What is Cancer?

Cancer is defined as the uncontrolled growth and proliferation of cells, which invade and evoke damage to surrounding tissue. Oral cancer can appear as growth or an ulcer in any region of the mouth that continues to persist for an extended period. Cancer of the lips, tongue, cheeks, the floor of the mouth, hard and soft palate, salivary glands, sinuses, and pharynx (throat) are combined and referred to as oral cancer. It can be life-threatening if not diagnosed and treated at the earliest.

Who Gets Oral Cancer?

According to the American Cancer Society, men are at twice the risk of developing oral cancer as women, and men who over the age of 50 years are at the highest risk of oral cancer. In India, oral cancer is the second most commonly occurring cancer and statistical figures on the incidence of oral cancer in India are on the higher side due to the increased use of tobacco.

CAUSES OF ORAL CANCER:

•  Smoking: The most important reason for oral cancer is the habit of smoking. People who are habitual to a cigarette, cigar, or pipe smoking habit are six times more likely to develop cancer than nonsmokers.

•  Smokeless tobacco users: there are various forms of smokeless tobacco such as gutka, pan, quid, misri, mawa, etc. which are being increasingly used in our country. These products are usually placed on the cheek for a prolonged period. This increases the chances of cancer in the region by around 50 times. Users of dip, snuff, or chewing tobacco products more likely tend to initiate cancers of the cheek, gums, and lining of the lips.

·  Excessive consumption of alcohol. Oral cancers are about six times more common in drinkers than in nondrinkers. Alcohol has a synergistic effect with tobacco and increases the chances of cancer. It is also essential to note that over 25% of all oral cancers occur in people who do not have a habit of smoking and only who drink alcohol occasionally.

•  A family history of cancer- A family history of cancer considerably increase the risk of cancer for an individual.

•  Excessive sun exposure, especially at a young age can lead to cancer of the lip, typically the lower lip. UV rays are chief causative agents for such conditions.

•  Human papillomavirus (HPV). Certain strains of HPV are etiologic for increased risk of Oropharyngeal Squamous Cell Carcinoma (OSCC)

Symptoms of oral cancer:

•  Oral cancer can begin as a small lesion and progress into one of the following conditions, the most common symptoms include:

•  Areas of swellings/thickenings, lumps, rough crusts or eroded areas on the lips, gums, etc. inside the mouth

The development of velvety, white or red, smooth or speckled (white and red) patches in the mouth.

•  Sudden bleeding in the mouth for no reason.

•  Unexplained loss of sensation, pain or sensitivity in any area of the face, mouth, or neck.

•  Persistent lesions on the face, neck, or mouth that tend to bleed and do not heal within a two-week duration.

•  Increasing difficulty in opening the mouth and stiffness in the region of the cheeks.

•  A soreness or sensation that something is trapped in the hindmost part of the throat

•  Trouble chewing or swallowing, speaking, or performing any movements of the jaw or tongue

•  Hoarseness of voice or change in voice

•  Ear pain that persists for a long duration with no apparent reason.

•  An alteration in the way your teeth or dentures fit.

•  There is a drastic loss of weight in a short period.

So, is it cancer?

Well, we can arrive at a diagnosis temporarily for the time-being, using a brief disease history from the patient and a clinical examination. But the gold standard for confirmation can be arrived at only after performing a biopsy and microscopic analysis by an oral pathologist.

Biopsy is a procedure in which the diseased tissue is partially or wholly removed and for histopathological analysis(under the microscope analysis).The oral pathologists will do the examination and will provide us with a diagnosis as to whether it is cancer and if yes, at what stage it is currently persisting, and chances of spread to other regions.

Staging of cancer is essential as it gives us a clear picture as to what is the extent of the cancerous lesion.

•  Region and size of the cancerous lesion.

•  Involvement of lymph nodes

•  Spread to other regions indicating the severity of cancer.

The treatment plan and survival prognosis are chiefly dependent on this staging process.

Oral cancer treatment:

As mentioned earlier, depending on what stage cancer persists, the treatment is decided. Surgery is usually the option followed by chemotherapy and radiotherapy. If surgery involves removal of an additional healthy structure apart from the lesion (generally in terminal cases of cancer) such as the jaw, tongue, cheek, etc., adequate reconstruction will also be planned. This is done to ensure that the person has a healthy social and personal life post-cancer survival.

Oral cancer Awareness:

In the current 21st century, the cases of oral cancer steadily continue to increase. ‘Quit tobacco and alcohol’ has become a standard mantra as doctors, public activists and government organizations struggle to educate the public on ways to avoid cancer.

‘Prevention is better than cure.’ Cancer detected at early stages has a greater survival rate and is curable. Hence if you notice any of the mentioned symptoms, do not hesitate to contact your dentist or health care professional.