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Early Detection and Prevention of Oral Cancer

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Early Detection and Prevention of Oral Cancer

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Oral cancer is becoming extremely common due to the increase in the use of tobacco products and limited awareness. Read the article to know more.

Medically reviewed by

Dr. Anuthanyaa. R

Published At June 17, 2021
Reviewed AtApril 24, 2024

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.

Risk factors related to oral cancer include

The risk of oral cancer increases with age. When race is accounted for, then blacks are affected more than whites. Other risk factors include

  • Immunosuppression due to conditions like AIDS, and organ transplantation.

  • Infection of viral papillomavirus.

  • Plummer-Vinson Syndrome.

  • Vitamin A deficiency and other nutritional deficiencies.

  • Genetic factors.

  • Mate a leaf infusion used in South America can cause oral cancer.

  • Chronic trauma due to sharp teeth, restorations, or dentures.

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. A thorough history and physical examination are to be done. Palpation is done digitally, manually palpating, and inspection with palpation is done. Proper light source to be used to identify the problem. Mouth mirrors are usually used and gauze pieces can be used to depress the tongue to view the posterior lateral tongue and tongue base.

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 that involve the soft tissues.

Screening light: Special lights can be used to identify diseased tissues in the mouth.

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 a self-examination of the mouth once a month.

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

  6. Maintain good oral hygiene.

  7. Change the 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. Individuals must 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 early detection helps to limit 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 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 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 in multiple sittings. Again, this also comes with side effects like dry mouth, damage to teeth, and 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 painkillers, sleep-inducing medicines, and a 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 with difficulties faced by their loved ones.

Conclusion:

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

Frequently Asked Questions

1.

How to Prevent Oral Cancer at an Early Stage?

Many oral cancers are prevented at early stages by sensible choices such as self-care, periodic dental checkups, and healthy lifestyle modifications. Avoiding smoking, tobacco use,  and alcohol consumption helps in preventing oral cancers.

2.

How Are Early Stages of Oral Cancers Detected?

There are no existing routine protocols for the early detection of oral cancers. However, periodic screening tests are done during regular dental checkups. Various precancerous conditions and cancers are detected early (when they are treatable) in routine oral examinations and detailed medical history, which is assessed by a dentist or healthcare professional.

3.

What Foods Help in Preventing Oral Cancer?

Nutrition plays a vital role in preventing oral cancers. Fresh vegetables and fruits have been found to reduce the potential risk of developing oral cancers. Vegetables and fruits that are rich in carotenoids (bright red, orange) and green vegetables contain antioxidants that prevent oral cancers.

4.

What Is the Early Treatment of Oral Cancer?

Most patients with early oral cancers (stage I, stage II) respond well when treated by excision (removal of cancer tissue) surgery and radiation therapy. Chemotherapy is concomitantly given with radiation for better treatment outcomes. 

5.

What Are the Risk Factors that Lead to Oral Cancer?

The risk factors that increase the chance of developing oral cancers include tobacco use and smoking (cigarettes, pipes, cigars, and chewing tobacco), excessive alcohol use, overexposure to the sun, infections through sexually transmitted viruses like human papillomavirus (HPV), and altered immune system.

6.

Can Early Detection Prevent Oral Cancer?

Yes, early detection and screening could prevent oral cancers. Most oral cancers start as precancerous lesions (white patches, sores, and areas of aberration) that could be easily identified in regular screening tests. This primary detection helps in preventing the development of oral cancers from precancerous lesions.

7.

What Is the Importance of Early Detection of Oral Cancer?

Early diagnosis of oral cancers increases the chance of successful treatment outcomes. Early detection prevents the spread of cancer to other parts of the body (metastasis), thereby increasing the survival chance of the patients. Greater complications associated with treatment (chemotherapy and radiation) and a higher financial burden for supportive care could be greatly reduced.

8.

What Are the Diagnostic Techniques for Oral Cancer?

The diagnosis of oral cancer includes a thorough physical examination with a detailed medical history, a biopsy of the suspected tissue, and its analysis. Dentists thoroughly examine the lips, cheeks, and oral cavity to detect any abnormalities or skin color changes (areas of irritation, sores, and white patches). If suspected, a small part of the tissue is removed (biopsy) and tested for confirmation.

9.

What Foods Worsen Oral Cancers?

While foods containing antioxidants (fruits, vegetables, curcumin, and green tea) reduce oral cancer risks, studies have proven that pro-inflammatory diets that are rich in red meat, fried, and over-processed foods along with tobacco use, alcohol, and betel quid chewing enhance the chance of developing oral cancers.

10.

Can Stress Cause Oral Cancer?

Though there is no clear evidence that directly links stress to oral cancer risk, studies show that stress could indirectly increase the severity and progression of oral cancers. People under emotional stress who develop unhealthy habits such as smoking or drinking alcohol are prone to an increased risk of getting oral cancers.
Source Article IclonSourcesSource Article Arrow
Dr. Ashwin Kumar. S
Dr. Ashwin Kumar. S

Dentistry

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chemotherapyquitting smokingoral cancer
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