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Oral Cancer

Oral cancer is the 2nd most prevalent cancer in India. Tobacco consumption (both smoke and smokeless), excessive alcohol intake, and HPV infection are the biggest risk factors of oral cancer.

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Overview

Oral cancer or mouth cancer is cancer that is seen in the lining of the lips, cheeks, tongue, soft and hard palate, the floor of the mouth, sinuses and throat. 95% of oral cancers are seen to occur among individuals aged over 40. It is also found to be more common among men than women.

Oral cancer is the 2nd most prevalent cancer in India. Tobacco consumption (both smoke and smokeless), excessive alcohol intake, and HPV infection are the biggest risk factors of oral cancer.

At HCG Cancer Centre, we have a multidisciplinary team that consists of specialists from multiple disciplines, who together discuss every cancer case thoroughly before recommending the best treatment plan for each patient.

Symptoms

Symptoms of oral cancer can vary from person to person. If any of the below symptoms are witnessed, consult your physician immediately.

  • A persistent mouth ulcer
  • Pain or numbness in the face and neck
  • Difficulty moving the jaw
  • Difficulty swallowing
  • Loose teeth
  • Speech problems/change in voice
  • Ear pain or hearing loss
  • Swelling of the jaw
  • Sore throat and hoarseness
  • White or red patches in the mouth or throat
  • Dramatic weight loss

Causes

Researchers have identified various factors that are found to increase one’s risk of developing oral cancer.

  • Tobacco and alcohol use: Both first-hand and second-hand smoking and consumption of smokeless tobacco such as gutka increase one’s risk of developing oral cancer. Alcohol consumption also poses the risk of oral cancer.
  • Human papillomavirus (HPV) infection: HPV infection increases the risk of oral cancers.
  • Gender: Oral cancers are more common among men than women.
  • Age: The risk of developing oral cancers increases with age.
  • Exposure to Ultraviolet (UV) light: Prolonged exposure to UV light increases one’s risk of developing cancer of the lip.
  • Poor nutrition and excess body weight: Poor nutrition and excess body weight contribute to the increased risk of oral cancer.

Diagnosis

There are various tests used to detect and diagnose oral cancers:

a. Physical examination: Physical examination is the first step of an oral cancer diagnosis. The doctor thoroughly examines the oral cavity, lips, nasal and neck region for any abnormalities, such as lumps, red or white patches, persistent ulcers, bleeding, etc.

b. Endoscopy: This procedure allows the specialist to thoroughly examine the mouth and throat regions for any signs of cancer.

c. Imaging Tests: Various imaging tests such as X-ray, ultrasound, PET CT and MRI can help in obtaining detailed pictures of the tumour and planning the treatment accordingly. Results from PET CT and MRI can help specialists in staging the disease and devising appropriate treatment plans.

d. Biopsy: Biopsy is the only way to achieve a definite diagnosis. During the biopsy, a small amount of tissue is excised and examined under the microscope for the signs of tumour growth.

Treatment

In most cases, oral cancers are treated with a multimodal approach. Oral cancers are treated with surgery, radiation therapy, chemotherapy, immunotherapy or targeted therapy, either alone or in combination.

a. Surgery: Surgery is performed to remove the tumour and a small margin of the surrounding healthy tissue. Today, we have minimally invasive surgeries, such as robotic surgeries and endoscopic surgeries, which help specialists operate the tumours without causing much damage to the functioning and appearance of the mouth region. These minimally invasive surgeries help improve the recovery rates, reduce pain and blood loss and lower the side effects.

In some cases, oral cancer surgeries are followed by reconstructive surgeries in order to restore the structure, functioning and appearance of the regions that were affected by the tumour growth. Reconstruction becomes necessary for patients with larger tumours in the regions of mouth, throat and neck.

b. Radiation Therapy: Radiation therapy is found to be extremely effective for oral cancers. During radiation therapy, the cancer cells are killed by delivering high-energy radiation beams. It is also used to destroy the cancer cells that would’ve remained after the surgery.

c. Chemotherapy: During chemotherapy, anti-cancer drugs are administered orally or intravenously to kill the cancer cells. Chemotherapy is either administered before the surgery or after. Chemotherapy is also given as a part of palliative care to delay the progression of the disease and relieve pain.

Lastly, immunotherapy and targeted therapy are also recommended for oral cancers. These therapies specifically target the cancer cells and kill them.

Frequently Asked Questions

1. How do I detect mouth cancer at home?

A quick self-oral examination can help you find if there are any abnormalities in the mouth region. Following are the signs that you need to look out for when you are examining your mouth region:

  • Persistent and painful mouth ulcers
  • Persistent lumps in the mouth and neck region
  • Loose teeth and sockets
  • Numbness and odd feeling on the lip or tongue
  • Red or white patches on the lining of the mouth
  • Change in the speech (for example, lisp)

These are the common signs of oral cancer, and if these are reported early, it may positively impact the clinical outcome.

2. Is oral cancer treatable?

Yes, oral cancer is treatable. However, early detection is important. The earlier the oral cancer is caught, the easier it is to treat.

Any abnormal change in your oral region should be reported and discussed with your dentist or physician, who will help you make an informed decision.

3. Where are oral cancers most commonly found?

Common locations where oral cancers are found include:

  • Tongue
  • Tonsils
  • Oropharynx
  • Gums
  • The floor of the mouth
4. How can I prevent oral cancers?

Quitting tobacco and reducing alcohol intake helps in preventing oral cancers. Apart from these, other ways to reduce your oral cancer risk include having a healthier lifestyle, practising safe and healthy sex habits, reducing your exposure to UV light and undergoing regular oral cancer screening.

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