Oral Cancer
Clinical OncologyOtolaryngology
The "oral" region comprises multiple sites, including the lips, tongue, floor of the mouth, hard palate, and gums, as well as the oral mucosa, buccal mucosa, and salivary glands. Any malignant tumour growing in these locations is collectively referred to as oral cancer, which is also one of the types of head and neck cancer.
Symptoms
Like other cancers, the development of oral cancer is related to DNA (deoxyribonucleic acid). When the DNA of the lip or oral cells undergoes mutations, the affected cells continue to grow and divide uncontrollably, while healthy cells may die. If these abnormal oral cells continue accumulating, they can form a tumour, known as oral cancer, with the potential to spread to the head or neck.
Symptoms of oral cancer include:
- Oral ulcers or non-healing sores: Persistent oral ulcers, especially sores that do not heal over an extended period.
- Abnormal lumps in the oral cavity: Unusual lumps or swelling appearing in the oral cavity.
- Pain or discomfort: Ongoing pain, burning sensations, or discomfort in the oral cavity.
- Difficulty breathing or swallowing: Oral cancer may affect breathing and swallowing functions.
- Voice changes: Oral cancer can impact the voice, leading to hoarseness or a deepened voice.
Factors
As of now, the exact reasons for DNA mutations leading to oral cancer remain unclear. However, the medical community has identified several factors that can increase the risk of developing oral cancer:
- Prolonged and heavy use of any form of tobacco, such as cigarettes, cigars, pipes, etc.
- Long-term betel nut chewing or the consumption of Gutka (especially in Southeast Asia), a combination of betel nut and tobacco.
- Chronic alcohol consumption (the American Cancer Society notes that approximately 70% of oral cancer patients have a history of heavy alcohol use).
- Prolonged exposure of the lips to intense sunlight.
- Poor oral hygiene or the presence of cavities.
- Infection with HPV (human papillomavirus) through sexual contact.
- GVHD (graft-versus-host disease) triggered by stem cell transplantation.
- Weakened immune system.
Diagnosis
If oral cancer is suspected in a patient, the doctor will conduct the following examinations:
Clinical Examination | The doctor examines the patient's lips and the interior of the oral cavity, observing for any abnormalities such as white patches or swelling. |
Biopsy | If the doctor suspects oral cancer, a small tube with a camera is inserted into the patient's throat to look for signs of cancer cell spread. |
Endoscopy | X-rays create detailed images of internal soft tissues, providing information about the tumour's volume, location, and whether it has spread to nearby tissues, lymph nodes, or the lungs. |
CT Scan | X-rays create detailed images of internal soft tissues, providing information about the tumour's volume, location, and whether it has spread to nearby tissues, lymph nodes, or the lungs. |
MRI | MRI uses radio waves and strong magnets like a CT scan to obtain detailed images of the patient's internal soft tissues. It helps examine whether cancer cells have spread to the neck, brain, or spinal cord. |
PET Scan | Also known as positron imaging, this method utilizes the characteristics of cancer cells to absorb more sugar than normal cells. A radioactive sugar is injected into the patient's body, and a PET scan is performed to examine the radiation distribution inside the body, revealing whether cancer cells have spread to other locations. |
taging
After the tests mentioned above, the doctor will determine the stage of oral cancer based on the tumour's volume and extent of spread. The detailed classification is as follows:
Stage 0 | The cancer is confined to the surface layer of oral cells and has not spread to nearby lymph nodes or distant tissues. |
Stage I | The tumour has a diameter of no more than 2 cm and has not invaded nearby tissues, lymph nodes, or distant locations. |
Stage II | The tumour has a diameter of more than 2 cm but less than 4 cm, and it has not invaded nearby tissues, lymph nodes, or distant locations. |
Stage III | The tumour has a diameter exceeding 4 centimetres but has not spread to lymph nodes or distant locations. |
Stage IV | Any tumour volume that has grown into other nearby tissues, including the jawbone, deep muscles of the tongue, facial skin, etc. |
Early-stage oral cancer may be curable through various treatment methods. However, if the cancer cells are diagnosed in the late stage, the possibility of a complete cure is lower. The goal of treatment is to stop tumour spread, relieve symptoms, and improve the patient's quality of life. The doctor will choose the most appropriate treatment method based on the tumour stage, development trend, and the patient's overall health. Standard treatment methods for oral cancer include:
Surgery | Surgical procedures aim altogether to remove cancer cells from the patient's body. The scale of the surgery depends on the tumour's size. Smaller tumours can be removed through simple surgery or laser, while larger tumours may require more extensive procedures, potentially leaving scars on the face or neck. |
Radiotherapy | Radiation therapy typically requires a combination of surgery or chemotherapy unless the oral cancer is in the early stage. High-energy rays, such as X-rays or protons, destroy cancer cells. Radiation therapy can be performed externally or internally, depending on the patient's needs. |
Chemotherapy | Chemotherapy involves the administration of drugs, either orally or through intravenous injection, to fight cancer cells that may have spread to other locations. Chemotherapy may be combined with radiation therapy for optimal results. Side effects may include skin pain, oral or throat pain, taste loss, loss of appetite, dry mouth, and hair loss. |
Photodynamic Therapy | Photodynamic therapy involves injecting photosensitive drugs into the patient's bloodstream. A specific wavelength of laser light then activates these drugs to destroy the surrounding cancer cells. After treatment, patients may be susceptible to light, and sun exposure should be minimized. |
FAQ
HEAL Oncology Centre
We provide a variety of treatment options for oral cancers, including surgery, chemotherapy, targeted therapy, immunotherapy, radiation therapy, and traditional Chinese medicine. Our multidisciplinary team of specialists will tailor the best treatment plan for each patient, providing comprehensive and holistic care to ensure you receive the best possible outcomes and support throughout your cancer treatment journey.
HEAL Oncology Centre
16/F, Entertainment Building, 30 Queens Road Central, Central, Hong Kong
Mon - Fri 9:00am - 6:00pm
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