What Is Jaw Cancer?
Jaw cancer is a common type of head and neck cancer. It is one of the many types of oral cancer. Jaw cancer makes up about four percent of all cancers in the United States of America. Jaw cancer can affect the mouth's upper (maxilla) and lower (mandible) jaws. Jaw cancer can spread rapidly throughout the oral cavity, including the tongue, floor of the mouth, and throat, to other areas of the head and neck. The survival rate of most jaw cancer patients is usually five years post-surgical and chemotherapy treatment. Jaw cancer usually develops when oral cancer is located in the floor of the mouth, tongue, tonsils, minor and major salivary glands, or palate metastasize (spread) to the jaws causing jaw cancer. Rarely, jaw cancer develops on its own as osteosarcoma, a type of malignant bone cancer.
Jaw cancer can either be located in the upper or lower parts of the jaw:
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Mandibular Cancer- A type of jaw cancer that develops in the lower jaw or the mandible.
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Maxillary Cancer- When jaw cancer develops in the upper jaw or maxilla, it is called maxillary cancer or cancer of the hard palate.
Jaw cancer usually occurs in the advanced stages of oral or oropharyngeal cancers, including stage four. These cancers may or may not be associated with HPV (human papillomavirus) DNA (deoxyribonucleic acid). Jaw cancers that contain human papillomavirus DNA are referred to as p-16 positive, and those that do not have human papillomavirus DNA are referred to as p-16 negative. The p-16 (cyclin-dependent kinase inhibitor) positive cancers have a better prognosis than the p-16 negative jaw cancers.
What Are the Types of Jaw Cancer?
Oral squamous cell carcinoma is the most common type of jaw cancer, usually accounting for more than 90 percent of cases. Less commonly, other types of cancer may also affect the jaws, including osteosarcomas (bone cancers), metastatic cancers (cancers present in other parts of the body that can spread to the jaws and multiple myeloma (a type of blood cancer). Odontogenic tumors that develop in the jaw can be either malignant (cancerous) or benign and are called odontogenic tumors.
Malignant types of odontogenic tumors include
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Ameloblastic Carcinoma: An aggressive but rare tumor.
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Primary Intraosseous Carcinoma: A rare type of squamous cell carcinoma arising in the bone.
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Sclerosing Odontogenic Carcinoma: A particularly rare type of primary intraosseous carcinoma arising in the bone.
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Clear Cell Odontogenic Carcinoma: A rare type of odontogenic (tumors arising from tooth-forming tissues) tumor.
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Ghost Cell Odontogenic Carcinoma: An extremely rare type of odontogenic epithelial tumor.
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Odontogenic Carcinosarcoma: An extremely rare type of odontogenic tumor.
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Odontogenic Sarcomas: A connective tissue tumor containing epithelial tissue.
Most of these malignant odontogenic tumors grow in the mouth's back (posterior) part, near the molars on the lower jaw (mandible), or the unerupted third molars. Some of these tumors affect the upper jaw (maxilla).
What Causes Jaw Cancer?
The various causes of jaw cancer (lower jaw or upper jaw) may include a combination of local environmental and hereditary factors. However, several risk factors can also be attributed that can play a role in the etiopathogenesis of the disease and increase the risk of tumor development. These several risk factors include:
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Tobacco: Tobacco in either smoking or chewable forms is the most common predisposing factor for causing both mandibular and maxillary cancers.
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Alcohol: Overconsumption of alcohol is also found to increase the risk of oral squamous cell cancers. It is believed that smoking, along with excessive intake of alcohol, may double the risk of jaw cancer.
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Betel Nut (Areca Nut): People who consume too much betel nut (supari), a seed from the areca tree, are at a higher risk of developing jaw cancer.
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Obesity: Excessive body weight can impose a higher risk of oropharyngeal and laryngeal cancers.
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Age: Head and neck cancers are most commonly present in people older than 55 years.
