Cancer Treatment

Oral Cancer

Oral cancer is one of the most common malignancies in the world. Oral cancer or mouth cancer arises in the tissues of any part of the mouth when cells develop mutations in their DNA, making the cells grow and divide abnormally, leading to the formation of tumours.

With time the tumour may spread inside the mouth and the other areas of the head and neck.

Symptoms of Oral Cancer:

Soreness in lip /mouth which is persistent without the capability to heal
Persistent Swelling/ lump in the mouth
Abnormal bleeding in the mouth
Persistent White/ red patch in tongue, gums, buccal mucosa
Progressive voice change
Difficulty in chewing, swallowing, speaking
Difficulty in moving the jaw or protruding tongue
Unexplained sudden weight loss
Persistent Ear pain/ Ringing sensation in the ear
Numbness/ Pain in mouth or face
Persistent Swelling/ lump in the neck
Loose painful teeth

Oral cancer includes cancers originating in any of the following parts of the mouth or the oral cavity:

Lips
Tongue
Gums
Buccal mucosa/Inner cheeks
Hard Palate
The floor of the mouth/Underside the tongue
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Types of Oral Cancer

Based on the cell of origin, oral cancer can be divided into:

  • Carcinoma
  • Lymphoma
  • Mucosal melanoma
  • Sarcomas
Squamous cell carcinoma: Squamous cell carcinoma is the most common type of mouth cancer, accounting for 9 out of 10 cases i.e., more than 90% of the oral cancers. Squamous cells are found in many areas of the body, including the insides of the mouth, throat and skin. These cells mutate and divide to grow abnormally to form cancers. Verrucous carcinoma is a type of squamous cell cancer which is slow-growing and does not spread to other body parts very often. It accounts for 5% of carcinoma cases.
Lymphoma: When cancers develop in the lymph nodes, a part of the body's immune system, they are called lymphomas.
Minor Salivary Gland Tumours: These include multiple types of tumours that affect the minor salivary glands, which form the inner lining of the mouth and the throat.
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What are premalignant lesions? How to identify them?

A precancerous lesion/Premalignant condition is characterized by a significantly increased risk of cancer. Many non-cancerous tumours and growths can grow in the mouth if not treated on time, they may become cancerous over a period of time.

The most common precancerous lesions are

  • Oral Leukoplakia
  • Oral Erythroplakia
  • Oral submucous fibrosis[OSMF]
  • Oral Lichen planus

Leukoplakia: It is the most common premalignant disorder characterized by white patches with higher risk and is seen 6 times more among tobacco users than non-tobacco users.

Erythroplakia: It is fiery red in colour and clinical appearance is characterized by a flat or slightly raised erythematous change of the mucosa without a patch lesion. These lesions usually bleed when scraped and are typically found on the buccal mucosa, floor of the mouth and soft palate.

Oral submucous fibrosis: This is a precancerous condition that causes inflammation and progressive fibrosis of the submucosal tissues making them rigid and limiting jaw mobility.

Oral Lichen planus: It appears as white lacy patches with red swollen tissues or open sores and affects mucous membranes inside the mouth, causing a burning sensation, pain or discomfort.

When to see the doctor?

Oral cancer symptoms can appear in multiple forms, varying from person to person, depending on the location and would be best to consult our specialists to rule out any possibilities of cancer as a preventive measure if you are experiencing a combination of any of these symptoms.

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What are the risk factors of Oral Cancer?

The factors that increase the risk of mouth cancers are as follows

Tobacco use in any form-Smoking Cigarettes/ Beedi, Chewing tobacco, Snuffs, Gutkha, Pan masala.
Excessive alcohol consumption
Family history of cancer
Excessive sun exposure
HPV or Human papillomavirus infection

What are the stages of Oral Cancer?

The cancer staging process is crucial to determine the treatment approaches and is done by analyzing the size and the spread of the disease.

The Oral cancer is staged as follows to make treatment decisions:

Stage I
Stage II
Stage III
Stage IV

What can I do to Prevent Oral Cancer?

Most of the oral cancers are preventable. Some measures that you can take to prevent these cancers are:

Avoid tobacco use/ smoking.
Avoid drinking alcohol.
Eat a healthy diet.
Avoid overexposure to sunlight
Drink plenty of water and fresh juices
Do regular self-examination of your oral cavity.
Periodical check-ups regularly with dentists/oncologists.

How is Oral Cancer treated?

The treatment choice depends upon the type of oral cancer, test results and the stage of oral cancer. The objective of treatment is to cure, control or help ease the impact caused by cancer.

Oral cancer can be treated by:

Surgery
Radiation
Chemotherapy/ Targeted therapy/ Immunotherapy
Combined modality approach
Supportive care

How is Oral Cancer diagnosed?

