Oral cancer, a.k.a mouth cancer, is a type of cancer that originates in the oral cavity and throat.
And since it makes up more than 40% of all cancer cases recorded in India every year, we decided to dig in deep and find out everything about it.
What you will find in this article:-
1. Factors that increase the risk of mouth cancer, and why it is so high in the South-East Asian part of our world.
2. Mouth cancer symptoms and signs to help you spot it early.
3. Stages of its progression explained with the help of an interactive infographic.
4. And the various ways it can be treated and cured.
So let's dive in.
What Causes Mouth Cancer?
With hundreds of studies done on the subject, it is clear, without a shadow of a doubt, that tobacco and its products together are the number one cause of oral cancer in the world.
And while smoking does cause oral cancer to some extent, the main culprits are chewable tobacco (like gutka), areca nut (supari), and paan with slaked lime (chuna) and areca nut pieces.
The other causes are as follows:-
1. Eating excessively spicy food every day
2. Using mouthwashes that have alcohol in them
3. Excessive exposure of the face and lips to the UV rays of the Sun.
4. Infection by Human Papillomavirus (STD)
5. Family history of oral cancer
Mouth Cancer Symptoms and Signs
#1 White/Red Patches in the Mouth
Oral cancer takes time to develop in the mouth and throat. And one of the earliest signs of its development is the presence of white, red, or mixed patches in the mouth.
These pre-cancerous lesions most commonly appear as rough patches in the mouth and are of three types based on their color.
Leukoplakia - white patches.
Erythroplakia - red patches.
Erythroleukoplakia - speckled version with a mixed pattern of red and white.
And you can identify them by using a moist cotton cloth to try and wipe them clean.
If the patches come off easily, then you don't have oral cancer, and instead, have a fungal infection in your mouth (a.k.a Candidiasis).
But if they are non-scrapable, then you need to visit the oral surgeon immediately for a check-up.
#2 Unhealing Sores in the Mouth and Lips
Another classic sign of oral cancer is the presence of a sore or ulcer in the mouth that has not healed even after 2 months.
#3 A Growing Mass inside the Mouth
Oral cancer typically occurs on your cheeks, near the back of your mouth, or along the side of your tongue (both of which commonly come in contact with tobacco quid).
But it can still crop up anywhere in the mouth, including the lips, gums, floor of the mouth (beneath your tongue), and hard and soft palate.
That's why if you find an irregular mass inside your mouth that has been growing persistently for 2 months, then visit an oral surgeon immediately.
In fact, if this mass tends to bleed when you touch it, then it is a bigger cause for concern.
#4 Difficulty in Swallowing Food
We are not talking about the occasional difficulty you face when you try to swallow a large quantity of food at the same time.
We are talking about chronic difficulty in eating and drinking, which is a sign of throat cancer (spectrum of oral cancer).
#5 Lump in the Neck
The lymphatic fluid (part of blood) collected from all the structures inside your mouth is drained in lymph nodes present under your chin and on either side of your neck.
And in advanced stages of oral cancer, cancer cells pass into this lymphatic fluid and reach your lymph nodes, where they start growing.
That's why a hard lump in the side of your neck or under your chin is also a sign of oral cancer.
#6 Loose Teeth
This symptom is only seen if the cancer has affected your gums.
In such a case, the cancer cells slowly eat away the jaw bone and cause the teeth in your mouth to shift around and become loose.
#7 Ill-fitting Dentures
This is again a sign of oral cancer of the gums because the cancerous growth destroys the natural structure of your jaw bones, which prevents your dentures from fitting in your mouth.
#8 Weight Loss in a Short Span of Time
One of the earliest signs of cancer, irrespective of the location in the body, is lack of hunger, which leads to malnourishment and weight loss in a very short period of time.
#9 Long-standing Pain in the Ear
Cancerous growths in the mouth usually invade deeper structures of the body, including nerves. This is the reason behind the referred pain in the ear.
#10 Hoarseness or Sudden Change in Voice
This is also related to nerve involvement and is usually seen in more advanced stages of throat cancer.
Stages of Oral Cancer: How Does it Progress?
The various stages of oral cancer have been classified by the American Joint Committee on Cancer (AJCC) and is called the TNM Staging of Oral Cancer.
You can read the complete medical classification here.
Or check out the simplified version of it in the infographic below.
What is the Cure?
As mentioned in the infographic above, the average survival rate of all the stages of oral cancer is 81%.
Unfortunately, this number drops to 56% in 5 years because most of the time, the cancer is only detected in its more advanced stages (because of lack of awareness of its symptoms or fear of diagnosis).
Nevertheless, the relapse rate of oral cancer is low because treatment options are quite effective when it comes to this cancer.
And while the exact treatment plan depends on the stage of the cancer, location in the mouth (or throat), and type, the following are the broad treatment modalities for oral cancer:-
1. Surgery - Total excision of the tumor and involved lymph nodes along with a margin of healthy tissues to prevent relapse. Requires reconstruction with prosthesis or grafts, afterward.
2. Radiation therapy of the head and neck - usually given twice a day for 5 days a week (for 2 - 8 weeks).
4. Target therapy - Drugs that target specific proteins produced by tumors and prevent their growth.
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