Oral cancer is the most common neoplasm of the head and the neck region. It may involve lips and inner surfaces of the mouth. The main oral cancer risk factors include smoking and alcohol abuse. Learn facts about oral cancer, its causes and symptoms.
According to data collected by the World Health Organisation (WHO), oral cancer takes the 13th place among all malignant neoplasms. In 2020, 377,713 people all over the world were diagnosed with this disease, and 177,757 patients died of it. Oral cancer is most often diagnosed in men and elderly people. The highest incidence of this disease affects low- and medium-income countries.
In terms of global incidence rates, Asian countries (and India, Bangladesh, Pakistan, and Afghanistan in particular) come first, followed by Europe. The highest number of cases and deaths is reported in Hungary.
What is oral cancer? Expert explains
It is not possible to discuss oral cancer diagnosis and treatment without explaining the background of this disease. It is a group of malignant neoplasms, which initially develop in tissues of the oral cavity. Usually, they originate in squamous tissue. They may affect:
- lips;
- tongue;
- gums;
- bottom of the oral cavity;
- buccal mucosa;
- soft and hard palate; or
- oropharynx.
Oral cancer is a malignant carcinoma. This means it can spread to regional lymph nodes or other organs.
The average age of the oral cancer diagnosis is 63 years. Only 20% of these cases are people under 55 years of age. The number of male patients is more than twice that of women with this disease.
In recent decades, the incidence rates for oral cancer have risen. According to estimations, even as many as half of the cases are diagnosed when the disease is already at the advanced stage. This is probably associated with a low awareness of the society (as well as doctors) of risk factors, symptoms and prevention of oral cancer. For this reason, the moment of the diagnosis and implementation of cancer treatment is delayed, and this strongly affects the prognosis.
Oral cancer prognosis
In the case of oral cancer, the prognosis mainly depends on the tumour location and the disease stage at the moment of its detection. According to the data of the Surveillance, Epidemiology, and End Results (SEER), the overall 5-year survival rate is 68%. It increases up to even 90% when the neoplasm is found at its initial stage.
The overall 5-year survival rate for oral cancer depends on the disease site and, according to SEER, is as follows:
- lip – 91%;
- tongue – 68%;
- bottom of the oral cavity – 52%;
- oropharynx – 50%.
Therefore, the early diagnosis of oral cancer is extremely important. All people (especially those from the risk group) should know its initial signs and symptoms. This way, they can receive the required medical care on time.
Oral cancer causes and symptoms
Oral cancer is caused by uncontrolled proliferation of abnormal cells within the oral cavity. The process is a consequence of mutations within their DNA. These mutations result from many factors, including environmental ones.
Oral cancer risk factors include:
- smoking (substances found in the tobacco smoke directly contribute to damages in cell DNA);
- use of smoke free tobacco products (like chewing tobacco) and other stimulants (like betel quid);
- regular consumption of excessive quantities of alcohol;
- infection with human papillomavirus (HPV);
- failure to observe or insufficient oral hygiene (this leads to chronic inflammation in the oral cavity);
- chronic microinjuries within the oral cavity (e.g. caused by incorrectly fitted dentures);
- excessive exposure to UV radiation.
The rate of cancer development depends mainly on a dose and a frequency of exposure to carcinogens.
Other risk factors for oral cancer include:
- being male;
- older age;
- a history of oral cancer in the family.
Benign pre-cancer lesions in the oral cavity are also a risk factor for development of this disease. One of them is oral leukoplakia, in which lesions in form of white patches or plaques develop on lips or oral mucosa. These pre-cancerous lesions may develop into cancer.
Oral cancer symptoms
Oral cancer symptoms mainly depend on the tumour location. You should treat any new things in your mouth as a red flag. They may include white or red spots, ulceration, and thickening (either painful or not). You may easily observe them during routine hygiene procedures.
Oral cancer may quite early develop metastases to local lymph nodes. In such cases, a palpable or a visible tumour on the neck is the first sign.
The remaining oral cancer symptoms include:
- bleeding from gums;
- lip numbness;
- soreness of tissues or pain in the oral cavity (in some cases, radiating to the ear);
- restricted mobility of the tongue;
- unpleasant smell from the mouth;
- problems with swallowing and speaking;
- trismus;
- change in the voice tone;
- unintended weight loss.
When symptoms of oral cancer develop, you should consult a doctor immediately. Detailed diagnostics must be implemented. The sooner the doctor diagnoses you and implements the treatment, the better the prognosis.
How is oral cancer diagnosed?
Oral cancer diagnostics are based on medical examination and auxiliary diagnostic tests. They include:
- ultrasound scan of the neck, with lymph nodes evaluation;
- magnetic resonance imaging of the head and the neck;
- computed tomography of the head and the neck.
To diagnose oral cancer, a sample must be collected from the suspicious lesion and analysed under a microscope. This examination additionally helps to establish a degree of histological differentiation and the tumour type, and to confirm its malignancy.
During examinations and tests for oral cancer, it is also important to have tests that determine the disease stage and confirm or exclude metastases to other organs. They include: the chest computed tomography, a panoramic radiography of the mandible, and the abdominal ultrasound.
Recovering from oral cancer treatment – helpful tips
Oral cancer treatment mainly depends on the tumour location, the disease stage, and the overall health of the patient. In the case of cancers at their initial stage, it is enough to resect the tumour with a margin of healthy tissue or lymph nodes in the vicinity. Sometimes, more advanced surgical intervention is required (e.g. when the disease also involves the mandible). The treatment is supplemented with chemotherapy and radiotherapy (it is also used when the tumour resection is impossible).
After completion of the oral cancer treatment, you should:
- remain under care of your dentist (cancer or its treatment may affect your teeth);
- ask the doctor in charge of your case for a schedule of visits and follow-up tests and examinations;
- learn worrying symptoms that should prompt you to see your doctor;
- implement health promoting actions (including a healthy diet and regular exercises);
- strictly avoid risk factors for oral cancer.
Oral cancer prevention
Oral cancer prevention mainly includes giving up smoking (or the use of smoke free tobacco products) and drinking alcohol completely. A daily oral hygiene is also extremely important. You should pay particular attention to any wounds, ulcers, or nodes within your mouth, gums, cheeks and tongue. If you wear dentures, visit your dentist to ensure they fit perfectly. This prevents mechanical irritation of the oral mucosa. Furthermore, regular visits to the dentist’s are recommended.
ConclusionThe first oral cancer symptoms include spots, ulcers or thickening in the oral cavity. If you notice any lesions of this kind, you should contact the doctor immediately. The oral cancer diagnostics include diagnostic imaging and histopathological examination of a section collected from the suspicious lesion. Oral cancer can be prevented. Oral cancer prevention mainly includes giving up smoking and drinking alcohol.