Oral Cancer

Here we present an overview of oral cancer. It is a common type of cancer and is generally treatable if detected early enough.

Definition: Oral cancer is a type of head and neck cancer which occurs in the oral cavity or mouth. Oral or mouth cancer is most commonly a cancer of the tongue, but it can occur on the floor of the mouth, in the cheek lining, in the gums, lips or even on the roof of the mouth.

According to the National Cancer Institute, more than 40,000 oral cancer cases are diagnosed ever year (NCI). The average age of people diagnosed with oral cancer is over 60 years old.

Around 90% of all oral cancers are of the type squamous cell carcinomas. This type of cancer effects the top layer of tissues which are on the outside of some part of the body. This would include things like the skin, or the lining of the mouth although it could be the lining of another part of the body.

We ought to state that in addition to self education, one ought to seek the aid of a health professional when dealing with serious health issues.

Symptoms of Oral Cancer

There are many symptoms of oral cancer. The first thing to say is that one of the real dangers of this type of cancer is that in its early states, it can go unnoticed. It may start out as being painless and as not causing any problems; therefore it may not be discovered quickly. Oral cancers are most often discovered after they have spread to the lymph nodes of the neck, unfortunately.

Early symptoms

This cancer may start out as a usually small lesion, lump, or ulcer on the tongue, lip or other areas of the mouth which does not vanish or subside after a few weeks. Other locations might include behind the wisdom tooth or even behind the ear. Watch out for a white patch or a red patch on the soft parts of the mouth. It is often pale, but maybe dark or otherwise discolored. It starts out as usually being painless, but may become painful with a burning sensation after the tumor has become advanced.

Later Symptoms

As this disease progresses, additional problems can arise. These include difficulty in swallowing, moving your tongue, mouth sores which won't heal, loose teeth, a lump in your neck, an earache, and bleeding in your mouth.

Causes of Oral Cancer

Alcohol

Heavy alcohol use is definitely a factor recognized by the medical community as a contributor to the chances of getting oral cancer. The risk increases as the amount of alcohol consumed on a regular basis increases. Add to this the fact that combining the two popular recreational drugs of alcohol and tobacco, has a synergistic effect against you. Risk of cancer is six times greater in those that drink on a regular basis than those who don't. Yet, as bad as this is, those who both smoke and drink have 15 times the risk of getting oral cancer as those who don't. You probably know that doctors strongly recommend their patients to stop using tobacco and alcohol to reduce the risk of cancer as well as other health problems. A final statistic, about 70% of all patients with oral cancer drink alcohol frequently.

Human papillomavirus

There is a growing percentage of patients who get their oral cancer from this virus. This is a group of people who unlike older drinkers and smokers, are of a younger age group, and who are not necessarily drinkers or smokers. This younger and rapidly growing group of people are between the ages of 30 and 50 years old, are predominately nonsmoking, and white. The percentage of males to females is roughly the same. The causative factor is a living entity rather than chemical, and is known as HPV16. This virus is sexually transmitted between partners. HPV16 represents the most common sexually transmitted disease in the United States. Actually, this is the same virus which is the cause of more than 90% of all cervical cancers. It is interesting to note that in people under the age of 50, HPV16 may even be replacing tobacco as the leading cause of oral or mouth cancer. Due to the current spread of HPV16, the virus is now considered the primary cause of over 60% of newly diagnosed patients

The HPV virus is a piece of DNA which exists by invading a living cell and taking over the machinery of that cell, directing it to reproduce copies of itself. The kinds of cells this particular virus likes to infect are those on the surfaces of the human body, such as the skin, mouth interior, throat, tongue, tonsils, vagina, cervix, vulva, penis, and anus. This virus jumps from one person to the next when these surfaces come into contact, which they do during lovemaking. There are over 200 strains of this organism, and one of the most common types of viruses in the U.S. Out of these 200, only nine are known to do with cancers. A few others are associated with benign growths (warts) and the vast majority of them are harmless. HPV infections are common, and the immune system is strong enough most of the time to ward them off. Many go without being noticed, or causing any problems.

