Oral Cancer: Oral cavity (Mouth) encompasses your lips, gums, teeth, tongue, inside of the cheeks, teeth and palate. Mouth is one of the most important aspects of your body involved in speech & swallowing. There are about 7 Lakh new cases of cancer diagnosed in India every year of which oral cancer contributes approximately 3 Lakh cases with an average expenditure of 3.5 lakh on its treatment.

What causes oral cancer?

Tobacco and various tobacco-based products is the main cause of oral cancer. In addition, consumption of alcohol along with smoking increases the risk up to 17 times. Presence of potential carcinogens (cancer agents) such as nicotine, polonium, poly-cyclic hydrocarbons, damage the oral mucosa leading to warning signs (Pre-cancerous cell growth) of cancer followed by a full-blown cancer.

What are the other causes of oral cancer?

Many people often relate oral cancer to tobacco usage and use of other forms of tobacco and tobacco-based products, but surprisingly there are other causes too. They include loose fitting denture, constant trauma to the tongue by sharp or jagged tooth and poor oral dental hygiene. Recent studies have shown HPV (Human Papilloma Virus) as one of the causative agents of oral cancers.

What are pre-cancerous lesions?

Leucoplakia (whitish patches), Erythroplakia (Reddish patches) commonly seen at the same site in the mouth where gutka is usually kept are the warning signs. Oral Submucous fibrosis, a progressive condition characterized by burning sensation in the mouth after eating spicy food followed by limited mouth opening to an extent that even normal eating becomes difficult – are  the prominent signs of oral cancer.

If you have a precancerous lesion in your mouth, will you get cancer?

If you notice a precancerous lesion in your mouth – in spite of that if you still continue your bad habit of chewing tobacco, then the risk of getting oral cancer increases manifold. Which means, it all depends upon your continuance of the habit! Discontinuance of the habit along with a regular follow up with your doctor goes a long way in preventing any possibility of cancer and future complications.

Warning Signs

The warning signs of oral cancer include the following: a sore or an ulcer that doesn’t heal for more than 2-3 weeks & progressively increases in size; difficulty in chewing, swallowing or pain on movement of tongue, loosening of teeth, inability to open the mouth wide enough and an unusual persistent lump in the neck or along the jaw.

Remember, oral cancer is extremely malignant and even slightest delay can lead to the cancer spreading to lymph nodes (becomes metastatic) making the prognosis difficult.

What to do next?

In the presence of any of the above signs or symptoms, an urgent review by an ENT Surgeon or a Head and Neck Specialist should be sought.

Careful clinical examination followed by a biopsy, CT scans/MRI and a PET scan (an expensive but very effective scan which helps identify cancers in your body) can help the head and neck surgeon to make a proper diagnosis.

Every good cancer center has a multi disciplinary team comprising of medical & radiation oncologists, plastic surgeons, head and neck surgeons, speech therapists, pathologists and radiologists, who discuss every case in detail and formulate a plan of treatment and work collaboratively.

Treatment Options

Treatment options usually depend upon the stage of the cancer (Staging is usually done by the Surgeon on the basis of clinical examination & relevant investigations)

Cancers diagnosed early usually do well with surgery alone. Advanced cancers usually end up with surgery followed by radiation therapy.

Unfortunately most oral cancer patients present late either due to ignorance or due to the fear of a cancer surgery.

Remember, oral cancers are treatable if diagnosed early. Fortunately cancers of the mouth unlike those elsewhere in the body have an early presentation, it’s just about making the right life style choices like quitting smoking, consuming gutka, betel nut and Zarda and approaching a specialist ENT surgeon or head and neck surgeon up on noticing anything unusual – such as the first appearance of symptoms will help in prompt diagnosis and treatment.