Oral and Oropharyngeal Cancer
Overview :
Oral cancers are the most common cancers , especially in Men. Tobacco ,Gutkha, Smoking along with alcohol are the major contributing factors. The incidence of the disease is increasing at an alarming rate , despite it being preventable. Approximately , 40% of the cancers in men are oral cancers and include :
Oral Cavity – Tongue , Buccal Mucosa (inner surface of cheek), Floor of the mouth, gums, palate
Pharynx – The area behind the tonsils
The surfaces of the mouth , tongue and lips are covered by flat cells (squamous cells). Almost all cancers initiate in these cells and hence are called squamous cell carcinomas.Cancers have a high tendency to spread (metastasize) and carcinomas including squamous cell carcinoma spread via clear body fluid called lymph and drains into a lymph node. The group of lymph nodes affected by Oral Cancers are present in the Neck.
Cancer can also spread to other parts of the body which is termed as distant metastasis and the sites of spread for the oral cancer include the lungs or the liver.
Symptoms
1
Non healing ulcer in any part of the oral cavity.
2
Swellings, lumps or eroded areas in any part of the oral cavity.
3
White or red patches in the mouth.
4
Unexplainable bleeding from the oral cavity
5
Unexplainable numbness or pain in any part of the mouth or face
6
A feeling of something been caught at the back of the throat
7
Difficulty in speaking, swallowing or moving the jaw
8
Ear pain
9
Weight loss
Diagnosis and Work – Up
- Detailed History of the Patient along with clinical examination and investigations such as Biopsy, CT Scan/ MRI Scan, PET scan.
- Endoscopy – Minimally invasive procedure to visualize the interior surface of certain organs and cavities.
Treatment
- The main treatment approach in patients with oral cancer are: surgery and radiotherapy with or without Chemotherapy.
How To Prevent Oral Cancer
- Avoiding Tobacco and Tobacco containing products such as Gutkha, Paan, Khaini, Beedi, Cigarette.
- Avoiding Alcohol
- Maintaining Good oral and dental hygiene
By early detection and adequate management, it is possible to cure Oral Cancer.
Laryngeal Cancer
Larynx, or “voice box” consists of three parts:
- Glottis: the middle portion of the larynx that contains the vocal cords
- Supraglottis: the area above the vocal cords
- Subglottis: the area between the vocal cords and the trachea (windpipe
Symptoms
1
Hoarseness of voice
2
Difficulty in swallowing or breathing.
3
Persistent sore throat
4
Ear pain
5
Lump in the neck
Diagnosis
- Diagnosis is determined after thorough clinical examination and Video Laryngoscopy along with biopsy. CT Scan, MRI or PET Scan to know the extent of the disease are also performed.
Treatment
- The main treatment approach in patients with oral cancer are: surgery and radiotherapy with or without Chemotherapy.
How To Prevent Oral Cancer
- Early stage laryngeal cancers (stages I-II surgery or radiation therapy have equal response
- Intermediate stage cancers (stages II-III), a combination of radiation + chemotherapy or radiation + surgery provide the best opportunity to preserve the larynx.
Advanced Surgical modalities contribute a lot in preserving the larynx and thus the voice , however in patients in whom the entire larynx or the vocal cords have been removed, there is loss of voice. Options to restore speech include voice prosthesis, electrolarynx, and speech therapy.
Salivary Gland Cancer
The major salivary glands include the Parotid gland, Submandibular gland and the Sublingual gland. The most common symptom of salivary gland cancer is a swelling on the side of the face just infront of the ear , or below the jaw bone. This may also be accompanied by facial palsy which includes numbness and drooping of one side of the mouth.
The diagnosis includes a detailed history and physical examination along with radiological investigations such as a CT scan or a MRI . Finally a biopsy or an FNAC is done to confirm the histopathological type of the cancer.
Surgery is the modality of choice in management of Salivary gland tumors. If the tumor is cancerous, Radiation may be required as an adjunct.