Oral Cancer is defined as the uncontrollable growth of cells that invade and cause damage to surrounding tissue. Appears as a growth or sore in the mouth that does not go away . Oral cancer, which includes cancers of the lips, tongue, cheeks, floor of the mouth, hard and soft palate, sinuses, and pharynx (throat), can be life threatening if not diagnosed and treated early.
The most common symptoms of oral cancer include:
Swellings/thickenings, lumps or bumps, rough spots/crusts/or eroded areas on the lips, gums, or other areas inside the mouth
The development of velvety white, red, or speckled (white and red) patches in the mouth
Unexplained bleeding in the mouth
Unexplained numbness, loss of feeling, or pain/tenderness in any area of the face, mouth, or neck
Persistent sores on the face, neck, or mouth that bleed easily and do not heal within 2 weeks
A soreness or feeling that something is caught in the back of the throat
Difficulty chewing or swallowing, speaking, or moving the jaw or tongue
Hoarseness, chronic sore throat, or change in voice
A change in the way your teeth or dentures fit together
Dramatic weight loss
If you notice any of these changes, contact your dentist or health care professional immediately.
Causes: Smoking . Cigarette, cigar, or pipe smokers are six times more likely than nonsmokers to develop oral cancers.
Smokeless tobacco users. Users of dip, snuff, or chewing tobacco products are 50 times more likely to develop cancers of the cheek, gums, and lining of the lips.
Excessive consumption of alcohol. Oral cancers are about six times more common in drinkers than in nondrinkers.
Family history of cancer.
Excessive sun exposure, especially at a young age.
Human papillomavirus (HPV). Certain HPV strains are etiologic risk factors for Oropharyngeal Squamous Cell Carcinoma (OSCC).
It is important to note that over 25% of all oral cancers occur in people who do not smoke and who only drink alcohol occasionally.
GRADE & STAGES OF ORAL CANCER :
Grades of mouth cancer
The grade of a cancer tells you how much the cancer cells look like normal cells. This gives your doctor an idea of how the cancer might behave and what treatment you need.
There are 3 grades of mouth cancer:
grade 1 (low grade) means cancer cells look like normal mouth cells
grade 2 (intermediate grade) look slightly different to normal mouth cells
grade 3 (high grade) look very abnormal and not much like normal mouth cells
Your cancer might be graded as Gx. This means that the grade cannot be assessed.
Differentiation means how developed or mature a cell is. Doctors might describe cancer as poorly or well differentiated.
Doctors might describe:
grade 1 cancer as well differentiated
grade 2 cancer cells are moderately differentiated
grade 3 cancer cells are poorly differentiated
The stage of mouth cancer tells you its size and depth, and whether it has spread. The grade tells you how much the cancer cells look like normal cells. This gives your doctor an idea of how the cancer might behave and what treatment you need.
Doctors stage mouth cancers differently to cancers that start in the throat behind the mouth (oropharyngeal cancer). This page is about the number stages for cancers starting in the mouth. This includes cancers starting in the lips, gums, the soft sides of the mouth and the front part of the tongue.
There are different ways of staging mouth cancer. These are the number staging system and the The Number staging system divides mouth cancer into 4 main stages, from 1 to 4. Stage 1 is an early cancer and stage 4 is an advanced cancer. Some doctors also use stage 0.
Stage 0 or carcinoma in situ (CIS)
Stage 0 cancer or carcinoma in situ (CIS) means your cancer is at a very early stage. Some doctors prefer to call this pre cancer. There are cancer cells but they are all contained within the lining of the mouth or oropharynx. The cancer cells have not spread.
If the pre cancer is not treated, there is a high risk the condition will develop into an invasive cancer.
This is the earliest stage of invasive cancer.
It means the cancer is 2cm or smaller and it is 5mm deep or less. It has not spread to nearby tissues, lymph nodes or other organs.
In the TNM staging system stage 1 mouth cancer is the same as T1, N0, M0.
Stage 2 can mean different things including:
the cancer is 2cm or smaller, and it is deeper than 5mm but no deeper than 10mm
the cancer is larger than 2cm but no larger than 4cm, and it is 10mm deep or less
The cancer has not spread to nearby lymph nodes or other organs.
In the TNM staging system stage 2 mouth cancer is the same as T2, N0, M0
Stage 3 means one of the following;
the cancer is larger than 4cm, or deeper than 10mm, but has not spread to any lymph nodes or to other parts of the body
the cancer is any size but one lymph node contains cancer cells on the same side of the neck as the cancer, and the lymph node is no more than 3cm across
In the TNM staging system stage 3 mouth cancer is the same as one of the following:
T3, N0, M0
T1,2 or 3, N1, M0
Stage 4 means the cancer is advanced. It is further divided into 3 stages - 4a, 4b and 4c.
Stage 4a can mean different things, including:
the cancer has grown further than the mouth into surrounding structures
cancer has spread to lymph nodes on either side of the neck, which are between 3 and 6 cm in size
cancer has spread into one nearby lymph node which is no larger than 3cm and it has also spread into tissue surrounding the lymph node
In the TNM staging system stage 4a mouth cancer is the same as one of the following:
T4a, N0 or 1, M0
T1,2,3 or 4a, N2, M0
Stage 4b can mean different things, including:
cancer has spread into nearby areas such as the space behind the jaw, the base of the skull, or the area of neck surrounding the arteries (carotid arteries)
a lymph node containing cancer is larger than 6cm
cancer has spread into tissues surrounding the lymph node
In the TNM staging system stage 4b mouth cancer is the same as one of the following:
any T, N3, M0
T4b, any N, M0
Stage 4c means the cancer has spread to other parts of the body such as the lungs or bones.
In the TNM staging system stage 4c mouth cancer means:
any T, any N, M1
Conduct a self exam at least once a month. Using a bright light and a mirror, look and feel your lips and front of your gums. Tilt your head back and look at and feel the roof of your mouth. Pull your checks out to view the inside of your mouth, the lining of your cheeks, and the back gums. Pull out your tongue and look at all surfaces; examine the floor of your mouth. Look at the back of your throat. Feel for lumps or enlarged lymph nodes in both sides of your neck and under your lower jaw. Call your dentist's office immediately if you notice any changes in the appearance of your mouth or any of the signs and symptoms mentioned above.