Mouth & Oral Cancer: Comprehensive Overview

Mouth and oral cancer is a significant health concern, with India accounting for a substantial portion of global cases. It affects various parts of the oral cavity, including the lips, tongue, gums, cheeks, and the area behind the wisdom teeth. Early detection and treatment are vital for effective management.

Signs and Symptoms of Mouth & Oral Cancer

Oral cancer can manifest through several symptoms, including:

• Non-healing ulcers
• Bleeding from the mouth
• Lump or swelling in the jaw, face, or mouth
• Loosening of teeth
• Pain, numbness, or weakness in the face
• Difficulty in opening the jaws and chewing
• Trouble swallowing
• Changes in speech
• Ear pain or hearing loss
• Difficulty in breathing
• White or red patches in the mouth
• Unexplained weight loss
• Swelling in the neck

Types of Mouth & Oral Cancer

Common types include:

• Lip Cancer
• Cheek/Buccal Mucosa Cancer
• Lower and Upper Alveolus Cancer
• Retromolar Trigone (RMT) Cancer
• Floor of the Mouth Cancer
• Tongue Cancer
• Hard Palate Cancer

Most oral cancers are squamous cell carcinomas.

Screening and Diagnosis: Regular self-examination and annual dental check-ups are crucial. If you notice any persistent white or red patches or non-healing ulcers, consult a healthcare professional immediately.

Diagnostic Procedures: A thorough diagnostic process involves:

• Medical history evaluation
• Physical examination
• Biopsy of suspected areas
• Endoscopy
• Laboratory tests (blood, urine, or node samples)
• Imaging tests (X-rays, CT scans, MRI, PET scans)

Myth: Biopsy and Cancer Spread : A biopsy, involving the removal of a small tissue sample, is essential for accurate diagnosis and does not cause cancer to spread.

Tumor Board/Multispecialty Clinic Evaluation : A multidisciplinary team of specialists—including surgical oncologists, medical oncologists, radiation oncologists, pathologists, and imaging specialists—reviews each case to devise a personalized treatment plan based on international guidelines (e.g., NCCN).

Treatment Options: Treatment plans may include:

• Composite Resection/Commando Operation
• Maxillectomy
• Neck Dissections
• Reconstruction with Free Flaps (e.g., Anterolateral Thigh Flap, Radial Artery Forearm Flap)
• Plastic Surgery for facial, neck, and oral defects

Frozen Section Technique: This technique ensures the complete removal of cancer by assessing the main specimen immediately during surgery, providing rapid results for more accurate treatment.

Causes and Risk Factors: Common risk factors include tobacco use, excessive alcohol consumption, certain HPV strains, and a history of oral diseases.

Post-Surgery Care DO’s:

• Speak minimally to promote healing.
• Follow a liquid diet with adequate salt at regular intervals.
• Use feeding tubes as directed, with the patient in a 30-degree head-up position.
• Continue prescribed medications, including those for chronic conditions.
• Maintain oral hygiene with recommended mouthwashes.
• Adhere to specific sleeping positions if undergoing flap reconstruction.
• Engage in recommended physical activities and shoulder exercises.
• Regularly clean tracheostomy tubes if applicable.
• Monitor and manage drain and wound care as advised.

DON’Ts:

• Avoid sudden exertion or room heaters with a tracheostomy tube.
• Refrain from smoking or alcohol consumption.
• Avoid brushing teeth unless instructed otherwise; follow diet and mouth care guidelines.

When to Contact the Treating Team

• Attend all scheduled appointments.
• Report sudden swelling, bleeding, or difficulty breathing.
• Seek help for persistent or unusual symptoms.

For comprehensive care and management of mouth and oral cancer, consult with a specialized team for an accurate diagnosis and effective treatment plan.