Early Detection and Prevention of Oral Cancer

What Is Oral Cancer?

Any uncontrolled growth of cells and their invasion of the adjacent structures is called cancer. Oral cancer is one such development in areas associated with the mouth. Oral cancer is becoming extremely common due to the increase in the use of tobacco products and limited awareness. Like any other malignancy, oral cancer also does not show symptoms in the early stages. Mostly, the disease is diagnosed after the symptoms have progressed. It is also difficult for the individual to self-diagnose, and nearly all of the lesions are painless.

What Are the Causes of Oral Cancer?

1. Smoking and tobacco-related habits.

2. Betel and areca nut chewing habit.

3. Human papillomavirus infection.

4. Constant trauma from sharp teeth.

5. Excessive alcohol consumption.

6. Excessive sun exposure.

What Are the Symptoms of Oral Cancer?

Symptoms of oral cancer may not be consistent, but it will be one or many of these.

1. Lump in any area of the mouth, throat, lips, or jaws.

2. A non-healing ulcer anywhere in the mouth or throat.

3. Difficulty while swallowing.

4. Hoarseness of voice or change in voice.

5. Red or white patches in the mouth.

6. Poor appetite and weight loss.

7. Numbness in any part of the mouth.

8. Sudden loosening of the teeth.

9. Unexplained bleeding in the gums.

How Is Oral Cancer Diagnosed?

1) Physical Examination of the Lesion - Dentists are the first ones to identify such diseases, and they are accidental findings more often. The dentist will be doing a visual and palpation examination to arrive at a differential diagnosis.

2) Screening Dye - A dye like Methylene blue can help in diagnosis sometimes. X-rays and CT scans can show the presence and the extent of spread. A PET scan will help in finding out whether cancer has spread to other parts of the body. An MRI scan also helps in detecting cancers which are involving the soft tissues.

3) FNAC - Fine-needle aspiration cytology involves picking up deeper cells from the lesion and testing them in the lab. Endoscopy can help in visualizing cancers in the throat or voice box.

4) Biopsy - Biopsy is the gold standard for diagnosing oral cancerous lesions. This can be a complete excisional biopsy or wedge biopsy where only a part of the lesion is removed along with normal surrounding tissues. The pathology lab will confirm the presence or absence of the disease.

How Is Oral Cancer Prevented?

1. Stop smoking habit.

2. Reduce or stop alcohol consumption.

3. Avoid prolonged exposure to the sun.

4. Do self-examination of the mouth once a month.

5. Avoid tobacco-related products, betel, and areca nut.

6. Maintain good oral hygiene.

7. Change your ill-fitting dentures.

8. Get sharp teeth corrected by the dentist.

9. Visit the dentist for regular screening of the mouth.

Early Detection - Early detection is extremely crucial as this alone can significantly improve the chance of recovery. It is crucial for individuals to take note of the symptoms and report them to their dentist as soon as possible. So, it is said that prevention and screening are more important; also the early detection helps to limit the aggressive complications to improve the survival rate and quality of life.

Determining the Extent of Spread - Any cancer, including oral cancer, is graded from I to IV in the increasing order of severity. Grade I means the cancer is small and confined to that area alone, whereas Grade IV means it is large and it has spread to other areas of the body. This staging helps in determining the type of treatment to be given.

What Are the Treatment Options for Oral Cancer?

Treatment can include a combination of chemotherapy, radiotherapy, and surgery. Doctors will have to decide based on the extent of spread and involvement of associated structures.

1. Surgery:

Doctors will decide to cut off the entire tumor along with some healthy tissues. This is to prevent cancer from recurring in the site again. Surgeries for oral cancer may involve the removal of a portion of the entire jaw, tongue, and associated neck structures. If cancer has originated from inaccessible sites or areas very close to vital structures, surgery may not be an option. As most cancer surgeries are disfiguring, reconstruction of lost parts becomes compulsory. Current technology permits this by taking skin or bones from other parts of the body or by placing biocompatible artificial substitutes to rebuild the facial structure.

2. Chemotherapy:

The use of drugs to kill cancer cells is called chemotherapy. Chemotherapy is given before and/or after surgery to reduce the size of the tumor or to kill the cancer cells and prevent a recurrence. Chemotherapy works synergistically with surgery and radiation therapy. It has side effects like nausea, vomiting, hair loss, weight loss, and overall weakness of the body. Most of the side effects are reversible after the therapy is discontinued.

3. Radiation Therapy:

The use of high beam radiation is effective in many cases of oral cancer. This is also used in combination with surgery and chemotherapy. The radiation is directed to the affected areas for a limited period of time in multiple sittings. Again, this also comes with side effects like dry mouth, damage of teeth, jaws, and mouth ulcers.

4. Palliative Therapy:

Patients with advanced stages of cancer will have to undergo palliative therapy, which is only treating the symptoms associated without actually treating cancer. This is just to provide symptomatic relief and relieve the patients of severe cancer pain. This includes the use of heavy pain killers, sleep-inducing medicines, and few immunotherapy agents to keep them comfortable as long as they are alive.

5. Developing Attitude:

Oral cancer can severely dent a person’s self-confidence and morale as it wreaks havoc in the individual’s life. The surgeries can be quite disfiguring, and reconstructions can be quite extensive. It requires immense willpower of the patient and support from the loved ones to withstand such procedures. Also, the family members undergo mental trauma and will have to cope up with difficulties faced by their loved ones.

Conclusion:

Oral cancer is a devastating disease that is difficult to detect. The one and only key for saving lives is early detection. Most of the cases are preventable by modifying the habits. Always remember, prevention is better than cure. Be aware, and let us fight cancer together.

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