Other Causes

It is not common in the United States and is less common in Europe, but there are drugs used in places such as Africa and Asia which can increase the risk of oral cancer. Chewing betel nut, using Areca nut, and using paan, a combination of the two can increase your risk of mouth cancer. This is a mild stimulant, and is a little like chewing tobacco in some parts of the world. In India, for example, such practices are common, and oral cancer there causes up to 40% of all cases, compared to just 4% in the UK.

Treatments for Oral Cancer

There are a few different treatments for oral cancer. It is important to consult with your doctor or doctors as there are many factors to consider, and this could be one of the most important decisions in your life. Choice of treatment can depend upon general health, where in your mouth or throat the cancer started, the size of the tumor, the scope of the cancer and how much it has grown and if it has spread outside of the mouth area. Each treatment has possible side effects. You will want to consider how treatment may affect eating, swallowing, talking, and so on. In particular radiation treatment can take a beating on the salivary glands.

It is common for more than one kind of treatment for cancer to be used together.

As a pre-treatment precaution, it will be recommended by your health practitioner to see a dentist and to possibly have dental work done a month prior to starting treatment for oral cancer.

Quit Using Tobacco

If you are a smoker, and your cancer was brought on due to smoking, then your doctor will tell you to quit smoking. Quitting can not only help cancer treatments work better, it can reduce your chances of getting another cancer. Quitting can of course have other health benefits such as reducing the risk of heart disease, lung disease and so on.

Your doctor can help point you in the right direction. There are medicine or nicotine replacement therapies available. There are often local programs or trained professionals who focus on this problem. Also, available on the World Wide Web information can be found covering this topic.

Chemotherapy

Chemotherapy works by using chemicals to destroy cancer cells. This is done by interfering with the cancer cell's ability to grow. The advantage of chemotherapy is that it has the ability to treat cancer which is not just localized in one spot in your body, but which is widespread. The other two main types of treatment, surgery, and radiation, can only treat localized cancer.

A patient's treatment plan will be individualized for his or her specific cancer. Chemotherapy has become more refined over its years of use. It can be used in some cases before surgery to reduce the size of the cancer, or after surgery to clean up anything which surgery did not take out. It can and often will be used in combination with radiation to enhance the local, regional and distant elimination of the disease. Because of these techniques cure rates have improved over time. Hidden cancer cells may escape the area being treated by surgery or radiation and it is those cells which result in recurrences of the cancer and which chemotherapy hopes to prevent by killing.

There are older chemotherapy drugs which like radiation therapy rely on the bodies healthy regular cells to multiply and recover from damage as these cancer treatments are like a bomb, destroying everything around them. Newer promising drugs are called targeted therapy drugs and refer to other substances that work in more specific ways. They may block the growth and spread of cancer by interfering with molecules specific to the particular type of tumor. Or they may work by altering specific aspects of specific types of cancer cells. Although this area of technology is relatively new, Cetuximab (Erbitux) is one targeted therapy approved for treating certain cancers in certain situations. Cetuximab stops the action of a protein that's found in many types of healthy cells, but is more prevalent in certain types of cancer cells.

Chemotherapy is a very involved and complicated science and it is recommended that you consult your doctor to learn about chemotherapy and what will be done for you.

One must be aware of the side effects of chemotherapy. Chemotherapy works by interfering with the ability of cells in your body to grow and reproduce. So, both normal cells and cancer cells are affected. When the chemotherapy has been completed, the normal cells bounce back or are replaced by new healthy cells. This causes the symptoms to cease. The symptoms are therefore related to various types of normal cells being interfered with. If the symptoms are too severe, then additional medications may be prescribed.

Just some of the general symptoms of chemotherapy as a broad treatment for cancer include the following. It will be necessary to learn from your doctor exactly which side effects for the particular drug or drugs which you will be taking may be as there are a variety of drugs which may be employed in your treatment.

• hair loss
• painful mouth and gums
• bleeding in the mouth
• severe anemia
• weakness
• poor appetite
• nausea
• vomiting
• diarrhea
• mouth and lip sores
• numbness in hands and feet

The following drugs are commonly used in cancer chemotherapy treatment. Again, consult your doctor as this is a general list.

