Mouth Cancer

Overview

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Mouth cancer, also known as oral cancer, refers to cancer that develops in the tissues of the mouth, including the lips, gums, tongue, inner lining of the cheeks, roof and floor of the mouth, and the tonsils. It can occur as a single tumor or multiple lesions and is classified under head and neck cancers.

It can occur as a single tumor or multiple lesions and is classified under head and neck cancers.

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Symptoms
  • Sore or ulcer in the mouth that doesn't heal
  • Lump or thickening in the mouth or on the lip
  • White or red patches in the mouth
  • Pain in the mouth, throat, or ears
  • Difficulty swallowing or chewing
  • Numbness in the mouth
  • Changes in voice or speech difficulties
  • Loose teeth or changes in the fit of dentures
  • Swelling in the jaw
Complications
  • Metastasis: Spread of cancer to other parts of the body, such as lymph nodes, lungs, or liver.
  • Disfigurement: Surgical treatment can lead to changes in appearance.
  • Difficulty eating and swallowing, leading to nutritional deficiencies.
  • Infections: Open sores can become infected.
  • Pain Management Issues: Chronic pain may develop post-treatment.
Causes
  • Tobacco Use: Smoking, chewing tobacco, and snuff.
  • Alcohol Consumption: Heavy and prolonged alcohol use increases risk.
  • HPV Infection: Certain strains of the human papillomavirus are linked to oral cancers.
  • Sun Exposure: For lip cancer, excessive sun exposure can be a risk.
  • Poor Oral Hygiene: Chronic irritation from dentures or misaligned teeth may contribute.
  • Diet: A diet low in fruits and vegetables may increase risk.
Prevention
  • Avoid Tobacco: Do not smoke or use tobacco products.
  • Limit Alcohol Consumption: Drink in moderation or not at all.
  • HPV Vaccination: Vaccination can reduce the risk of HPV-related oral cancers.
  • Healthy Diet: Eat a balanced diet rich in fruits and vegetables.
  • Regular Dental Check-ups: Professional cleanings and examinations can help detect early changes.
  • Sun Protection: Use lip balm with SPF and avoid excessive sun exposure.
Risk Factors
  • Age: Higher risk in individuals over 40.
  • Gender: Males are at higher risk than females.
  • Tobacco and Alcohol Use: Combined use significantly increases risk.
  • HPV Status: A history of HPV-related conditions.
  • Family History: Genetic predisposition may play a role.
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How is it treated?

  • Surgery: Removal of the tumor and surrounding tissue; may include reconstruction.
  • Radiation Therapy: Often used post-surgery or for those who are not surgical candidates.
  • Chemotherapy: Used in advanced cases or in conjunction with other treatments.
  • Targeted Therapy: Focuses on specific molecular targets associated with cancer.
  • Immunotherapy: Stimulates the immune system to fight cancer.
  • Supportive Care: Pain management, nutritional support, and psychological support.
  • Early detection and treatment are crucial for improving outcomes in mouth cancer. Regular check-ups and being aware of the symptoms can lead to earlier diagnosis and better management of the condition.
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How is it Diagnosed?

Mouth cancer (oral cancer) is diagnosed through a combination of clinical examination, imaging, and biopsy. The process begins with a detailed history focusing on symptoms such as persistent mouth ulcers, lumps, difficulty swallowing, unexplained bleeding, or numbness. Risk factors like tobacco use, alcohol consumption, human papillomavirus (HPV) exposure, and poor oral hygiene are also explored.

A thorough physical examination of the oral cavity is done to identify any suspicious lesions, discoloration, or mass. If any abnormality is found, the next step is typically a biopsy—either incisional or excisional—to confirm the presence of malignant cells. The biopsy specimen is examined histopathologically to determine the type and grade of cancer.

Imaging studies play a vital role in assessing the extent of disease. Common imaging modalities include CT scan, MRI, and PET-CT, which help evaluate local invasion, lymph node involvement, and distant metastasis. In some cases, ultrasound-guided fine needle aspiration cytology (FNAC) of cervical lymph nodes is done. Endoscopic examination may be required for deeper lesions or suspected extension to adjacent structures like the oropharynx or larynx.

Staging is then performed using the TNM (Tumor, Node, Metastasis) system, guiding treatment decisions and prognosis. Blood tests and chest X-rays may be included to assess overall health and metastatic spread. Early diagnosis significantly improves outcomes, underscoring the importance of regular dental checkups and prompt evaluation of suspicious symptoms.

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