What Is Buccal Cancer?
Any abnormal proliferation of tissue in the lining of the cheeks and back of the lips that is in contact with the teeth that leads to the formation of tumors can be called buccal cancer. It is pretty rare, but it can be aggressive, and the chances of recurrence may be high. It is a type of head and neck cancer. A thin layer of flat cells called squamous cells (They are thin, flat cells, that look like fish scales and are found in the tissue that forms the surface of the skin or the lining of respiratory and digestive tracts) forms the inner buccal mucosa. So the buccal cancer is also classified as squamous cell carcinoma. It usually interferes with eating, speaking, swallowing, and even breathing in severe cases. So it is necessary to take treatment in the initial stages. The incidence is higher among men, and it can be completely cured when treated at early stages.
What Are the Causes for Buccal Cancer?
The major reason for buccal cancer is the use of tobacco and alcohol as well as continuous chewing of betel nut is also one of the reasons causing buccal cancer. The excessive use of cigars, chewing tobacco, and cigarettes can damage the DNA (deoxyribonucleic acid) of the cells in the buccal mucosa, leading to the cells' abnormal proliferation.
What Are the Risk Factors for Buccal Cancer?
The main risk factors for buccal cancer include;
1.Oral Hygiene – If there are persistent ulcers or some sharp tooth irritating buccal mucosa for a long time which causes ulcer, there are chances that it may develop into cancer.
2.Poor Nutrition – Unhealthy food habits such as junk foods, less consumption of fruits and vegetables, can generally increase the incidence of cancer.
3.Virus Attack – Certain viruses like human papillomavirus (HPV) may cause abnormal proliferation of tissue inside the mouth. HPV infection is generally through sexual contact; even skin-to-skin contact is sufficient.
4.Age Factor –With elderly people who have the prolonged habit of chewing tobacco as a routine are more likely to be diagnosed with buccal cancer.
5.Genetic Factors - The gene mutations, DNA (deoxyribonucleic acid) damage repairs, and defects are some of the genetic factors that may lead to buccal cancer.
6.Weakened immune system.
What Are the Premalignant Lesions That Can Turn Into Buccal Cancer?
The main premalignant lesions that can transform into buccal cancer include;
1.Leukoplakia – They are the white patches or plaque present on the surfaces of the oral cavity. Its prevalence is more in people who smoke.
2.Oral Lichen Planus – It is a chronic inflammatory disease that affects the mucous lining of the mouth.
3.Erythroplakia – They are the abnormal red patches found in the oral cavity. They cannot be defined clinically or pathologically as any other condition.
4.Oral Submucous Fibrosis – It is the chronic inflammatory disease of the oral cavity characterized by progressive fibrosis. It is prevalent in betel chewers.
What Are the Symptoms of Buccal Cancer?
The most common symptoms of buccal cancer include mouth ulcers that do not heal for many weeks, erythematous (abnormal redness) patch that may bleed easily, persistent lumps in the cheek, white or dark patches in the mouth, numbness of the buccal mucosa, jaw pain, pain around the teeth, difficulty in moving jaw, hoarseness (sound when it is scratchy or rough) of voice, persistent lumps in lymph glands of the neck, difficulty in chewing and swallowing, and unintentional weight loss.
When to See a Doctor?
If you notice any symptoms mentioned above, for more than two to three weeks, especially if you are a habitual smoker or an alcoholic, then seek the help of a dentist or general physician at the earliest.
How to Diagnose Buccal Cancer?
The main diagnostic tools involve physical examination, blood tests, X-rays to determine the stage of cancer in the lungs, if any, imaging studies, fine-needle aspiration biopsy (FNA), and an incision biopsy.
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Physical Examination - In the physical examination, the physician evaluates the symptoms, examines the location and size of the tumor and lymph nodes.
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Fine-Needle Aspiration - The fine-needle aspiration biopsy is almost similar to a blood test. In this, a thin needle is placed in the mouth, and cells from the lesion are aspirated and the cells are observed under a microscope. It is done to see whether the cells are cancerous.
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Incision Biopsy - The incision biopsy can also be done where a small section of tissue is cut under local anesthesia and is observed under a microscope.
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Imaging Studies - The imaging studies involve computerized tomography scan, magnetic resonance imaging, and positron emission tomography (PET) scan to determine the tumors' spread.
What Is the TNM Staging System?
The TNM staging helps to know the seriousness of the tumor and to treat the patient accordingly.
‘T’ refers to tumor size, ‘N’ refers to lymph node involvement, and ‘M’ refers to the distant metastasis or extent of spread of cancer to other areas of the body.
Primary Tumor - T
Lymph node involvement - N
The distant metastasis - M
What Is the Treatment for Buccal Cancer?
The main treatment approaches for buccal cancer involve surgery, radiation therapy, and chemotherapy. The main goals of the treatment involve treating cancer, maintaining the function and appearance of the mouth, and preventing recurrence. Depending upon the stage of tumor treatment will vary. The habits like drinking and smoking should be avoided before and after the treatment, in order to let the treatment work effectively. If the cancer is restricted to the cheek area alone, it can be completely cured with surgery. If the spread is large and has affected other parts, then a combination of radiotherapy and chemotherapy will be essential. During surgery, the tumor is completely excised.
The size of the tumor determines the size of the incision. If it is a small tumor, an incision can be made on the inside of the cheek, which will preserve the skin. But if the tumor is large, the skin will also be involved. In such cases, reconstruction of the cheek will be necessary. Reconstruction surgery can be done using a skin graft from the forearm or chest. The lymph nodes adjacent to the site of cancer may also be removed in some cases. Radiation therapy is generally given as an adjuvant (a substance given to enhance immunity or to prevent recurrence of tumor) after surgery to prevent the tumor's recurrence. It is mainly indicated when the cancer is not completely removed or it has spread to the lymph nodes. Chemotherapy is recommended only when the tumor is spread to lymph nodes and other organs. The medicine as it circulates in the blood interrupts the proliferation of cancer cells. Wherein this cannot cure the disease completely. It has to be combined with surgery or radiation therapy to see effective results.
Conclusion:
Buccal cancer when treated in the initial stages has a good prognosis. With proper care and medical intervention, it is curable to an extent. But as always, prevention is better than cure. Habits like smoking, betel nut chewing should be avoided in order to prevent the incidence of this condition. Follow a good lifestyle and habits for a healthy and long life.
