Oral cancer: Causes, symptoms, prevention and treatment


A healthy body starts with a healthy mouth as it is a gateway into the body’s overall health and to maintain a healthy self, one has to regularly do self-check tests, ideally once every month to look out for signs and symptoms that could be an indication of oral cancer. Any sudden growth or sore or patches in the mouth that bleeds or lasts longer must be immediately brought to the notice of a medical practitioner as early detection is the key to fight oral cancer.

Cancer that occurs on the inside of the mouth (oral cavity), including lips, base of the tongue, inside of the cheeks, floor of the mouth, hard and soft palate, sinuses, tonsils, vallecula and pharynx (throat) is called oral cancer or oral cavity cancer. It is a type of cancer that is grouped under the category of head and neck cancers and when it is diagnosed early, it is much easier for doctors to treat but unfortunately, many people wait until the condition gets advanced to treat effectively.

In an interview with HT Lifestyle, Dr Ankit Mahuvakar, Head and Neck Onco-surgeon at HCG Cancer Hospital in Mumbai, explained, “Oral cancer starts in the squamous cells, which are flat and when viewed under a microscope, looks like a fish scale. Squamous cell carcinoma is most common malignant neoplasm of oral cavity. Excessive use of tobacco and consumption of alcohol are the major risk factors of oral cancer. However, it can occur in patients with no known risk factors as well.”

He added, “Most of the times, oral cancer looks like a common problem with the lips or the mouth having white or red patches or sores that bleed. The only difference between a common problem and a potential cancer is that the latter does not go away within 2 weeks and if left untreated, it spreads to the other parts. For instance, if there is cancer of the cheeks which is left untreated, it gradually spreads to the muscles, then to the skin followed by the bone and so on.”

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Causes:

Dr Ankit Mahuvakar, shared, “When cells on the lips or in the mouth develop changes (mutations) in their DNA is when they continue to grow and divide and cause healthy cells to die. The accumulation of abnormal cells can form a tumor. As time passes, this spreads inside the mouth. Generally, mouth cancers begin in flat, thin (squamous) cells that line the lips and inside the mouth. They are squamous cell carcinomas.”

He cautioned, “Unhealthy habits like excessive consumption of tobacco in cigarettes, pipes or chewing tobacco and heavy consumption of alcohol increase the chance of contracting oral cancer. If the face and thus the lips are exposed to the sun or if the person has a weak immune system is when the chances increase. Also, sexually transmitted virus called human papillomavirus (HPV) is an established risk factor for oropharyngeal cancers.”

Symptoms:

· Swelling or thickening, lumps or rough spots or eroded areas on the lips, gums, cheek or other areas inside the mouth

· White or red patches in the mouth that look velvety

· Unexplained bleeding in the mouth

· Numbness, loss of feeling, pain or tenderness in any area of face, mouth or neck

· Persistent sores on face, neck or mouth that bleed and do not heal within 2 weeks

· Feeling that something is caught in the back of the throat

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· Difficulty chewing or swallowing, speaking or moving the jaw or tongue

· Chronic sore throat or change in voice

· Pain in the jaw or the ear

· Sudden weight loss

Prevention:

According to Dr Ankit Mahuvakar, “Oral cancer can be prevented provided the individual plays an active role in order to reduce the risk of contracting it. People who are used to smoking or chewing tobacco must try and discontinue it as it directly exposes the cells in the mouth to dangerous cancer-causing chemicals. Alcohol consumption must also be reduced as it can irritate the cells making them vulnerable to oral cancer. Drinking in moderation can help reduce the risk.”

He advised, “The skin on the lips must be protected from sun exposure at all times. Hence it is advisable to either wear a broad hat or carry an umbrella that will help cover the face. Also, sunscreen lip products must be a daily routine for sun protection. Getting vaccinated against the human papillomavirus (HPV) is also necessary. Having a balanced diet is the key to fight any cancer. It is also important to see a dentist regularly for a thorough inspection of the entire mouth to prevent pre-cancerous changes.”

Treatment:

Highlighting that the treatment depends on the location, stage and type of cancer and the age and health of the patient, Dr Ankit Mahuvakar said, “Brachytherapy is employed in the treatment of oral cancer. This includes, for instance, removal of a part of the tongue or the jawbone or the lymph nodes. These significantly change the person’s appearance and their ability to talk or to eat. Detecting oral cancer early can reduce the possibility of it growing or spreading further. It is possible by simply doing a monthly self-examination where the lips, front of the gums and roof of the mouth must be examined by the finger.”

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He revealed, “The neck and the area under the lower jaws must be examined for any lumps or enlarged lymph nodes. Using a bright light and a mirror, the inside of the mouth must be examined. Also, by tilting the head slightly the roof of the mouth must be observed. The cheeks must be pulled out to see the inside of the mouth, the lining of the cheeks and behind the gums and the tongue must also be pulled out to see if any changes are there on the top, bottom, sides or the floor of the mouth.”

Oral health is equally important and it is not just about getting a cavity filled but it is about the overall health of the individual. The doctors strive for both – complete cancer removal as well as preservation of the appearance and functions of the mouth, what we need to do is to regularly check the inside of the mouth for any changes and also immediately report those to the doctors to prevent its spread.



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