• cisplatin
• fluorouracil
• Methotrexate
• Carboplatin
• paclitaxel

Radiation Therapy

In the area of your body where there is cancer, there will both be normal cells and cancer cells. Radiotherapy or radiation therapy uses radioactive energy to destroy the DNA of the cells in and around where the cancer is located. After the DNA is damaged from the radiation, the cells can no longer grow. Although radiation damages both cancer cells and normal cells, normal healthy cells are able to repair themselves and can thereafter continue a normal existence in your body.

Your actual expose to radiation is limited. It has been determined by medical science that it is more effective and safer to deliver the radiation in smaller amounts called fractions which are given on a daily basis, usually just five days a week. These smaller doses are easier to tolerate while still giving the benefit of the treatments. Each treatment may take only 10 to 15 minutes with the majority of the time being spent on setting up the equipment and arranging the treatment.

The goal is to strike a balance between attacking the cancer cells, and allowing your own body's normal cells to rebound by repairing themselves. This is why it may take two weeks or even two months to complete the treatments. Anything which can help the body repair its own tissue during treatment, such as obtaining optimum nutrition is recommended. The balance is between having daily doses which destroy the cancer cells while sparing the normal cells from excessive levels of radiation.

Radiation Therapy has known side effects which include the following

• Changes in voice, taste, and smell
• Dry mouth
• Fatigue
• Infection
• Soreness
• Thyroid problems
• Tooth decay

It will be mentioned here that again, one of the side effects of this type of treatment, which you should discuss with your specialists, is that there might be damage to the saliva glands. The result of this of course will be a variety of dry mouth symptoms.

Oral Cancer Follow-up

Just because you have completed your oral cancer treatment does not mean that you are finished. Oral cancers are unfortunately the type of disease which can reoccur. This generally happens within 2 years of treatment. So, you should keep all follow-up medical appointments which will be more frequent immediately following treatment, and will be less frequent latter on. Please maintain adequate medical insurance.

Some patients require therapy and reconstructive surgery after treatment for mouth cancer. The surgery would be for both cosmetic as well as functional purposes for the mouth. Included in these are dental implants, and muscle, bone and skin grafts. Speech therapists may also be employed if the ability to speak has been impaired. Then there are the types of therapy which can assist with chewing and swallowing so that these activities can become comfortable again. In addition to all of this, a dietitian or nutritionist may be helpful for advice and guidance on how to maintain a healthy diet. This is because treatment may have affected appetite, taste, and the ability to chew and swallow

Oral cancer has also been known to lead to other health problems. Radiation therapy and chemotherapy for mouth cancer can cause dental problems. This is why you should have any prior dental problems dealt with before treatment begins.

Many patients feel extremely fatigued during recovery. Good nutrition, adequate rest, exercise and generally just taking good care of yourself can help. Exercise might also help with anxiety and minor depression. Your mental health should not be discounted. Cancer treatment can be an emotionally exhausting experience. Friends, family, cancer support groups, therapists and even social works may be of help to console and support you.

One of the more irritating consequences of having gone through treatment for oral or mouth cancer is that the part of the mouth which produces saliva or spit may be adversely affected. Both chemotherapy and radiation therapy can cause damage to the salivary glands. While chemotherapy can temporarily damage them, radiation therapy can permanently damage them. For one thing it may become really difficult to swallow food. Saliva not only helps you swallow your food, it begins the digestive process. It may be that you will lose some weight because of this. Another problem might be that it will be difficult to speak to others for a long period of time as your mouth will dry out and this will become uncomfortable to do.

After this overview of oral cancer, we now move onto the topic of what might be tried as far as relieving the singular problem of damaged or non-optimal salivary glands. There are several approaches one may take. One might try prescription drugs. Another approach would be to try one of several over the counter drugs. The third approach would be self management. Self management is fairly simple in its premise. This would include keeping a bottle of water with you to sip on to keep your mouth moist, dipping into a bowl of ice chips, using mouth lozenges and so forth. So we learn to live life after cancer treatment. Please read further.