Oral cancer: symptoms, causes & treatment

Definition

What is oral cancer?

Oral cancer is a cancer that attacks the tissues in the oral cavity. Initially, this cancer certainly did not just grow right away, but it was preceded by the appearance of a sore in the mouth that at first glance resembled a canker sores but did not go away.

Despite the name oral cancer, aka oral cancer, this condition does not only develop in the mouth. The floor of the mouth and the soft or hard upper palate can also be the target areas for this type of cancer.

In fact, the area around the mouth such as the sinuses or throat just behind the mouth (oropharynx) can also be affected by cancer cells. It's just that, this cancer growth generally occurs in the mouth, tongue, gums, and lips.

Oral cancer is rarely detected early. Most cases of this disease are usually found after spreading to the lymph nodes in the neck.

If not diagnosed and treated promptly, oral cancer can be life-threatening. That is why early detection is an important key to prevent oral cancer from developing more seriously.

There are many types of cells in the oral cavity to the throat, so that the types of cancer can be divided into several types, including:

• Squamous cell carcinoma. More than 90% of oral cancers are squamous cell carcinoma, which attacks the flat cells that line the mouth and throat.
• Verucous carcinoma. Less than 5% of oral cancers are slow-growing carcinomas of the verucosa and rarely affect other parts of the body. This type of cancer can form from squamous cell carcinoma that gets worse.
• Other types of cancer. Types of cancer of the minor salivary glands and lymphoma, are types of oral cancer that are quite rare. This cancer forms in the glands in the lining of the mouth and throat, tonsils, and the base of the tongue.

How common is this disease?

Cancer that attacks the tongue, gums, lips or other areas of the mouth is a type of cancer that can affect anyone, regardless of gender or age.

According to 2018 data from Globocan, tongue, gum and lip cancer ranks 16 as the most common type of cancer in Indonesia. It is known, the number of recent cases reached 5,078 people with a death rate of 2,326 people.

Signs & symptoms

What are the signs and symptoms of oral cancer?

In its early stages, cancer that attacks the tongue, lips, gums, or other areas in the oral cavity generally does not cause characteristics. That is why, it is quite difficult to identify the possibility of this disease.

Even so, some people may be aware of several symptoms as an early sign of cancer development in the oral cavity, namely in the gums, tongue, and lips, such as:

• Sores appear like canker sores on the inside of the mouth. The difference between canker sores and oral cancer is a condition that does not go away and gets worse over time.
• A type of swelling, lumps, and rough or crusty patches occurs on the lips, gums, or other areas of the mouth.
• The appearance of white patches that are slightly hairy, plus white and red spots on the mouth.
• There is pain in the mouth, gums, or tongue. Sometimes it is also described as a sensation of numbness in the mouth, face, neck and ears.
• Sores in the oral cavity can cause bleeding.
• If the cancer attacks the gums, it makes the teeth loose and easy to fall off.
• Pain and difficulty chewing, swallowing, speaking, or moving the jaw
• Body weight will decrease dramatically and the body is very easy to get tired.

Everyone experiences cancer symptoms differently. This allows for other symptoms not listed above.

When to see a doctor?

The signs and symptoms of cancer that attacks the tongue, gums, or lips are almost the same as for other health problems, for example the characteristics of canker sores or the early signs of gum disease.

However, it is important to emphasize that cancer will not improve with regular treatment so that the symptoms may get worse or do not improve over time.

Therefore, if you suspect that your symptoms are cancer, see a doctor immediately.

Cause

What causes oral cancer?

The cause of oral cancer (tongue, gum, or lip) is a mutation of DNA in cells. DNA stores a system of instructions for cells to carry out their duties properly and in an orderly manner, such as dividing, growing, and dying.

When the mutation occurs, the command system breaks down and makes cells function abnormally. Cells that are supposed to divide and die when needed, instead act out of control. The abnormal cells will continue to divide, grow, and do not die. As a result, cells will accumulate and cause the formation of malignant tumors.

Risk factors

What puts me at risk for oral cancer?

Researchers have found various factors that can increase a person's risk of developing cancer of the gums, tongue, or lips, including:

• Habit m Smoking and drinking alcohol

The risk of oral cancer increases due to smoking because cigarette smoke is carcinogenic. Likewise with people who have the habit of drinking excessive alcohol. The risk will be even greater if both are done.

• Getting older

Oral cancer develops over years, so it's not common in children or adolescents. Therefore, it is more common in people over 55 years of age.

• Infected with HPV (human papillomavirus)

This viral infection can cause oral cancer and throat cancer due to unhealthy sexual practices, for example performing unprotected oral sex on an infected person.

