What is Oral Cancer? Symptoms and Treatment Methods
Oral cancers encompass cancers that occur inside the mouth, typically including the lower lip, the base of the tongue, the tonsils, or the glands that produce saliva. The most common sites include the floor of the mouth and the tongue. Almost all of them originate from the mucosa covering the mouth, tongue, and lips, composed of stratified squamous epithelial cells.
These cancers fall within the expertise of Ear, Nose, and Throat (ENT) surgeons. Regular check-ups with doctors and dentists are necessary for early detection of oral cancers, which are twice as common in men as in women.
Ways to Prevent Oral Cavity Cancers:
- Avoiding cancer-causing substances like tobacco and alcohol,
- Undergoing regular check-ups with doctors and dentists,
- Getting treatment for existing dental and prosthetic issues that may cause ulcers in the mouth if present.
Risk Factors for Oral Cavity Cancer:
There is no clear scientific explanation as to why some people with similar lifestyles develop oral cancers while others do not. However, it is well-known that it is not contagious. In other words, one person cannot “catch” cancer from another! Nevertheless, studies indicate that some factors play a role in cancer formation.
Tobacco
It is one of the leading causes of almost all oral cancers. The risk significantly increases in long-term and heavy users of tobacco and tobacco products. The risk of oral cancer is especially higher in heavy smokers who also consume alcohol. 90% of oral cancers occur in tobacco users.
Alcohol
It is known to be more prevalent among drinkers compared to non-drinkers. The risk increases proportionally with the amount of alcohol consumed.
Sunlight
It plays a significant role in lip cancers, similar to all skin cancers. Its importance is heightened, especially in smokers.
Family history of cancer
A family history of cancer, poor nutrition, poor living conditions, and health problems increase the risk. Individuals who have previously been treated for head and neck cancer and continue to smoke are at a higher risk.
Presence of chronic ulcers caused by broken, sharp-edged prostheses or teeth in the mouth, especially in smokers, significantly increases the risk of oral cancers.
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Symptoms of Oral Cancer:
It manifests as white, red-white spots, and ulcers in the mouth and lips. White spots are called ‘leukoplakia’ and are lesions that can transform into malignant ones. Red spots are called ‘erythroplakia’ and have a higher risk of malignancy. When these spots are mixed red and white, they are referred to as ‘erythroleukoplakia.’
- The symptoms of oral cancer are as follows:
- Persistent sores and swellings in the mouth and lips,
- Thinning, erosion, and ulceration of the gums,
- Recurrent and bleeding ulcers,
- Color changes and a patchy appearance inside the mouth,
- Unexplained numbness and tingling in the mouth and tongue,
- Unexplained sensitivity and pain in the mouth and tongue,
- Persistent, non-healing ulcers on the face, neck, and shoulders, easily bleeding,
- Persistent sensation of something stuck in the throat for a long time,
- Bad breath,
- Difficulty chewing and swallowing,
- Difficulty speaking or moving the jaw,
- Persistent hoarseness and changes in voice,
- Unexplained tooth loss or changes in tooth shape, disruption of the fit of dentures, if any,
- Swelling and lump formation in the neck and throat,
- Unplanned weight loss.
How is Oral Cancer Diagnosed?
Early diagnosis is crucial in the treatment of oral cavity and lip cancers, as with all cancers. It is beneficial to undergo regular check-up examinations with both a doctor and a dentist to catch cancer in its early stages.
During the examination, if the doctor notices a suspicious sore or swelling in the mouth, tongue, cheeks, gums, or lips, they would want to perform a biopsy. A tissue sample will be taken under local or general anesthesia and examined under a microscope to determine if cancer cells are present.
If cancer cells are detected, the disease is staged to assess the extent of the tumor and the likelihood of it spreading to other organs. This requires further tests.
To develop a treatment plan, radiological tests such as X-rays, computed tomography (CT), and magnetic resonance imaging (MRI), endoscopic examinations, and laboratory tests are necessary. When oral cavity cancers are diagnosed early, there is a 90% chance of recovery.
How is Oral Cancer Treated?
Chemotherapy, also known as drug therapy for cancer, uses drugs that inhibit the growth of cancer cells. Sometimes it is combined with surgery and radiotherapy. Chemotherapy drugs have various side effects. They can have temporary negative effects on the liver and kidneys. Therefore, chemotherapy is attempted to be used in patients with normal liver and kidney function.
Another side effect is the loss of the patient’s hair. However, this condition is temporary, and hair regrows after treatment. Nausea and vomiting are the most common side effects. Loss of appetite and weakness can also accompany these side effects. Chemotherapy drugs can temporarily weaken the immune system, making the patient susceptible to infections. Therefore, it is described as a treatment type that should be used very carefully.
Surgery
It involves the removal of the tumor itself or adjacent tissues if necessary, including the removal of lymph nodes. Pain management may be required for some time after surgery due to difficulties in eating. Especially, the resolution of tissue edema and swelling may take a few weeks. Difficulties in nutrition during this time can be addressed by implementing appropriate diet programs. The team managing the treatment decides whether the patient will continue with radiotherapy or chemotherapy after surgical recovery.
Radiotherapy
Simply put, it involves the application of high-energy rays to the mouth and throat area to eliminate cancer cells and prevent the spread of cancer. Radiotherapy doses are determined based on the size and location of the tumor.
The most common side effects include dry mouth, tooth loss, throat pain, gum bleeding and pain, delayed healing of mouth ulcers, local infections, stiffness in the jaw joint, changes in smell and taste, mild burns on the skin, and fatigue. During treatment, meticulous oral care is necessary for the patient. An Ear, Nose, and Throat (ENT) specialist can assist the patient in managing the process with appropriate supportive treatment to mitigate all side effects.
