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(Friday, 25th Jul, 2014)
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Oral Cancer

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Oral cancer

What is oral cancer?

This is cancer which occurs in the mouth (oral cavity). The mouth is made up of many parts, such as the lips, teeth, tongue, the inside of the cheeks and the salivary glands. It also refers to the oropharynx (the part of the throat at the back of the mouth), which consists of the back one-third of the tongue, the soft palate, the tonsils and the back of the throat. Cancer that develops in any of these areas is referred to as oral cancer.

The commonest sites for oral cancer are the lips and tongue. Oral cancer is uncommon, accounting for about 5% of all cancers. Men are twice as likely to develop oral cancer than women and most cases occur over the age of 40.

What causes oral cancer?

Two known causes of oral cancer are tobacco use and alcohol use. Tobacco use includes smoking cigarettes, pipes and cigars, as well as chewing tobacco. Tobacco use accounts for the vast majority of oral cancer cases. People who stop using tobacco, even after long-term use, can greatly reduce their chances of getting oral cancer. Heavy or chronic use of alcohol also increases the risks of getting oral cancer, even for those who do not use tobacco. Those who do both are especially at risk.

Poor oral hygiene also increases the risk of developing oral cancer.

What are the symptoms of oral cancer?

While oral cancer is more commonly found in people over the age of 40, it can occur in people of all ages. One of the main symptoms is a sore in the mouth that just won’t go away. You may also experience soreness around the mouth, difficulty in moving the tongue or jaw, and difficulty in chewing or swallowing. You may notice a discoloured patch in the mouth or a lump in the cheek, or experience numbness of areas in the mouth.

It is important to visit your dentist or doctor if any of these complaints persist. It is essential to understand that pain is not an early symptom of oral cancer, so do not assume that if you are not experiencing pain, that there is nothing to worry about.

How is oral cancer diagnosed?

A biopsy is the only way to tell if an area in the oral cavity is cancerous or not. This involves removing part or all of the suspected area and checking it for cancer cells. If cancer is diagnosed, further tests may be carried out to provide more information on the cancer.

How is oral cancer treated?

The way in which oral cancer is treated depends on a number of factors, such as location of the tumour, its size, and the health and age of the patient. Treatment involves surgery or radiation therapy or a combination or both.

Surgery is the usual course of action. This involves the surgical removal of the tumour. Radiation therapy (radiotherapy) is sometimes used for small tumours. This involves high-energy rays that damage cancer cells and stop them from growing. Radiation therapy can be used before or after surgery. If used beforehand, it will shrink the tumours allowing easier removal during surgery. If used afterwards, it can destroy cancer cells that may have remained after surgery.

Before beginning any type of treatment, however, the patient is advised to get any required dental work done. This is because cancer treatment will often make the mouth sensitive and more prone to infection. Therefore, carrying out dental work before cancer treatment may stop such possible complications.

What are the possible side-effects?

Side effects can vary from person to person and depend on such things as the location and extent of the cancer. If a person has a large tumour which requires surgery, the surgeon may need to remove part of their jaw, palate or tongue. This will obviously affect some of the patient’s abilities, such as the way they talk. Their appearance may change also. Reconstructive surgery may be required. After surgery, the face will probably be swollen for a few weeks. In some cases, the swelling will last longer.

A side-effect of radiation therapy is mouth dryness. While this goes away in most people, in some it is permanent. The person may also become very tired during this treatment and men may lose some or all of their facial hair. (This usually grows back after treatment).

Weight loss can be a problem during oral cancer treatment due to the simple fact that it is difficult to eat with a sore mouth.

What is the outlook?

When oral cancer is detected and treated early, the outlook is good. Early treatment will result in a cure in about three quarters of cases.

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