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Oral cancer is a term that refers to cancer of the mouth, lip, tongue and pharynx. The pharynx is the part of the throat at the back of the mouth - including the back of the tongue, the soft palate, tonsils and back of the throat. Salivary glands throughout the mouth make saliva, which moistens the mouth and helps digest food. Like other parts of the body, the pharynx and oral cavity are made up of many types of cells. Almost all oral cancers are cancer of the squamous cells. Squamous cells line the oral cavity and pharynx. Cells divide in an orderly, controlled way to produce more cells when more cells are needed in the body. When cells divide in an abnormal, uncontrolled way, they can form either a benign or malignant tumor. Benign tumors are not cancerous and usually are not a threat to life. They can usually be removed, and generally will not grow back. Benign tumor cells do not invade other tissues and do not spread to other parts of the body. Malignant tumors are cancerous. Cancer cells can spread to nearby healthy cells and destroy them. The cancerous cells can also invade other parts of the body. Cancerous cells in the oral cavity and pharynx can spread to nearby lymph nodes and to other parts of the body. The spread of cancer is called metastasis. Risk Factors Over 90 percent of oral cancer cases occur in people who are over age 45. Other than age, the major risk factors for oral cancers are the use of tobacco products (including cigarettes and chewing tobacco) and excessive consumption of alcoholic beverages. Some other, less significant risk factors include excessive exposure to sunlight (for cancer of the lip), and the chewing of betel nuts, a practice among some people in India and Asia. Oral cancer occurs more frequently among African Americans than among whites. Studies have suggested that a Vitamin A deficiency may be a factor in promoting cancer of the oral mucosa, the lining of the mouth. Patients with AIDS have an increased risk of Kaposi's sarcoma and non-Hodgkin's lymphoma of the oral cavity; these are tumors that are associated with a suppressed immune system.
Early detection of oral cancer is important because treatment is most effective before the disease has spread. Regular dental checkups and routine physical exams should include an examination of the entire mouth. You can also do a monthly self-examination by looking in the mirror to check for some of the changes or symptoms listed below. Signs and symptoms of oral cancer can include:
Any of these symptoms may also be due to other, less serious problems. Still, it is important to see a doctor is any of these problems exist for more than two weeks, Do not wait for pain, because pain is not an early symptom. If exams show an abnormal area in the oral cavity or pharynx, the doctor will need to do a biopsy. A biopsy is a test in which some cells are removed from the abnormal growth. This is usually done by an oral surgeon. A pathologist examines the cells under a microscope to check for t presence of cancerous cells.
The doctor is the best person to answer questions about treatment. The choice of treatment options for each patient will depend upon the location, size, stage of the disease (whether it is just in the mouth or if it has spread to other places), and the patient's general state of health. The doctor develops a plan for treatment that fits each patient's needs. Questions to consider asking when you talk to the doctor:
Several kinds of treatment are available. Surgery is the most common treatment for oral cancer. Radiation therapy is also used, and chemotherapy is being tested as a treatment for oral cancers. Surgery may involve the removal of the cancer as well as some of the surrounding healthy tissue. Nearby lymph nodes may also be removed. Microsurgery is a new technique now being tested in which the doctor removes the cancer and then uses a microscope to look for any remaining cancer cells. With this procedure, less health tissue is removed. Radiation therapy is the use of high-energy rays to attack cancer cells. Like surgery, it only affects cancer in the areas that are treated. The radiation may come from a machine outside the body, or from radioactive isotopes placed in the area where cancer cells are found. Patients who quit smoking prior to radiation therapy are more likely to survive longer. In chemotherapy, drugs are used to kill cancer cells. These drugs travel throughout the body in the blood. Chemotherapy can be used after surgery to help prevent the cancer from spreading. This is called adjuvant therapy. Chemotherapy is also sometimes given before surgery to shrink the tumor. The lips and mouth help people with eating and talking. After treatments for oral cancer, patients may need special help to adjust to the effects of treatment. If a large part of the lip or mouth is removed, plastic surgery may be needed. And, patients may need help with learning to eat or speak again. Trained professionals can help oral cancer patients to recover and adjust to new ways of talking and eating. At The James, the treatment plan includes plans for helping patients return, a closely as possible, to a pre-cancer lifestyle.
Most Generally
Asked Questions About Oral Cancer 1. What should I look for with oral cancer? ANSWER:
Any of these symptoms may be caused by cancer or by other, less serious problems. Don't wait for something to hurt. Pain is usually not an early symptom of oral cancer. It is important to see a dentist or doctor if any of these conditions last more than 2 weeks. Early detection is the key.
2. How does my doctor know if the sore in my mouth is cancer? ANSWER: If an abnormal area has been found in the mouth, a biopsy is the only way to know whether it is cancer.
3. What treatment options can I expect? ANSWER: Treatment decisions can be complex. Treatment for oral cancer depends on a number of factors. Among these are location, size, type, and extent of the tumor the stage of the disease. Treatment can involve surgery, radiation, and chemotherapy and in some cases a combination of treatments. You may want to talk with your doctor about taking part in a research study of new treatment methods. Such studies are called clinical trials; they are designed to improve cancer treatment. 4. What causes oral cancer? ANSWER: Scientist at hospitals and medical centers all across the country are studying this disease to learn more about what causes it and how to prevent it. Doctors do know that no one can "catch" cancer from another person: it is not contagious. Two known causes of oral cancer are tobacco and alcohol use. Tobacco use - smoking cigarettes, cigars, or pipes; chewing tobacco; or dipping snuff - Chronic and/or heavy use of alcohol also increases risk of oral cancer. Studies have shown that many people who develop oral cancer have a history of leukoplakia, a whitish patch inside the mouth.
