Types of Oral Cancer
Classified according to the cell type the cancer starts in :
Squamous cell carcinoma – most common accounting for 90 percent of the oral cancer cases
Less commonly - Adenocarcinomas , lymphomas , sarcomas , melanomas
Risk Factors for Oral Cancer
Lifestyle - People consuming large quantities of tobacco , alcohol, smoking
Diet , Obesity , Age –risk increases with age
Genetic - Family history of oral or any type of cancer
HPV infection –presence of human papilloma virus increases the chances of oral cancer
Chronic sun exposure / radiation exposure /occupational hazard
Gender- most commonly seen in men ,twice more than women
Immune system suppression –patients taking medication to suppress the immune system may have increased risk of oral cancer .
Signs and Symptoms of Oral Cancer
Non healing ulcer in the oral cavity
White or red patches in oral cavity
Bleeding mouth sores
Difficulty chewing /swallowing
Difficulty in movement of jaw, change in fitting of denture
Hoarseness of voice
Diagnosis of Oral Cancer
Early detection of oral cancer is usually possible , tissue changes can be seen and felt easily .
Personal History of habitual tobacco usage , alcohol usually noticed
Medical Examination – clinical examination of oral and extra oral and perioral tissues .Leukoplakia and erythroplakia are two lesions which could be the precursor of oral cancer , any red (erythroplakia ) or white(leukoplakia ) lesion that last for more than 2 weeks should be evaluated . Mostly erythroplakia are more serious with increased incidence of being cancerous .
Biopsy performed to rule out malignancy .
Imaging studies like - Xrays , CT , MRI , PET scans help to stage the oral cancer
Staging of Oral Cancer
If diagnosed with biopsy as malignant , next step is imaging studies for staging of cancer .Staging helps in treatment planning, if wrong staging then wrong treatment option selection
Staging is based on three key components (TNM system of staging )
Tumor (T)- is the size of the tumor
Node (N )-whether the cancer is present in the lymph nodes
Metastasis (M)- whether the cancer has spread to other parts of the body
A number 0-4 is assigned ,higher the number greater the severity of disease
Treatment of Oral Cancer
The treatment modality of oral cancer depends on its staging as well as age and health of patient
Depending on the stage at which the cancer is diagnosed, treatment is planned , if wrong staging then wrong options .
Surgery , Radiation , Chemotherapy may be used alone or in combination for best possible results .
Surgical removal of tumor- involves removal of cancerous tissue alongside small surrounding healthy tissue . Surgery is usually performed when the tumor is small , for large tumors surgery and radiation plus chemotherapy is the treatment of choice .
Cosmetic reconstructive surgery –is performed to help patient cope up with cosmetic disfigurement and difficulty in chewing , swallowing here the surgeons transplant grafts of skin ,muscle or bone.
Radiation therapy – wherein high energy X-rays are utilized to destroy the cancerous tissue . Radiation therapy may be sufficient to treat in early stage of oral cancer . It involves
- External beam radiation
- After radiation effects :
- Mouth sores
- Bleeding gums
- Jaw stiffness
- Dry mouth
After effects of chemotherapy depend on the type and amount of drug received and end soon after the treatment is over .
Factors Affecting Cost Of Oral Cancer Surgery
The cost to the patient depends on a variety of factors like
- The hospital, the patient chooses.
- Room –Standard single room, deluxe room, super deluxe room for the number of nights specified (including nursing fee, meals, room rate, and room service).
- Fee for the team of doctors.
- Standard tests and diagnostic procedures.
- Type of surgery performed
- cost of Radiation /Chemotherapy
- Cost of the follow –up care required after the procedure