There is a saying that people should fill their mouths with life, not deaths…wish Indians realized this. In India, the age standardized incidence rate of oral cancer has been noted by World Health Organization (WHO) as 12.6 per 100,000 populations. The unhealthy habit of consuming hazardous carcinogenic agents like tobacco, cigarette, Pan Masaala, betel quid (paan) and betel nut (chaalia) plays a vital role in increasing the risk of Oral Cancer.
The prevalence of oral cancer is particularly high among men, the eighth most common cancer worldwide and in south-central Asia, cancer of the oral cavity ranks among the three most common types of cancer.
Oral cancer is cancer of the mouth, which commonly involves lips or the tongue. It may also occur on the:
- Cheek lining
- Floor of the mouth
- Gums (gingiva)
- Roof of the mouth (palate)
The symptoms of this type of cancer most often get ignored under the shadow of other medical conditions. Only a specialist can establish a correct diagnosis of this medical condition.
The diagnostic procedure involves a certain number of steps which include:
One of the first steps in establishing an oral cancer diagnosis is a detailed and complex medical review of a patient's past health problems and general health state, family medical history, oral cancer risk factors (especially smoking habits, tobacco and alcohol use), and symptoms.
The specialists look for any possible lump, abnormal or discolored tissue, or sores by the physical examination, of the lips, oral cavity, pharynx (back of the mouth, face and neck.
If any suspicious lesion or ulcer is found then, Biopsy is performed, which is followed by endoscopic examination and imaging investigations (Computed Tomography (CT), Magnetic resonance imaging (MRI), Ultrasonography) to find out the stage of the disease.
The treatment plan for oral cancer varies from patient to patient and is established according to the following five main factors:
- The patient's age, general health and past medical history,
- The cancer type, size, and location,
- The treatment tolerance,
- The risk for hidden disease
- The need to save certain functions.
A better treatment outcome is achieved in patients diagnosed with oral cancer at an early stage. The main treatment approach in patients with oral cancer is: surgery and radiotherapy with or without Chemotherapy.
Surgery is a procedure aimed to completely remove the tumor tissue together with adjacent healthy tissue in order to prevent relapse of cancer.
The common surgeries performed to treat oral cancer are:
Conservative Resections for oral cavity (mouth) Cancer: Conservative resections are done for early cancers of the oral cavity. Main objective is to preserve organs and attain good quality of life for the patient.
Composite Resections: These extensive surgeries are done for locally advanced tumours of oral cavity (mouth) which are caused by tobacco chewing and are very common in south Asia (India). This involve removal of part of jaw / whole jaw with adjoining buccal mucosa (Inner lining of cheek) with or without removal of skin of cheek.
Maxillectomy: For cancers of cheek bone (maxilla), radical maxillectomy is done, which involves removal of cheek bone (maxilla) with or without preservation of eye depending on involvement of eye or not. If, cheek skin is involved, that is also removed.
Mandible Arch and Floor of the Mouth Resections: These challenging surgeries for advanced loco-regional tumours of the jaw, involve removing the entire tumour including jaw, neck dissection for removal of lymph nodes, removing fibula (leg bone) of the patient and reconstructing the jaw with fibula.
Whereas, radiation therapy uses high-energy rays or particles to destroy cancerous cells at the local site. The purpose of this treatment is to destroy cancerous tissues preserving the healthy tissue. Usually it is performed as a curative treatment in patients who cannot be operated with small tumors or as an adjuvant treatment - in addition to surgery.
Chemotherapy, one among the commonly known procedure, is a systemic type of treatment (affects cells throughout the entire body) that uses drugs either to stop the abnormal growth and dividing process of the cancerous cells, or to kill them. This treatment also has the ability to interfere with the cancerous cells' replication. Chemotherapy can be administrated in combination with surgery and radiation therapy for a better treatment outcome. The chemotherapy drugs can be given intravenous or as oral pills.
As use of tobacco accounts for most oral cancers, the patients should be counsel to quit these products at the earliest. Quitting may also reduce your chance of developing other new cancers (especially other head and neck or lung cancers), which is a serious problem among oral cavity and oropharyngeal cancer survivors.
It’s high time you pay attention to your health, for a happy long life ahead.