Oral Cancer: Treatment, Procedure, Cost and Side Effects

Oral cancer is defined as the abnormal growth of cells in any part of the lips or mouth. Most oral cancers are known to commence in the lips or mouth lining. This is the region where we find the flat cells also known as the squamous cells. Other names for this type of cancer are oropharyngeal cancer and oral cavity cancer. There is a wide range of risk factors associated with oral cancer. This involves heavy alcohol consumption, smoking, having human papillomavirus (HPV), or marijuana usage. In case of lip cancer, exposure to UV light or tanning beds increases the risk for oral cancer. Symptoms include lumps or sores on the mouth region or the lips.

The diagnosis begins with the doctor conducting an oral screening exam as part of your routine dental exam. In specific terms, your dentist will try to find out the irregular changes of tissues in your oral cavity, neck, face, and head, or feel for lumps at the same areas. During the oral examination, he will look for discoloured tissues or sores. You may also require a biopsy to determine any suspicious looking areas. The treatment methods available for oral cancer are the same as any other cancers. Firstly, it involves a surgery to remove the cancerous growth of cells, followed by a chemotherapy or radiation therapy to fully remove the remaining cancerous cells.

Symptoms of oral cancer are similar to the symptoms of lip cancer, like:

• Swelling of lips
• White and red spots on the lip
• Lumps on the lip
• Bleeding mouth
• Numbness in the areas of the neck, mouth, or face
• Pain in ears
• Sore throat
• Jaw pain
• Weight loss
• Persistent sores
• Mouth bleeding

Summary: White and red patches are the most common symptoms of oral cancer. It can lead to sore mouths that would take a longer time for healing.

There are several causes of oral cancer which includes:

• Consumption of alcohol and tobacco: use of tobacco or cigarettes increases the risk of oral cancer. Taking both alcohol and tobacco can even worsen the condition.
• Infection with HPV: According to the research, infection with HPV (human papillomavirus) which is sexually transmitted, can be a cause of oral cancer. In order to prevent oral cancer, one should limit the number of sexual partners, or taking an HPV vaccination can also help to reduce the risk of HPV infection.
• UV rays: Direct exposure to sunlight without taking any protection measures to prevent UV rays can cause lip cancer.
• Age: Oral cancer can occur in people above the age group of 40 years.
• Poor oral hygiene: One should always maintain oral hygiene, especially for the people who take alcohol and tobacco.

Summary: Consumption of tobacco and alcohol are the main reasons for oral cancer. Other causes include oral hygiene and HPV infection.

There are a number of ways to diagnose oral cancer:

• Endoscopy: In endoscopy, the doctor passes a hollow tube equipped with a lens inside your nose to check the areas of the head and neck.
• Physical examination: In physical examination, the doctor checks the area of the lips, head, and nose. If the doctor finds symptoms related to oral cancer then he recommends further checkups.
• Biopsy: In a biopsy, a small tissue is taken for a checkup. It gives a definite result of the diagnosis. After taking a small tissue as a sample, various laboratory tests are done and the doctors check for the presence of lumps or any such symptoms of oral cancer.
• X-rays: It is done to get a picture of the abnormal conditions inside our body.

Summary: There are a number of ways to detect oral cancer, some of them are: endoscopy tests, biopsy tests, examining the patient, and X-rays.

After proper consultation with your doctor, you will be guided towards a specialist like an otolaryngologist, maxillofacial surgeon, plastic surgeon, radiation oncologist, and medical oncologist to treat this disease. These people specialize in surgery, radiation therapy and chemotherapy related to mouth cancer. Other health care professional include a speech pathologist, dentist, mental health counselor, and nutritionist.

Surgical treatment for the removal of cancerous cells is the most common treatment for oral cancer. At times, the surgeon removes the lymph nodes and other tissues from the neck as well. Patients may also have a combination treatment of surgery along with radiation therapy. Radiation therapy or radiotherapy is a kind of local therapy which affects the treated area only. It is used alone for patients who are unable to afford surgery or for treating small tumors. In some cases it is done before surgery to shrink the tumor by killing cancer cells. In order to treat oral cancer there are two types of radiation treatment used. These are external and internal radiation (implant radiation). External radiation comes from a machine and internal radiation comes from radioactive materials put in thin plastic and needles which are directly placed in the tissue. Chemotherapy is the usage of anticancer drugs to destroy cancer cells. This systematic therapy is associated with the drugs to enter the bloodstream and affect the cancerous cells throughout the body. It is usually given by injection.

Oral cancer can be prevented by just being careful about what you eat, maintaining your oral hygiene, and avoiding HPV infections.

