Oral cavity cancer: Here’s how deadly mouth cancer can be

Oral cancers or mouth cancers are a significant health issue. They’re one of the most typical cancers in the Indian subcontinent. Lip and oral cavity cancers account for 10.3 percent of all cancers in India among both sexes and 8.8 percent of cancer-related deaths, according to GLOBOCAN 2020 statistics. This means that every year in India, 135,000 thousand people are newly diagnosed with oral cancer, and roughly 75,000 people die from it.

Cancers of the tongue, buccal mucosa (inside surface of cheek), upper alveolus (upper jaw), lower alveolus (lower jaw), palate, and floor of mouth are all cancers of the oral cavity.

Here are some causes of oral cancer:

1. Tobacco usage is the leading cause of oral cavity cancer. Shockingly, gutkha, khaini, betel quid (paan), and other smokeless tobaccos are used by up to 21.4 percent of India’s population.
2. Drinking alcohol raises your chances of getting certain cancers.
3. Tobacco use is linked to a thirty times increased risk of having mouth cancer.
4. Paan contains areca nut (also known as betel nut or supari), which is a recognized cancer-causing ingredient that causes oral cavity cancer.

Symptoms of oral cancer

The majority of patients have a history of smoking. They complain of a non-healing lesion on the tongue or cheek, growth in the oral cavity, tooth loosening, a progressive reduction in mouth openness, and neck swelling.

Pre-cancerous diseases such as leukoplakia, erythroplakia, or sub-mucous fibrosis can all be predecessors to oral cancer. Leukoplakia is a white spot in the oral cavity that has no known cause. Erythroplakia is a reddish area that looks similar to erythroplakia. Submucous fibrosis is characterized by white bands on the underside of the cheek that are linked to greater sensitivity to spicy foods and a gradual decrease in mouth opening. If a patient seeks medical help early and stays away from smoking, the advancement of these lesions to cancer can be slowed.

How to find out if you have oral cancer?

When a patient with this kind of cancer visits a cancer center, a complete examination of the upper aerodigestive tract is performed, as well as a neck examination, to rule out additional lesions or disease spread to the neck. A biopsy is extracted from the suspected cancer location and sent to the lab for analysis, where a histopathological confirmation of cancer is obtained. Any neck swelling can be tested with FNAC (fine needle aspiration cytology) to see whether cancer cells are present.

Occasionally, radiological tests such as a CT scan or an MRI scan are necessary to determine the degree of cancer spread and to plan future therapy. A chest X-ray or CT scan is also performed to rule out the spread of tumor to the lungs.

Treatment of oral cancer

The stage of the illness determines how these lesions are treated. Stage 1 and 2 lesions can be treated with a single modality, such as surgery or radiation. Surgery is favored for these lesions since they are easily accessible and just require a single treatment.

In some circumstances, brachytherapy (a kind of radiation) may be employed. Stage III/IV lesions necessitate a multi-modal approach that involves surgery, radiation, and/or chemotherapy. In these circumstances, appropriate reconstruction in the form of local, regional, or free flaps may be necessary. If the defect is tiny, primary closure is performed after surgery. Otherwise, flaps from the local or regional area are employed.

Muscle from the chest is routinely utilized to restore the deficiency in regional flaps. When stated, free flaps are applied. Following surgery, bone or muscle from the leg, thigh, and forearm are used to rebuild the deficiency.

Adjuvant treatment is determined by the presence of negative histopathological findings in the final histopathology report. In certain circumstances, upfront chemo-radiotherapy may be recommended if the patient’s general state is adequate but the illness is exceedingly widespread or incurable.

After treatments, the patient is followed up on a regular basis to check for any residual illness, recurrence, or the emergence of a new lesion.

Rehabilitation after treatment of oral cancer

Oral cancer therapy includes a significant amount of rehabilitation. Patients with speech and swallowing impairments emerge after surgery that removes a portion of the tongue, cheek, or jaw. Patients suffer a lot of difficulty with eating and speaking even after non-surgical therapies like radiation and chemotherapy. To assist the patient retrieve these functions, aggressive rehabilitation procedures are used. Various swallowing movements are taught by speech and swallowing therapists to make swallowing easier. Speech therapy sessions are also scheduled on a regular basis to educate the patient how to speak more clearly after treatment.

For a while, patients may need to rely on a semi-solid diet. Family members’ constant encouragement and support are critical in helping the sufferer cope better. Occupational therapy is particularly necessary when mouth opening decreases after treatment. To aid promote mouth opening, jaw stretching exercises are used. After a neck dissection, physiotherapy in the form of neck and shoulder exercises is a vital element of the recovery process.

Here are some preventive measures one may take:

Certain lifestyle adjustments can help reduce a person’s risk of developing oral cavity cancer. Quitting tobacco consumption is the most crucial of these. This includes quitting chewable and non-chewable tobacco products. Alcohol and areca nut (supari) use should also be avoided.

Tobacco addicts and current users should be advised to quit from using these items. Addicts who have withdrawal symptoms after discontinuing these products should seek help from a de-addiction center or their nearby physician. Nicotine patches and gums are provided under medical supervision to assist addicts quit smoking. These facilities also provide counseling services.