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Oral Cancer

Oral cancer, a type of mouth cancer, where cancerous tissues grows in the oral cavity . Oral or mouth cancer most commonly involves the tongue. It may also occur on the floor of the mouth, cheek lining, gingiva (gums), lips or palate (roof of the mouth). Most oral cancers look very similar under the microscope and are called squamous cell carcinoma.

Squamous cell carcinoma is the most common type of mouth cancer. Squamous cells are found in many places around the body, including the inside of the mouth and under the skin.

Less common types of mouth cancer include:

  • Oral malignant melanoma - where the cancer starts in cells called melanocytes, which help give skin its color
  • Adenocarcinomas - cancers that develop inside the salivary glands

References:

Symptoms include:
  • Red or red and white, patches on the lining of mouth or tongue
  • One or more mouth ulcers that do not heal after three weeks
  • Swelling in mouth that lasts for more than three weeks
  • Pain when swallowing (dysphagia)
  • A persistent pain in the neck
  • A hoarse voice
  • Unexplained weight loss 
  • Unusual changes in sense of taste
  • Pain in ear
  • The lymph nodes (glands) in neck become swollen

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Oncogenes (genes that causes cancer) are activated as a result of mutation of the DNA. 

Various risk factors are: Smoking and alcohol

The two leading causes of mouth cancer are smoking cigarettes (or other tobacco products, such as pipes or cigars) and drinking too much alcohol. Both of these substances are carcinogenic, which means they contain chemicals that can damage the DNA in cells and lead to cancer. The risk of mouth cancer increases significantly in somebody who is both a heavy smoker and heavy drinker.

Betel nuts

Betel nuts are mildly addictive seeds taken from the betel palm tree, and are widely used in many southeast Asian communities, such as people of Indian and Sri Lankan origin.

They have a stimulant effect similar to coffee. Betel nuts also have a carcinogenic effect, which can increase the risk of mouth cancer. This risk is made worse as many people enjoy chewing betel nuts along with tobacco.

Due to the tradition of using betel nuts, rates of mouth cancer are much higher in ethnic Indian and Sri Lankan communities than in the population at large.

Smokeless tobacco

Smokeless tobacco is a general term used to refer to a range of products, such as:

  • Chewing tobacco
  • Snuff – powdered tobacco designed to be snorted
  • Snus – a type of smokeless tobacco popular in Sweden, which is placed under your upper lip, where it is gradually absorbed into your blood.

Cannabis

Smoking cannabis has also been linked to an increased risk of mouth cancer. Regular cannabis smokers may have a higher risk than tobacco smokers because cannabis smoke contains higher levels of tar than tobacco smoke, and tar is carcinogenic.

Human papilloma virus (HPV)

The human papilloma virus (HPV) is the name of a family of viruses that affect the skin and moist membranes that line your body, such as those in your cervix, anus, mouth and throat.

Infection with some types of HPV can cause abnormal tissue growth and other changes to the cells, which can lead to the development of cancer

Poor oral hygiene

There is evidence that poor oral hygiene, such as having tooth decay, gum disease, not brushing your teeth regularly and having ill-fitted dentures (false teeth) can increase your risk of mouth cancer.

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Biopsy

It may be necessary to remove a small sample of affected tissue to check for the presence of cancerous cells. This procedure is known as a biopsy.

Punch biopsy

A punch biopsy may be used if the suspected affected area of tissue is in an easily accessible place, such as your tongue or the inside of your mouth. The area is first injected with a local anesthetic to numb it. The doctor will then cut away a small section of affected tissue and remove it with tweezers. The procedure is not painful, but can feel a little uncomfortable.

Fine needle aspiration (FNA)

A fine needle aspiration (FNA) is a type of biopsy used if it is suspected a swelling in neck is the result of mouth cancer.

Pan endoscopy

A panendoscopy is a procedure used to obtain a biopsy when the suspected tissue is at the back of throat or inside nasal cavities.

The tests that may be used include:

  • An X-ray
  • A magnetic resonance imaging (MRI) scan
  • A computerised tomography (CT) scan
  • A positron emission tomography (PET) scan

A PET scan involves injecting a part of your body with a radioactive ‘tracer’ chemical that can be seen on a special camera.

Reference:

  • http://www.nhs.uk/Conditions/Cancer-of-the-mouth/Pages/Diagnosis.aspx

Surgery

For mouth cancer, the aim of surgical treatment is to remove any affected tissue while minimizing damage to the rest of the mouth.

Photodynamic therapy (PDT)

If the cancer is in its early stages, it may be possible to remove any tumors using a type of laser surgery known as photodynamic therapy (PDT). PDT involves taking a medicine that makes your tissue sensitive to the effects of light. A laser is then used to remove the tumor.

Radiotherapy

It uses doses of radiation to kill cancerous cells. It may be possible to remove the cancer using radiotherapy alone, but it is usually used after surgery to prevent the cancer from reoccurring.

Chemotherapy

It is often used in combination with radiotherapy when the cancer is widespread, or if it is thought there is a significant risk of the cancer returning.

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  • CREATED / VALIDATED BY : NHP CC DC
  • LAST UPDATED ON : Feb 04, 2016

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The content on this page has been supervised by the Nodal Officer, Project Director and Assistant Director (Medical) of Centre for Health Informatics. Relevant references are cited on each page.