Oral cancer is a type of head and neck cancer that occurs within various sub-sites of the oral cavity. The sub sites are lips, inner aspect of cheeks, gums, the floor of the mouth, oral tongue, hard palate
The 5 stages of oral cancer can help the patient plan out his treatment accordingly.
Check out the simplest pictures to understand the 5 stages
Stage 0:known as Carcinoma in-situ. This describes the presence of abnormal cells in the surface lining and having a high potential to invade the deeper layers.
Stage 1: The size of the tumor is less than or equal to 2 centimeters and the cancer cells did not spread to the lymph nodes.
Stage 2: The size of the tumor is between 2 and 4 centimeters and the cancer cells did not spread to the lymph nodes.
Stage 3: The tumor is larger than 4cm and without spreading to lymph nodes, or is of any size and had spread to only a single lymph node(less than 3cm).
Stage 4: It is the most advanced stage. The tumor may be of any size, but it has spread to:
- Adjacent tissue, skin, or bone
- Single lymph node (more than 3cm) or multiple lymph nodes.
- Distant body parts like lungs etc.
The rate of recurrence is high for the cancers in stage III and IV.
- Pain and discomfort in the mouth
- Difficulty in swallowing
- Difficulty in speaking
- Lump in the neck and ulcers
- Occasional bleeding or numbness in the mouth and lip
Consumption of tobacco products and drinking alcohol are the most common causative factors of oral cancer worldwide.
Risk factors include:
Tobacco
It includes smoking tobacco by cigarettes, cigars & pipes and consuming smokeless tobacco by snuffing and chewing.
Tobacco contains more than 19 known carcinogens; the by-products from these carcinogens are the primary mode for development of cancer. Also, the smoke and heat while smoking irritates the mucous membrane of the mouth and results in cancer.
Infection with Human Papilloma Virus (HPV)
Chronic irritation by dentures, teeth and poor dental hygiene
Diet low in Vegetables, Fruits, vitamins A, C and E
Family history of oral cancer
Immunosuppression
Excess consumption of Alcohol
The risk of oral cancer for heavy drinkers is 6 times that of non-drinkers. Tobacco smoke and alcohol act synergistically in causing oral cancer.
Prolonged exposure to sunlight
People who are exposed to continuous sunlight are at risk of developing lip cancer.
Chewing Betel quid and areca nut
This is the most common causative factor of oral cancer in South-East Asia.
Through excessive alcohol, consumption of tobacco products and smoking. Tobacco is the biggest reason for oral cancer because of the presence of 19 carcinogens in Tobacco products. The carcinogens are the entry for cancer into the body. Chewing of betel quid is the biggest reason for oral cancer in India.
A small amount of suspicious growth in the oral cavity will be sent to a pathologist for microscopic examination. This helps in confirmation of the oral cancer.
Incisional biopsy: In this, a piece of the suspicious lesion is taken without removing it all.
Punch biopsy: This is a type of incisional biopsy using a ‘punch forcep’, which helps in removing a small tissue from the suspected area.
Excisional biopsy: In this technique, the whole area of concern is removed.
Brush biopsy: A few cells off the surface of a suspicious lesion are taken.
If needed, the lump in the neck is examined by a biopsy.
Fine needle aspiration cytology (FNAC): This is the most common and easiest way to do biopsy in which a tiny needle is placed into the lump over the neck and some cells are drawn out through a syringe. This will be sent to a pathologist for microscopic examination. If needed, FNAC will be done with USG or CT guidance.
Core biopsy : It is similar to FNAC, but a larger needle is used to remove a core of tissue from the lump.
Open neck biopsy : This is performed by placing an incision over the lump, and either a piece or the entire lump is taken out for the diagnosis.
Evaluation of the extent of oral cancer requires the use of special x-rays like Panorex, CT scans and MRI scans.
Oral cancer can be treated for good through the mainstream ways of treatment like Surgery, radiotherapy, chemotherapy and molecular targeted therapy, either alone or in combination.
The above treatment methods are purely based on site, size, location, stage of the oral cancer and also differs from patient to patient. All these treatments will be done by an oral cancer surgeon in hyderabad
1. Smoking and Consumption of Tobacco has to stop permanently
2. Alcohol consumption has to be in limited levels
3. A balanced diet with fruits, veggies, and Vitamins A, C,and E
4. Improved dental habits and a regular follow up after treating cancers can keep it from returning.