Sunday, September 9, 2007

ORAL CANCER

What is Oral Cancer?

Oral cancer is a type of malignancy that begins in the oral cavity, which includes the lips, the inside of the lips and cheek, teeth and gums, the front portion of the tongue, the floor and roof of the mouth below the tongue, the bony roof of the mouth (hard palate), and the area behind the wisdom teeth.

Throat cancer (also called oropharyngeal cancer), develops in the area behind the mouth called the oropharynz. Often oral and throat cancer are discussed together because both the oral cavity and throat are involved in both breathing and eating. Saliva glands in both the mouth and throat help us digest the food we eat.

Types of Oral Cancer

Both cancers of the mouth (oral cancer) and throat (oropharyngeal cancer) can derive from different tissues that contain different types of cells in both the mouth and throat. These cell types can affect treatment and recovery.

Squamous cell carcinomas account for 90 percent of all oral and oropharyngeal cancers. Squamous cells make up the epithelium or lining of the mouth and throat. These cancers can spread beyond the top layer of epithelial tissue to become an invasive cancer. About 5 percent of squamous cell carcinomas of the mouth and throat are called verrucous cancer and rarely spread or metastasize beyond the original tumor site.

Cancer of salivary glands and lymph nodes of the mouth and throat and not included in oral cancers and are treated differently.

Statistics

Approximately 34,360 Americans will be diagnosed with oral cancer (including pharyngeal) cancer in 2007, and 7,550 are estimated to die from the diseases.

The five-year survival rate is 60 percent for those with oral cancer, though it rises to 84 percent when detected early enough.

The incidence of oral and oropharyngeal cancer has dropped 5 percent in each of the last two years.

Men are twice as likely to suffer from oral cancer as women.

Prevention

You can lower you risk of getting oral cancer by making certain lifestyle choices. The steps outlines below can serve as a guide to healthy living that may aid in preventing several cancers, including oral cancer.

Avoid any type of tobacco. About 90 percent of people with oral cavity and oropharyngeal cancer have used tobacco.

Avoid excessive alcohol use or the combination of tobacco and alcohol. Oral cancer is about six times more common in drinkers than in non-drinkers. And the combination of the two habits increased risk significantly.

Avoid being outdoors during the middle of the day, when the sun's ultraviolet rays are strongest. Use lip balms containing a sunscreen of SPF 15 or more to protect against sunlight.

Increase dietary intake of fruits and vegetables and whole grain foods.

Have an annual oral cancer screening by your dentist or health care professional.

Risks

You are at greater risk if you:

Chew and/or smoke tobacco: About 90 percent of people with oral cavity and oropharyngeal cancer use tobacco. The risk of developing these cancers increases exponentially with the amount of tobacco smoked or chewed and also with the length people have used tobacco. Smokers are six times more likely than nonsmokers to develop these cancers.

Abuse alcohol: About 75 to 80 percent of all patients with oral cancer drink a lot of alcohol. These cancers are about six times more common in drinkers than in nondrinkers.

Are age 40 and older: Half of all patients are over age 65.

Are a man: Oral and oropharyngeal cancer is twice as common in men as in women. This may be because men are more likely to use tobacco and alcohol.

Are an African-American man .

Are exposed to sunlight for long periods of time: More than 30 percent of patients with cancers of the lip have outdoor occupations associated with prolonged exposure to sunlight.

Maintain a diet low in fruits and vegetables.

Have human papillomavirus (HPV): The types of HPV found in cervical cancer are found in about 20 to 30 percent of oral cancers, but are also found in just a little more than 10 percent of samples of normal oral tissue. People with oral cancer associated with HPV infection have a better outlook than those without HPV. They are also less likely to be smokers and drinkers.

Have a vitamin A deficiency

Symptoms

In the early stages of oral cancer, there are usually no symptoms. Others may experience any of the following symptoms:

  • A white or red lesion on the gum, tongue or mouth lining
  • A lump or mass, which can be felt inside the mouth or neck
  • Pain or difficulty chewing, swallowing or speaking
  • Hoarseness lasting for a long time
  • Numbness of the tongue or other areas of the mouth
  • Swelling of the jaw
  • Loosening of the teeth
  • Pain in the mouth that doesn't go away
  • Persistent bad breath
  • Weight loss

Early Detection

To help detect oral cancer in its earliest stages conduct a monthly self-examination by looking in a mirror to check for any of the symptoms. Have regular dental checkups that include an examination of the entire mouth. And a sk your primary health care professional to examine your mouth and throat as part of a routine cancer-related checkup.

A thorough oral examination should include looking at the roof and floor of the mouth, back of the throat and insides of the cheeks and lips. Your tongue should be pulled gently out and your health care professional should check both the sides and underneath of the tongue. All lymph nodes in your neck should also be checked.

If an exam shows an abnormal area, a biopsy will be performed in which a small sample of tissue is and examined for cancer cells.

New early detection tools are being studied, including the use of fiber optics and dietary compounds from black raspberries.

Treatment

Several types of surgery are used to treat oral cancer. The type of procedure depends on the location and stage of the cancer. Oral cancer is characterized in stages from Stage 1 (the cancer is no more than 2 cm and has not spread to lymph nodes) through Stage IV (the cancer has spread to tissues around the lip and oral cavity and/or has spread to lymph nodes on one or both sides of the neck).

There are several types of surgical procedures used – surgery aims to remove as much of the cancer as possible and help restore the appearance and function of the tissues affected by the cancer. A primary tumor resection removes the tumor and surrounding tissue to prevent cancer cells from remaining. Other procedures include a full or partial mandible resection in which part of the jaw bone is removed when cancer is present, a maxillectomy, which involves removal of part of the roof of the mouth, or Moh's surgery, which is used on cancers of the lip to remove the tumor in thin slices. Other procedures are performed if the cancer has moved to the larynx or to lymph nodes in the neck.

External radiation (high energy x-rays kill cancer cells when aimed on the outside of the body) or internal radiation (use of a radioactive materials put directly on or near the cancerous tissue) and chemotherapy alone or in combination may follow surgery. Frequently plastic surgery is performed to restore speech and the ability to eat more normally.

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