Oral cancer is often diagnosed during routine dental exams/oral screening examinations. If the symptoms align with those of oral cancer our specialist gains insights into your entire health history, symptoms, risk factors, family history of disease and conducts a thorough physical examination and recommends screening procedures.

Physical examination: Our cancer specialists look for lumps or abnormal tissue changes, any sore or discoloured tissues in your lips, oral cavity, face, head and neck.

Investigations:

Biopsy: Biopsy is the only definitive way to confirm cancer. Tissue samples are collected from the suspected area using a small scalpel/surgical blade and inspected for the presence of cancer cells in our pathology labs with a turnaround time of 3 to 5 days for the test results.

After the diagnosis of oral cancer, additional tests are taken to determine the cancer staging and your overall health.

The following screenings and tests are performed to check inside your mouth, throat and neck regions.

  • Video-directed laryngoscopy: A well-lighted, small and flexible camera is inserted through your throat by our cancer specialist to look for abnormal indications.
  • Imaging: It is an essential tool in the management of oral cancer with the protocol involving taking images of the primary site and eliminating the suspicion of the spread of cancer cells to distant organs using:
    • CT scan of Head & Neck [CECT]: This procedure is affordable, quick, non-invasive and easy to perform and involves taking cross-sectional images of your body on various planes. It provides a clear picture of the appearance of tumours, their extension to the lymph nodes, surrounding tissues and bones.
    • Magnetic Resonance Imaging[MRI]: The advantage of the MRI procedure is that it emits less radiation than a CT scan and provides enhanced imaging of soft tissues. The disadvantage is that it cannot be performed on individuals with pacemakers, prosthetic cochlear implants or other metal implants.
    • Positron Emission Tomography Scan[PET/CT]: PET scan is a specialized imaging technique which uses short-lived radioactive drugs to produce 3D coloured images. It measures metabolic activity and the function of tissues. It helps to determine the growth and type of the tumour. The radioactive drug accumulates in certain tissues, emitting positrons, which are detected and examined to provide the exact disease status.
    • It allows cancer specialists to thoroughly examine the whole body, including the primary area where cancer cells originated, Lymph node involvement, and distant metastases. Thangam Cancer Centre Namakkal has a dedicated CT/ PET-CT machine which provides a one-stop solution for all imaging/staging procedures.
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Get in touch with our experts for a quick consultation:

Talk to our experts about your signs and symptoms for early screenings and detection to live worry-free.
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What are the treatment options available?

Treatment for oral cancer is either in local form or systemic wherein the local treatment removes, eliminates or controls cancer cells in one area. The systemic treatment eliminates/controls cancer cells that may have spread to other parts of your body.

Surgery and radiation comprise the local treatments typically used in oral cancer. Depending upon the cancer staging, your doctor might recommend a single treatment approach or combination treatments.

Surgery: Surgery, a common treatment procedure is recommended for early-stage oral cancer. Early diagnosis helps in tumour removal with clear margins necessitating no further treatments.
Radiation therapy: Radiation treatment involves using targeted high-energy beams in the form of Photons/ Electrons/Protons to eradicate the cancer cells. The patient has to undergo radiation therapy for 5 days continuously for a duration of 5 to 7 weeks which represents one cycle, depending on the tumour location, type and stage of cancer. Radiation therapy shares similarities with surgery in effectively controlling the tumour/cancer cells.
Chemotherapy: Chemotherapy is a form of systemic treatment used to eradicate/control tumour cells that have spread to other body parts. Systemic chemotherapy uses drugs or medicines, which are taken orally or injected intravenously to kill the cancer cells.
Targeted therapy: In this treatment, specific drugs that bind to cancer cell proteins are given to inhibit their growth.
Combined modality treatment: Treatment in the advanced stages of cancer comprises a combination of chemotherapy, radiation therapy and surgery combined or given in succession.
Nutritional Care: Treatment regimens make it difficult for a patient to swallow/drink food and water; since nutrition plays an important role in the treatment plan our nutritionist will prepare meal plans for the patient depending on his health condition and therapies.

Investigations:

Many people feel depressed and anxious when dealing with cancer.Cancer treatments can be taxing on the mind and body.

Discuss your concerns with your family and doctors.

Keep yourself active.
Speak with family/friends.
Rest as much as needed.
Ask for help from doctors/counsellors.
Join cancer support groups.

Doctors

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Surgical Oncology
Dr. Deepti Mishra
MS, MCh
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Surgical Oncology
Dr. Aruna Prabhu
MS, MCh
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Medical Oncology
Dr. Bhavesh Poladia
DNB, DM
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Plastic Surgery
Dr. Sachin Chavre
DNB, GS
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Radiation oncology
Dr. Karthick Rajamanickam
MD
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