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Oral cancerDefinition Oral cancer is cancer of the mouth. Causes, incidence, and risk factors Oral or mouth cancer most commonly involves the tissue of the lips or the tongue. It may also occur on the floor of the mouth, cheek lining, gingiva (gums), or palate (roof of the mouth). Most oral cancers look very similar under the microscope and are called squamous cell carcinomas. These are malignant and tend to spread rapidly. Smoking and other tobacco use are associated with 70-80% of oral cancer cases. Smoke and heat from cigarettes, cigars, and pipes irritate the mucous membranes of the mouth. Use of chewing tobacco or snuff causes irritation from direct contact with the mucous membranes. Heavy alcohol use is another high-risk activity associated with oral cancer. Other risks include poor dental and oral hygiene and chronic irritation (such as that from rough teeth, dentures, or fillings). Some oral cancers begin as leukoplakia or mouth ulcers. Oral cancer accounts for about 8% of all malignant growths. Men are affected twice as often as women, particularly men older than 40. Symptoms Skin lesion, lump, or ulcer:
Signs and tests An examination of the mouth by the health care provider or dentist shows a visible or palpable (can be felt) lesion of the lip, tongue, or other mouth area. As the tumor enlarges, it may become an ulcer and bleed. Speech difficulties, chewing problems, or swallowing difficulties may develop, particularly if the cancer is on the tongue. A tongue biopsy, gum biopsy, and microscopic examination of the lesion confirm the diagnosis of oral cancer. Treatment Surgical excision (removal) of the tumor is usually recommended if the tumor is small enough. Radiation therapy and chemotherapy would likely be used when the tumor is larger or has spread to lymph nodes in the neck. Surgery may be necessary for large tumors. Rehabilitation may include speech therapy or other therapy to improve movement, chewing, swallowing, and speech. Support Groups The stress of illness can often be eased by joining a support group of people who share common experiences and problems. See cancer - support group. Expectations (prognosis) Approximately 50% of people with oral cancer will live more than 5 years after diagnosis and treatment. If the cancer is detected early, before it has spread to other tissues, the cure rate is nearly 75%. Unfortunately, more than 50% of oral cancers are advanced at the time the cancer is detected. Most have spread to the throat or neck. Approximately 25% of people with oral cancer die because of delayed diagnosis and treatment. Complications
Calling your health care provider This disorder may be discovered when the dentist performs a routine cleaning and examination. Call for an appointment with your health care provider if a lesion of the mouth or lip or a lump in the neck are present and do not clear within 1 month. Early diagnosis and treatment of oral cancer greatly increases the chances of survival. Prevention You should have the soft tissue of the mouth examined once a year. Many oral cancers are discovered by routine dental examination. Other tips:
Illustrations
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