Introduction of oral cancer

The oral cavity includes lip, buccal mucosa, gum, retromolar area, mouth floor, hard palate, and anterior 2/3 of tongue. Once abnormal cancer cell appears, it could affect surrounding normal tissues or even metastasize to other parts of body. It is so called the “oral cancer”.

The prevalence of oral cancer increases year by year. The occurrence rate increases 30% compared to 5 years ago. It has become the sixth common cancer in our country and a huge disease burden to our people.

Etiology

Lots of factors may be related to oral cancer. The major one is betel nut chewing. 80% patients of oral cancer in Taiwan have the habits of chewing betel nuts. Buccal mucosa is the most common occurred area. In addition, tobacco and alcohol are both closely related to oral cancer. There is a triple impact on those who have habits of betel nut chewing, tobacco smoking and alcohol drinking. People who chew betel nut and also smoke have a 123 times greater chance of developing oral cancer than people who do not chew betel nut or smoke. Poor oral hygiene, tooth obliquity, indisposed denture, or chronic stimulation or damage to the oral mucosa, and leukoplakia all will cause oral cancer in the long run.

Clinical symptoms

The normal healthy oral mucosa is soft and pink. If you have any of the following symptoms, you should find ENT or oral surgeon for further cheek up:

1. change of color or appearance of oral mucosa, like whiten or redden lesion, or ulcer.
2. mass of oral cavity or neck, poor healing oral mucosa ulcer for more than two weeks.
3. difficulty in chewing, swallowing, and of speech; loss of sensation or numbness over half side of tongue.
4. local facial swelling, unusual sensation of face, or loosen tooth.
5. People who have the habit of betel nut chewing should take special awareness if dry mouth, hot, painful sense or trismus occurs.

Diagnosis

The key point of self examination:

1. use mirror to check cheek facial appearance

• asymmetric or protruding mass
• with or without trismus
• grab throat(neck) by finger and then swallow to see if there is  different sensation

2. use mirror to check cheek oral cavity

• open bucca and lip: cheek oral mucosa, mass, discolor (white or red) lesion, or unhealed ulcer for 2 weeks.
• Stretch out tongue and move, and check the sensation; roll up and cheek ventral side, border, or mouth floor to see if there is painful mass or ulcer

3. open mouth and say “R” and check soft palate, hard palate with uvula.

If you have one item of any of aforementioned symptom, please visit ENT or dental surgeon as soon as possible.

The most important diagnostic tool is pathological biopsy. Biopsy does not cause cancer spreading or worsening. Only by biopsy can doctors detect the disease earlier and provide correct treatment to raise cure rate.

Treatment

“Composite resection” and “neck lymph node dissection” are the most effective treatment modality. Early cancer can be cured by surgery or by radiotherapy. For those cases with late stage oral cancer, surgery combined with radiotherapy and chemotherapy can improve cure rate.

Prevention

1. Stop tobacco smoking, betel nut chewing, and alcohol drinking.
2. Take fresh food and have a regular life style
3. Improve oral hygiene by removing irritant from oral cavity and fix poor-fit denture
4. Whenever there is abnormal finding in your oral mucosa, please visit ENT or dental surgeon.
5. If you have a habit of betel nut chewing, we suggest you do a regular follow-up with your ENT or dental surgeon every half an year.