Oral cancer is one of the most common cancers in India. A large percentage of oral cancer cases are attributed to tobacco and alcohol consumption. Oral cancer has a better prognosis when it is diagnosed and treated in the early stages.
The oral cavity comprises different parts, namely the lips, gums, tongue, teeth, inside cheeks, roof of the mouth, and floor. These parts of the oral cavity have different types of cells that divide based on the information present in their DNA. Due to certain factors, such as radiation or excessive tobacco exposure, the information in the DNA changes (the process is called mutation), resulting in uncontrolled cell division. This excessive cell division leads to the formation of tumors in the oral cavity, and the condition is known as oral cancer or mouth cancer. Men are at greater risk of developing oral cancer than women.
Oral cancer is one of the top ten cancers globally. India has the largest number of mouth cancer cases, accounting for about one-third of the global burden of the disease. Approximately 70% of the oral cancer cases in India are diagnosed in advanced stages; thus, the five-year survival rate in India is only 20%.
Mouth cancer may start in any location of the oral cavity:
Oral cancer may occur on the lips in the form of lesions or tumors. Squamous cell carcinoma is the most common lip cancer. Patients with mouth cancer may often experience thickening of the lips with or without bleeding.
Gum cancer occurs when the cells of the gums (upper or lower) grow and divide uncontrollably, resulting in the formation of a lesion or tumor. It is usually seen in the form of a white or red mass that may also bleed.
Tongue cancer is characterized by the uncontrolled growth and division of tongue cells. It is usually presented in the form of red or white patches. Based on the site of cancer on the tongue, tongue cancer can be classified into oral tongue cancer and basal tongue cancer.
The cancer of the inner lining of the cheeks is known as buccal mucosal cancer. The patients have painful ulcers or sores and may be presented with raised red or white patches. Early-stage cheek mouth cancer can be treated with surgery.
The hard palate and soft palate make up the roof of the mouth. Cancer of the hard palate is considered a type of oral cancer, while soft palate cancer is classified as throat cancer.
Floor of the mouth cancer starts when the cells beneath the tongue divide and grow uncontrollably. Patients experience pain during swallowing, loose teeth, and ear pain.
As teeth do not have living cells, they do not have cancerous growth. However, various other cancers, such as gum cancer, palate cancer, or cancer of the floor of the buccal cavity, significantly affect tooth health.
Some of the common types of mouth cancer are
It is the most common type of oral cancer, constituting about 80-90% of all oral malignancies. Squamous cells are flat and thin, resembling fish scales.
It is considered a low-grade type of squamous cell carcinoma. It has slow growth due to slow mitotic activity. It has almost no potential to metastasize. However, it can significantly affect the adjacent tissues in the oral cavity.
Minor salivary glands are present in the oral cavity, especially in the palate and aerodigestive tract. Minor salivary gland carcinoma is rare, and mucoepidermoid carcinoma is the most common type of minor salivary gland carcinoma.
Lymphoma of the oral cavity ranks third among the oral cavity cancers, after squamous cell carcinoma and minor salivary gland cancers. Patients with AIDS have a higher risk of developing lymphoma in the oral cavity. Patients with oral cavity lymphoma experience dental pain, swelling, ulcers, and loosening of teeth.
Oral mucosal melanoma is a rare but aggressive cancer that rapidly progresses and metastasizes. It is usually presented as black or brown patches, nodular lesions, or macules.
The stages of Oral Cancer are:
The cancerous cells in this early-stage mouth cancer develop only on the outermost layer of the oral cavity.
In stage 1 mouth cancer, the lesion is not larger than 2 cm and does not spread to nearby structures or lymph nodes.
In stage 2 oral cancer, the lesion is larger than 2 cm but not more than 4 cm and does not spread to nearby structures or lymph nodes.
Stage 3 oral cancer refers to a tumor larger than 4 cm that has spread to the nearby lymph nodes.
Stage 4 oral cancer is metastatic cancer, which spreads to nearby lymph nodes and distant organs like the lungs or liver.
There are several differences between oral cancer and mouth ulcers. Mouth cancer is usually not painful, whereas mouth ulcers are almost always painful. Mouth ulcers heal within 2 to 3 weeks, while oral cancer does not heal and begins to spread gradually.
Oral carcinoma develops in the tissues/organs in the oral cavity, such as the gums, tongue, palate, and lips. There are different types of oral cancers. Squamous cell carcinoma is the most common cancer of the oral cavity. Other types of oral cancer include lymphoma, mucosal melanomas, and minor salivary gland tumors.