oral Cancer

Oral Cancer

Alternate Names

  • squamous cell cancer of the oral cavity
  • mouth and throat cancer
  • Mouth cancer

Definition

Oral cancer is a growth of genetically abnormal, or malignant, cells in the mouth or in the oropharynx, that part of the throat at the back of the mouth.

What is going on in the body?

Oral cancer occurs in the top layer of cells lining the mouth and oropharynx. The abnormal cells may be found in the lips, tongue, or inside of the cheeks. The tumor may also involve the floor or roof of the mouth, the tonsils, or the oropharynx. Oral cancer may start as a sore that is not malignant at first but becomes so over time, usually years.
Oral cancers can grow outward as a wart-like mass, or they can be ulcers that invade inwardly. The longer an oral cancer goes untreated, the more likely it is to metastasize, or spread throughout the body.

Risks

What are the causes and risks of the disease?

Oral cancer can occur at any age, but is most common in people older than the age of 45. Some of the factors that increase a person's risk for oral cancer are as follows:
  • drinking alcohol
  • eating a poor diet
  • exposing the lips to sun
  • having gum disease, such as gingivitis and periodontitis
  • smoking, chewing tobacco, and using snuff
The herpes simplex and human papillomaviruses are being investigated as possible causes of oral cancer.

Prevention

What can be done to prevent the disease?

Lifestyle changes can be highly effective in preventing oral cancer. A person who uses tobacco in any form should stop. Alcohol use should be avoided, or strictly limited. Lip balms and other methods should be used to avoid sun exposure.
It is important to eat a healthy, balanced diet. Good oral hygiene and regular dental care will not only help prevent oral cancer but can be a means of detecting one early if it occurs.

Diagnosed

How is the disease diagnosed?

Diagnosis of oral cancer begins with a medical history and physical exam. A biopsy, or sample, may be taken from suspicious masses. If cancer is found, the healthcare provider will order tests to see the extent of the cancer. These may include X-rays of the chest and jaw. The provider may also order a CT scan, ultrasound, or MRI.
Oral cancers are graded as poorly or well differentiated, terms that describe how the cancer cells look under the microscope. The grade of a cancer is a major factor that determines how fast it will spread.
The following factors are also taken into account:
  • any evidence that cancer cells have spread to nearby areas
  • the size of the initial lesion
  • whether cancer has spread to nearby lymph nodes

Long Term Effects

What are the long-term effects of the disease?

Oral cancer can be completely cured if it is treated in the early stages. Many people remain free of the cancer after effective treatment. Others, however, are at risk for a second episode unless they make lifestyle changes to lower their risk factors. Oral cancer that spreads to aggressive local neck disease can cause death. Rarely, death occurs from tumors that have developed in distant parts of the body.

Other Risks

What are the risks to others?

Oral cancer is not contagious and poses no risk to others.

Treatments

What are the treatments for the disease?

Treatment options for oral cancer vary, depending on a number of factors, such as:
  • the extent of metastasis, or spread, of the cancer
  • the individual's age and general health
  • the location, size, type, and extent of the tumor
  • the stage of the cancer
The healthcare provider may also recommend a complete dental exam, and the treatment of any dental problems discovered, before beginning therapy for the cancer. Oral cancer treatment may make the person's mouth more sensitive and prone to infection.
Some of the treatment options for oral cancer are as follows:
  • chemotherapy
  • radiation therapy
  • surgery to remove tumors or lymph nodes
Two or more treatment options may be combined to kill as many cancer cells as possible.

Side Effects

What are the side effects of the treatments?

Surgeons try to minimize deformity and loss of function. Sometimes, in an effort to cure a person, it is difficult to achieve these goals. Surgeons need to remove about 1 to 2 centimeters of cancer-free tissue around the sore in order to achieve a cure if one is possible. This can result in lip deformity, scarring, loss of tongue function, and difficulty swallowing.
Radiation therapy may cause the following:
  • a change in the color of the skin
  • increased risk of mouth infections
  • loss of salivary gland function, chronic dry mouth and increased cavities in teeth
  • secondary cancers
People who receive neck and throat radiation may need to have some or all of their teeth removed because teeth are more susceptible to decay following this treatment. Dentures can be fitted afterwards. Radiation therapy may be offered in an effort to spare organ function that would be lost in surgery.
Chemotherapy may cause the following problems:
  • hair loss
  • an increased need for blood transfusions
  • infection
  • nausea and vomiting

After Treatment

What happens after treatment for the disease?

People who have had oral cancer must be closely followed to make sure the cancer does not return. The person should also be monitored to make sure no new oral cancers occur. If the cancer has spread to other body organs, additional treatment may be needed.

Monitor

How is the disease monitored?

The person will also need frequent mouth exams to ensure that oral cancer does not return. This person will remain at risk for developing other cancers. Chest X-rays and CT scans may be done to determine whether cancer has spread or developed in other parts of the body. Any new or worsening symptoms should be reported to the healthcare provider.

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