• Poor diet

Lack of intake of fibrous foods, such as fruits and vegetables coupled with a lack of physical activity increases the risk of gum cancer.

• Certain diseases or health problems

Oral cancer commonly affects people with a weak immune system (people with AIDS or organ recipients), the elderly with lichen planus skin disease, and people with anemia syndrome fanconi and congenital dyskeratosis.

Medicines & Medicines

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

What tests can be done to diagnose oral cancer?

The symptoms of cancer affecting the gums, tongue, or lips are similar to other health problems. To confirm a diagnosis of oral cancer, your doctor will recommend that you undergo a series of tests, including:

• Physical examination

The doctor will observe the symptoms and changes in the oral cavity and check for swelling of the lymph nodes in the neck. The doctor will also look at the patient's and family's medical history.

• Imaging test

Aims to see the presence of abnormal cells, measure the size of the tumor, and detect the location of cancer cells by means of CT scans, chest X-rays, MRI, and PET scans.

• Biopsy

A diagnostic test is done by taking a sample of suspected cancerous tissue to be seen using a microscope in the laboratory (incisional biopsy). Other types of biopsy for diagnosing oral cancer are exfoliative cytology and biopsy fine needle aspiration (using a thin needle to suck out the abnormal tissue).

• Blood test or other tests

There are also blood tests, HPV tests, and tests barium swallow to help confirm a cancer diagnosis.

What are my treatment options for oral cancer?

There are several ways to treat cancer that attacks the tongue, gums, or lips, including:

1. Operation

Surgical removal of the tumor is the main way to treat oral cancer. The goal is to prevent the tumor from getting bigger and stop its spread. The type of surgery will be adjusted to the patient's condition, which is usually done:

• Mohs micrographic surgery.Mohs surgery is performed by removing the tumor in a very thin incision, which is around the lips.
• Glossectomy.This operation is performed to treat tongue cancer, which is to remove part of the tongue that is affected by cancer (partial), or possibly completely (totally).
• Mandibulectomy.This surgery is performed to remove part or all of the jawbone (mandible) that is affected by cancer. The bone that is removed will be replaced with bone from another part of the body.

2. Radiation therapy

Radiation therapy or radiotherapy makes use of high-energy rays, such as X-rays and protons, to kill cancer cells, including oral cancer.

Radiation therapy for gum, tongue, or lip cancer can have side effects, such as tooth decay, sore throat, dry mouth, and bleeding gums.

3. Chemotherapy

The next way to deal with oral cancer is chemotherapy. In this oral cancer treatment, you will be given drugs to kill cancer cells or reduce the size of the tumor.

Some of the drugs used in chemotherapy for the tongue, gums, or lips are cisplatin, carboplatin, 5-fluorouracil (5-FU), paclitaxel (Taxol®), docetaxel (Taxotere®), methotrexate, bleomycin, and capecitabine.

This cancer treatment can cause hair loss, fatigue, diarrhea, nausea, and vomiting as well as decreased appetite.

3. Targeted therapy

A number of targeted drugs, for example Cetuximab (Erbitux), are capable of treating the development of oral cancer. The way it works is by changing the structure of cancer cells, thereby disrupting their growth in the body.

These targeted drugs can be used alone or in combination with other oral cancer treatments.

4. Immunotherapy

Immunotherapy treatment uses the help of your immune system to fight cancer cells, including oral cancer. Supposedly, the immune system is in charge of fighting the development of cancer cells.

However, the proteins produced from cancer cells actually interfere with the work of the immune system. This is where immunotherapy treatments come into play to disrupt the process by strengthening the immune system.

Slightly different from other treatments, immunotherapy is generally intended for oral cancer patients who are no longer resistant to other treatments.

Home care

What are some lifestyle changes or home remedies that can be done to treat oral cancer?

There is no proven way to treat oral cancer naturally, like using traditional natural plants as herbal remedies.

Although they do not cure, some natural ingredients may be reliable as a way to relieve cancer symptoms in the gums, tongue, lips or other areas in the oral cavity. For example, curcumin extract or turmeric drink, green tea extract, or spirulina. However, the use of these materials must be supervised by a doctor.

Prevention

How do you prevent oral cancer?

There is no sure way to prevent cancer of the oral cavity (gum, tongue, and lips). However, you can reduce the risk of disease with the following tips:

• Quit smoking and limit alcohol consumption.
• Limit exposure to direct sunlight by applying sun cream or wearing skin protection, such as a hat.
• Increase your consumption of vegetables, fruit, nuts, and whole grains and reduce foods high in fat, high in sugar, and preservatives.
• Always practice healthy sexual activities, such as using condoms and not changing partners to avoid transmitting HPV infection.