What is Oral Cancer ?

Mouth cancer, also referred to as oral cavity or oral cancer, may grow in any part of the mouth that include -

• Floor of the mouth
• Lips
• Tongue
• Roof of the mouth
• Gums
• Inside lining of the cheeks

Types of Oral Cancer:

The most common type of oral/mouth cancer is squamous cell carcinoma. This specific type of cancer can be found in a number of places in the body that also include under the skin and inside of the mouth. Other not so common types of mouth cancer are -

• Adenocarcinomas: This rare type of mouth cancer grows within the salivary glands.
• Oral Malignant Melanoma: This is also a rare type of mouth cancer that begins in cells known as melanocytes. These melanocytes are responsible for providing the skin its color.

Causes of Oral Cancer

Oral cancer happens when there is something wrong or unusual in the normal cell lifecycle. This abnormal working of the cell lifecycle results in uncontrollable growth and reproduction of these cells.

Symptoms of Oral Cancer:

• Dramatic weight loss
• Bumps or lumps, thickenings/swellings, rough spots or eroded areas or crusts on the gums, lips and/or other areas within the mouth
• Ear pain
• Persistent sores on the mouth, face or neck that causes bleedings and that do not heal within two weeks
• A change in the way the dentures or teeth fit together
• Pain, unexplained numbness, loss of feeling in any area of the neck, face or mouth
• Change in voice, hoarseness or chronic sore throat
• Unexplained bleeding in the mouth
• Problem in speaking, moving the tongue or jaw, swallowing or chewing
• The development of velvety red, white or speckled patches inside the mouth
• A feeling that something is there in the back of the throat

Stages of Oral Cancer:

Stage 0 (Carcinoma in Situ) : This stage is considered as the pre-cancer stage. In this stage, there are cancer cells that are inside the lining of the mouth that have not yet spread. If this stage is left untreated then it can develop into an invasive cancer.

Stage 1: This is considered as the early stage of invasive cancer. Now the cancer has started to develop through the mouth lining and also in the deep tissues below. The cancer has not spread close to other organs, tissues or lymph nodes and this cancer is not beyond 2 cm across.

Stage 2: In the second stage, the tumor is more than 2cm but is less than 4cm. Other organs or lymph nodes are remains unaffected by this cancer.

Stage 3: One or more conditions are true in this stage- first; the tumor is of any size that has spread to 1lymph nodes on the same side of the neck. Second, the cancer is more than 4 cm that has not spread to any part of the body or to any lymph nodes.

Stage 4: This stage is known as the advanced stage of oral cancer that is categorized into three stages -

• Stage 4A: This stage is marked by the growth of the cancer through the tissues around the mouth and lips. At this stage, it is possible that lymph nodes may or may not possess any cancer cells.
• Stage 4B: This stage is marked by the spread of the cancer to any lymph node which is bigger than 6 cm or to lymph nodes on both neck sides, or to more than one lymph node on the same side of the neck.
• Stage 4C: This stage is marked by the spread of the cancer to different body parts that include bones or lungs.

Diagnosis of Oral Cancer:

A number of tests are performed for diagnosing mouth cancer that include -

• Biopsy: A small tissue sample is taken in biopsy that is further sent to a laboratory for determining the type of cells and whether they are cancerous or non-cancerous.
• Throat and Mouth Examination: A special instrument known as flexible laryngoscope is used for viewing within the throat and mouth.

Certain other tests are also required for determining the spread of the cancer. These tests are -

• A Barium Swallow and Meal Test: This test requires a patient to swallow a drink having barium. An x-ray will present images of abnormal growths in the digestive system down to the stomach.
• X-rays: X-rays are done of the lower and upper jaw or a chest x-ray can also be done.
• Endoscopy: This test helps in viewing the body from within. An endoscope (a narrow and flexible tube having a telescopic camera) is used for performing this test.
• Certain other biopsies of nearby lymph nodes are also done.

Treatment of Oral Cancer:

The treatment options of oral cancer have been categorized into surgical and non-surgical treatments.

Surgery : The affected tissue is removed with the help of surgery that also includes the use of lasers. The surgical procedure may also involve the removal of certain affected tissues in the mouth or lymph nodes in the neck. The removal of a small tumor in the mouth may not result in any problems. On the other hand, the removal of large tumor may also require removing of a part of jaw, palate or tongue. All the cancer cells can be destroyed if the surgery is followed by radiotherapy or chemotherapy.

Non-surgical Treatments:

Biological Therapy: The activity of the cancer cells is changed with the help of biological therapy. A type of biological therapy is known as Cetuximab that is also referred to as a monoclonal antibody. The surface of the cancer cells that triggers the development of cancer cells is blocked with the help of Cetuximab.

Chemotherapy: This therapy makes use of drugs for destroying the cancer cells. The injection of these drugs is done into a vein. Chemotherapy can also be combined with radiation therapy. Chemotherapy destroys the cancer cell that may have traveled somewhere else in the body while radiotherapy destroys the cancer area.

Radiotherapy: This therapy makes use of radiation for destroying cancer cells. This therapy shrinks the tumor by targeting a beam of radiation onto the cancer cells. Rarely, a radioactivity source can be implanted in the mouth that is known as Brachytherapy. The nearby tissues are not damaged by this therapy.