Oral Cancer

Global burden

The incidence of Oral Squamous Cell Carcinoma is 3% in United States of America whereas it is 30% in India and other Asian countries. According to the American Cancer Society, approximately 48,000 Americans develop oral cancer every year and 8500 people die of the disease annually.

Indian burden

India records more than 1, 00,000 cases of oral cavity cancers every year. India has the highest prevalence of oral cancer in the world (19/100, 000 population). It is the most common cancer in men and the third most common cancer in women, and constitutes 13%–16% of all cancers. Of all the oral cancers, 95% are related to the use of tobacco products.

What is Oral Cancer?

The cancer appearing in any parts of oral cavity (like lips, tongue, cheeks, floor of the mouth, hard and soft palate, sinuses, and pharynx) is called as oral cancer.

Oral Cancer

Risk Factors

Anything that increases your chance of developing oral cancer is called
as Oral Cancer Risk factor.

Oral Cancer

Signs & Symptoms of Oral Cancer

The most common signs & symptoms of oral cancer include:

  • Red or red and white, patches on the lining of mouth or tongue.
  • Leukoplakia > 2cm in size.
  • One or more mouth ulcers that do not heal after three weeks
  • Swelling in mouth that lasts for more than three weeks
  • Pain when swallowing (dysphagia)
  • Difficulty chewing, swallowing, speaking or moving tongue.
  • Difficulty in opening mouth, moving jaw, or swelling or pain in jaw.
  • A persistent pain in the neck
  • A hoarse voice
  • Unexplained weight loss
  • Unusual changes in sense of taste
  • Difficulty in tolerating spicy foods
  • Excessive salivation
  • Pain in ear
  • The lymph nodes (glands) in neck become swollen
Oral Cancer

Anatomy of Oral Cavity

The Oral Cavity includes,

  • Lips
  • Front two thirds of the tongue.
  • Gingiva (gums).
  • Buccal mucosa (the lining of the inside of the cheeks).
  • Floor (bottom) of the mouth under the tongue.
  • Hard palate (the front, bony part of the roof of the mouth).
  • Soft palate (the muscular back portion of the roof of the mouth).
  • Retro-molar trigone (the small area behind the wisdom teeth).

Oral cavity cancer may appear in any of these tissues of the oral cavity.

Oral Cancer Prevention

Avoiding risk factors and increasing protective factors may help to prevent oral cavity cancer.

  • Avoiding risk factors such as smoking, chewing tobacco, heavy alcohol consumption and oral infections may help to prevent oral cavity cancer.
  • Quitting tobacco: Studies have shown that when people stop smoking cigarettes, their risk of oral cavity cancers decreases by one half (50%) within 5 to 9 years. Within 20 years of quitting, their risk of oral cancers is the same as for a person who never smoked cigarettes.
  • Quitting alcohol: Some studies show that when people stop drinking alcohol, their risk of oral cavity cancer decreases within about 20 years.
  • Increasing protective factors such as good oral hygiene, regular self-oral examination, Oral Visual Inspection by health care professionals may also help prevent oral cavity cancers.
  • Increased consumption of fish, eggs, raw and cooked vegetables, and fruit is associated with a decreased risk of oral cancer.
  • Limit your exposure to the sun.
  • Conduct a self-exam at least once a month.
  • See your dentist on a regular schedule
  • Talk to your doctor or other health care professional about how you might lower your risk of
    oral cavity cancer.

Screening for Oral Cavity Cancer

Who should be screened?

A dentist or medical doctor may check the oral cavity during a routine check-up. The exam will include looking for lesions, including areas of Leukoplakia (an abnormal white patch of cells) and erythroplakia (an abnormal red patch of cells). Leukoplakia and erythroplakia lesions on the mucous membranes may become cancerous. More than half of oral cancers have already spread to lymph nodes or other areas by the time they are found.

Who should be screened?

Inclusion criteria:

  • Any individual (woman or man) aged 30 years and above should be screened at all screening centers.
  • Those who use tobacco in any form and / or alcohol.

Screening methods for oral cancer:

  1. Questionnaires
  2. Oral Visual Inspection (OVI)
  3. Mouth self-examination
  4. Biopsy and histo-pathological examination

How is Oral Cancer treated?

Oral cancer is treated the same way many other cancers are treated with surgery to remove the cancerous growth, followed by radiation therapy and/or chemotherapy (drug treatments) to destroy any remaining cancer cells.

Oral Cancer