Recently, one notices a pale lump inside the mouth that doesn’t seem to be healing.
It’s not like anything seen before then it means that the person has encountered an early sign of oral or throat (oropharyngeal) cancer.
The American Cancer Society estimates more than 30,000 new cases of oral and throat cancer occur annually in the United States.
Oral cancer includes cancer of the lips, mouth, tongue, gums and salivary glands. Throat cancer involves cancer of the part of the throat just behind the mouth. It’s estimated that more than 7,000 Americans die of oral and throat cancers annually.
Periodic self-examination of the mouth is the best way to detect the early signs of oral and throat cancer. When detected early, oral cancer is always successfully treated.
Unfortunately, many oral and throat cancers are far advanced by the time a doctor is made aware of the situation. This is because oral and throat cancers are usually painless in their early stages or have minor symptoms similar to other health problems, such as a toothache. Oral cancer represents only about 3% of all cancers.
Causes of Oral Cancer
Oral cancer appears to occur as a result of damage to the DNA in the cells in the mouth. Using tobacco and excessive alcohol consumption can damage these tissues. The combination of smoking or chewing tobacco and excessive drinking creates a much higher risk of oral and throat cancer. Excessive exposure to ultraviolet light also can cause damage. Damage to cells may cause them to malfunction and mutate into cancer cells.
Symptoms of Oral Cancer or Signs of Oral Cancer
An early indication of oral cancer is one or more changes in the way the soft tissues of the mouth usually look or feel. The most common symptoms of oral cancer or the signs of oral cancer include:
- Difficulty in chewing or swallowing food
- Persistent pain in the mouth
- Moving the tongue becomes difficult
- A thickening, lumpy feeling in mouth, throat, or tongue
- Tongue problems
- Abnormal taste
- Any red or white lesions that stay for long periods of time
- White, red or dark patches inside the mouth
- Unhealing mouth sores or increases in size
- Sores that tend to bleed easily
- Thickening of the cheek
- Soreness in the throat or feeling that something is caught in the throat
- Bad breath
- Changes in the voice
- Pain around the teeth, or loosening of the teeth
- Numbness of the tongue or elsewhere in the mouth
- A lump in the neck
The Skin lesion, lump, or ulcer on the tongue, lip, or other mouth area may be usually small, most often pale colored, may be dark or discolored, may be a deep, hard edged crack in the tissue, usually painless initially, may develop a burning sensation or pain when the tumor is advanced.
Oral Cancer Treatment
Doctors use surgery and radiation therapy for oral cancer treatment in the earliest stages. For oral cancer in more advanced stages, doctors use surgery combined with radiation therapy or radiation therapy combined with chemotherapy.
The treatment plan should be developed for the patient specifically based on multiple factors by an integrated team of doctors including surgeons, cancer specialists (oncologists) and oncologists who specialize in treating oral cancer with radiation (radiation oncologists). Treatment options include:
Sometimes surgeons need to remove bone tissue from the jaw or the roof of the mouth. To treat a cancer of the tongue or the upper part of the throat, the surgeon may need to remove tissues that are used to swallow and in some cases the voice box (larynx). If the oral cancer has spread beyond the mouth, then the surgeon may also need to remove lymph nodes in the neck.
There may not be any major side effects from surgery to remove a small tumor from the mouth. However, extensive surgery may require major adjustments in the way one chews, swallows, breathes and speaks.
The patient may need a prosthetic device in the mouth to replace removed portions of the teeth, gums and jaw. In more advanced cases, patient may need to use tubes for feeding and breathing and an artificial voice aid for speaking.
Radiation therapy (also called radiotherapy) is a type of local therapy. It affects cells only in the treated area. Radiation therapy is used alone for small tumors or for patients who cannot have surgery. It may be used before surgery to kill oral cancer cells and shrink the tumor. It also may be used after surgery to destroy oral cancer cells that may remain in the area.
Radiation therapy uses high-energy rays to kill cancer cells. Doctors use two types of radiation therapy to treat oral cancer:
External radiation: The radiation comes from a machine. Patients go to the hospital or clinic once or twice a day, generally 5 days a week for several weeks.
Internal radiation (implant radiation): The radiation comes from radioactive material placed in seeds, needles, or thin plastic tubes put directly in the tissue. The patient stays in the hospital. The implants remain in place for several days. Usually they are removed before the patient goes home.
Some people with oral cancer have both kinds of radiation therapy.
Chemotherapy uses drugs to destroy cancer cells. You take these drugs either through your veins (intravenously) or orally. The type of drugs and the length of treatment depend on the size and location of the tumor. In the case of a large and invasive tumor, chemotherapy may be used in combination with radiation therapy and in place of surgery.
Angiogenesis inhibitors: Cetuximab (Erbitux) is a medication that stops the growth of new blood vessels that cancers need to grow. This drug has recently been approved for use along with chemotherapy in cancers of the oral cavity.
Oral Cancer Prognosis
The Oral cancer prognosis or the outlook of the disease is better if detected early. Approximately 50% of people with oral cancer will live for longer than 5 years.
If the oral cancer is detected early, before it has spread to other tissues, the cure rate is nearly 75%.
Unfortunately, more than 50% of oral cancers are advanced at the time the cancer is detected. Most have spread to the throat or neck.
Approximately 25% of people die from oral cancer because of delayed diagnosis and treatment.
Oral Cancer Survival Rate
Oral cancer survival rate following the diagnosis depend on several factors, including the size of the primary lesion, local extension, lymph node involvement, metastases, the patient’s ability to cope and the histologic differentiation of the malignancy. As with many other cancers, the key to controlling this disease is early detection.
Mortality remains high because of the advanced stages at which the disease is often first detected, and morbidity remains high due to aggressive therapy in an attempt to cure advanced disease.
Because elderly patients visit their physicians more often than they visit their dentists, physicians have an important opportunity to detect oral cancer at an early stage. Physicians need to be vigilant about oral health problems, which are among the most prevalent chronic conditions in the elderly.
When oral cancer is detected early–when lesions are smaller than 3 cm and there is no evidence of metastases–the survival rate increases dramatically. The five-year survival rate is only 17 percent for patients with distant metastases and 30 percent for those with local extension, but 63 percent for those with local disease.