There are various ways that can contribute to Oral Cancer prevention:

• Avoid consumption of alcohol and tobacco: consumption of alcohol and tobacco are the leading reasons which increase the risk of oral cancer. One must stop chewing tobacco, smoking, and drinking alcohol to prevent oral cancer.
• Oral hygiene: You should brush your teeth regularly to maintain good oral hygiene. This helps to prevent HPV infections which thereby helps to reduce the risk of oral cancer.
• Prevent direct exposure to sunlight: To prevent harmful effects of the UV rays, you should use UV-A/B blocking sun protection products on your lips to stop the damage caused by the harmful UV rays.

Summary: You can prevent oral cancer by maintaining your oral hygiene and by avoiding the consumption of alcohol and tobacco.

A patient who has a small tumor or is unable to tolerate or afford surgery is eligible for radiation therapy. Someone with locally advanced disease is eligible for surgery.

A patient who is older than 75 years is not eligible for the treatment. Also, pregnant women are not eligible.

Side effects of the treatment include soreness, pain or redness in the mouth and throat, loss of senses of taste, hoarseness, and skin colour change on the head and neck as tanned or sunburns which eventually fades away.

It is very important that the patient receives proper follow-up care after the treatment. Even if it seems that the cancer has been completely destroyed or removed, the disease has a tendency to return because of the undetected cancerous cells remaining in the body. Recurrence of cancer cells is regularly monitored by the doctor. Your doctor will recommend you to keep investigating your mouth and come for screening exams regularly. He may do a blood test, x-rays or a complete physical examination. Doctors also urge you to strictly stop the usage of tobacco and consumption of alcohol to prevent recurrence of oral cancer.

It may take more than a year depending upon the severity of the disease. Side effects may still remain.

The cost of treatment ranges from Rs. 3,00,000 to Rs. 3,50,000.

No the results of the treatment for oral cancer are not permanent as the cancer cells can return in case they were not detected earlier.

Spices like turmeric, fruits like banana and avocado, and coffee, along with a Mediterranean diet rich in vegetables, fruits, whole grains like sorghum, button mushrooms, and fish, as well as folate-rich foods, aid to reduce the incidence of mouth/oral cancer and oropharyngeal cancer.

To avoid oral cancer, avoid smoking or chewing tobacco, and restrict or avoid alcohol use, which are the two main causes of the disease. Certain foods, such as cauliflower, cocoa, peppermint, mustard, and currant, may not be good for oropharyngeal cancer treatment and prevention, and dietary supplements of cabbage, nutmeg, poppy, clove, and fava bean should be avoided.

As a result, adhering to a specific dietary plan becomes an important aspect of any cancer treatment plan.

Summary: You need to take a proper healthy diet to prevent and cure oral cancer. In general, cruciferous vegetables are regarded as a healthy food for cancer patients.

Alternative treatments for oral cancer include using herbs like turmeric (curcuma longa), mint, thyme, basil and green tea. The usage of these herbs will provide benefit in easing the symptoms associated with oral cancer.

Patients should begin slowly and gradually increasing their exercise intensity. Yoga and other flexibility exercises can help you maintain mobility and prepare for more strenuous activities.

You can go to aerobic workouts like jogging, cycling (stationary bikes are OK), swimming, or brisk walks whenever you feel comfortable.

Resistance exercise can also aid in the preservation of muscle and bone mass, which is beneficial both before and after therapy.

Summary: According to the studies, exercise can help to minimize the incidence of cancer. The exercise should be in moderate intensity, with 50-70 percent of maximum working capacity, and it must be done three times a week for at least two months.

Chemotherapy medicines and oropharyngeal malignancies that can be given with or without radiotherapy include:

1. Cisplatin
2. Docetaxel
3. Paclitaxel
4. Carboplatin
5. 5-fluorouracil is a drug that is used to treat cancer (5-FU)
6. Hydroxyurea

Other medications that are less commonly used include:

1. Methotrexate
2. Capecitabine

Chemotherapy drugs can be in combination with other medicines. Combining medications can help reduce tumors more effectively, but it also increases the risk of unwanted effects. Carboplatin and 5-FU are a popular combo.

This combination helps in shrinking the oral cavity and oropharyngeal tumors. Cisplatin, 5-FU, and docetaxel are other common combinations. Chemotherapy may be used in conjunction with a targeted medication or immunotherapy in some circumstances.

Summary: Oral cancer patients may be treated with medicines, by chemotherapy, in which a group of chemicals is used to kill cancer cells all across the body, and targeted therapies, which target cancer cells.

Conclusion: Any area of the mouth might develop oral cancer; it can be your lips, tongue, or mouth. It mostly occurs in men, especially those who smoke and drink alcohol. It mostly occurs in people who were previously infected with neck cancer. Lip cancer is also linked to a lot of sun exposure. It can be diagnosed by biopsy, endoscopy, and physical exam. Three ways to treat oral cancer are Chemotherapy, surgery, and radiation therapy.