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Poor Oral Hygiene: Poor oral health, including the health of your mouth and gums, may serve as an attributing factor in the development of oral cavity and oropharyngeal cancers.
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Viral Infections: Viral infections such as HPV (human papillomavirus) increase the risk of the development of jaw cancers in people younger than 50.
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Poor Nutrition: A diet that is low in fruits and vegetables increases the chance of oral cavity and oropharyngeal cancers.
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Genetic Mutations: People with inherited mutated genes have a higher risk of developing jaw cancers.
What Are the Signs and Symptoms of Jaw Cancer?
The signs and symptoms of jaw cancer vary depending on the cancer stage. The patient may feel no or very few symptoms in the early stages. Some patients may begin to feel some pain at the affected site. Some of these symptoms experienced by the patient include
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Pain and difficulty in swallowing food.
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Painful mouth sores.
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Unhealed ulcers.
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Difficulty in opening the mouth.
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Red or white lesions in the mouth that are long-lasting.
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Recurrent bleeding from the mouth.
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Bad breath.
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Swelling and numbness in the mouth.
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Numbness in the tongue.
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Jaw pain can even radiate to the ears.
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Difficulty eating or speaking.
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Dentures become loose and ill-fitting.
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Damage to the alveolar bone causes loose teeth.
How Is Jaw Cancer Diagnosed?
The dentist or your doctor will do a full physical examination, including checking for any lumps in the throat, neck, mouth, and cheeks, as well as ask for your family medical history. The following tests can be performed.
1. Oral Biopsy- A small sample of tissue will be removed with an incisional or punch biopsy from the affected jaw to send for histological examination. A fine needle aspiration cytology (FNAC) biopsy of nearby affected lymph nodes may also be performed to evaluate the spread of cancer.
2. Panendoscopy- Endoscopy is performed to ensure there are no other related cancers in the body to rule out metastatic cancers.
3. Imaging Tests- These tests may also be performed in order to identify and stage cancer. These may include-
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X- Rays - To capture neck, mouth, and jaw images.
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Computed Tomography- To provide cross-sectional images to evaluate the size and location of a tumor.
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Magnetic Resonance Imaging - To provide detailed images of the body's soft tissues to evaluate whether cancer has spread (metastasized) to other tissues or invaded the bone marrow.
What Is the Treatment of Jaw Cancer?
The treatment of jaw cancers varies depending upon the location, size, and extent of your cancer, as well as the stage. Usually, surgery is the initial treatment of choice for treating jaw cancers, but radiation therapy and chemotherapy may also be considered specific options.
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Surgery- The surgery of the jaws would not be considered an appropriate treatment option if the patient is not healthy. The type of surgery depends on the site of the location of cancer. Hard palate surgery, also known as maxillectomy, involves the removal of a part or whole of the maxilla (upper jaw) or alveolar bone that forms the roof of the mouth. Mandibular surgery involves mandibulectomy, which is a surgery to remove part or whole of the lower jaw (mandible).
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Radiation Therapy- Radiation therapy is usually recommended after surgery by doctors. It is done to prevent the recurrence of tumors. Radiation may also be provided for aggressive or invasive types of cancers.
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Chemotherapy-Though not commonly recommended for treating jaw cancers, chemotherapy is sometimes advised with supportive radiation therapy if cancer has metastasized to surrounding tissues or still remains after surgery.
What Is the Prognosis of Jaw Cancer?
According to the American Cancer Society, the survival rate for cancers of the gums and other parts of the mouth, including the jaws, is usually five years.
Conclusion
Early diagnosis and treatment of jaw cancers, like other cancers, reduce the chances of cancer spreading rapidly. Approximately one-third of patients who are treated for jaw cancers might develop new cancer. Therefore if you observe a red or white patch in your mouth, visit your dentist immediately, and if you have been treated for jaw cancer, arrange for follow-up examinations with your doctor.