5. What are those white patches in my mouth? ANSWER: The white patches that develop with tobacco use are called leukoplakia. Leukoplakia cannot be wiped off. Tobacco use is the most important identifiable factor in its beginning but not the only factor. Leukoplakia occurs six times more frequently in smokers than in nonsmokers. Studies have shown that 40 to 60 percent of smokeless tobacco users exhibit a lesion in the area where the tobacco is held, usually within a few months of beginning regular use. Frequency and duration of tobacco use are positively related to the prevalence of leukoplakia. The site distribution of tobacco-induced leukoplakia is very much dependent on tobacco habits. The palate (top of mouth) is a common site among pipe smokers and occasionally cigar smokers. The buccal (gum) and labial (lip) are the common sites among smokeless tobacco users. A generally benign-appearing leukoplakia must be examined in detail for any small suspicious area. From a clinical standpoint, no leukoplakia should be ignored. Transformation of a benign leukoplakia to malignancy cannot be predicted. Nor can one predict which lesion will transform, which part of a lesion will transform, or when transformation might occur. It is not necessary for tobacco to produce leukoplakia before it produces a malignancy. Other tobacco-induced Mucosal (mouth) conditions:
This is just to name a few. See your doctor for any signs and symptoms that you may be experiencing.
6. How do I prevent mouth cancer? ANSWER: One of the best ways to prevent tobacco-induced mouth cancers Is: Don't Start! If you are already a smoking, chewing, or dipping, Stop! The body will begin to heal itself. If you are having difficulty stopping, see your doctor. While you are smoking, chewing, or dipping, see your dentist frequently. 7. If diagnosed with mouth cancer, before treatment begins, you may want to ask the doctor these questions: What are my treatment choices? Which do you recommend for me? Why? What are the risks and possible side effects of each treatment? What are the expected benefits of each kind of treatment? What can be done about side effects? Would a clinical trial be appropriate for me?
8. What are the methods of treatment for mouth cancer? ANSWER: There are several modes of treatment. Speak with your doctor regarding what is best for you. Surgery to remove the tumor in the mouth is the usual treatment for patients with mouth cancer. If there is evidence of spread, the surgeon may also remove lymph nodes in the neck. If the disease has spread to muscles and other tissues in the neck, the operation may be more extensive. Before surgery, you may want to ask the doctor these questions:
9. Radiation
therapy (also called radiotherapy) is the use of high-energy
Radiation therapy is sometimes used instead of surgery for small tumors in the mouth. Patients with large tumors may need both surgery and radiation therapy. Radiation therapy may be given before or after surgery. Before surgery, radiation therapy can shrink the tumor so that it can be removed. Radiation therapy after surgery is used to destroy cancer cells that may remain. For external radiation therapy, you may go to the hospital or clinic each day for treatments. Usually, treatment is given 5 days a week for 5 to 6 weeks. This schedule helps to protect healthy tissues by dividing the total amount of radiation into small doses. Implant radiation therapy puts tiny "seeds" containing radioactive material directly into the tumor or in tissue near it. Generally, an implant is left in place for several days, and you will stay in the hospital in a private room. The length of time nurses and other caregivers, as well as visitors, can spend with you will be limited. The implant is removed before you go home. Before Radiation therapy, you may want to ask your doctor these questions:
Chemotherapy is the use of drugs to kill cancer cells. Researchers are looking for effective drugs or drug combinations to treat oral cancer. They are also exploring ways to combine chemotherapy with other forms of cancer treatment to help destroy the tumor and prevent the disease from spreading.
Clinical Trials : Researchers are developing treatment methods that are more effective against oral cancer, and they are also finding ways to reduce side effects of treatment. When laboratory research shows that a new method has promise, doctors use it to treat cancer patients in clinical trials. These trials are designed to answer scientific questions about the new approach and to find out whether it is both safe and effective. Patients who take part in clinical trials make an important contribution to medical science and may have the first chance to benefit from improved treatment methods.
Clinical trials to study new treatments for oral cancer are under way in hospitals throughout the country. Some trials involve ways to shrink or destroy the primary tumor. In others, scientists are testing ways to prevent the cancer from coming back in the mouth or spreading to other parts of the body. Still others involve treatments to slow or stop cancer that has already spread.
10. What about the side effects of treatment? What can I expect? ANSWER: It is hard to limit the effects of cancer treatment so that only cancer cells are removed or destroyed. Because healthy cells and tissues may also be damaged, treatment often causes unpleasant side effects. The side effects of cancer treatment vary. They depend mainly on the type and extent of treatment and the specific area being treated. Also, each person reacts differently. Some side effects are temporary; others are permanent. Doctors try to plan the patient's therapy to keep side effects to a minimum. They also watch patients very carefully so they can help with any problems that occur.
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