Oral cavity carcinoma

Cancer of the lining of the lips, mouth, or upper throat

Oral cancer
ZungenCa2a.jpg
Oral cancer on the side of the tongue, a common site along with the floor of the mouth
Synonyms	Cancer of the lip, oral cavity, and pharynx; mouth cancer
Specialty	Oncology, ENT surgery, oral and maxillofacial surgery
Symptoms	Persistent rough white or red patch in the mouth lasting longer than 2 weeks, ulceration, lumps in the neck, pain, loose teeth, difficulty swallowing
Risk factors	Smoking, alcohol consumption, HPV infection, sun exposure, chewing tobacco
Diagnosis	Tissue biopsy
Differential diagnosis	Non-squamous cell carcinoma oral cancer, salivary gland tumors, benign mucosal diseases
Prevention	Avoiding risk factors such as smoking and excessive alcohol use, HPV vaccination
Treatment	Surgery, radiation therapy, chemotherapy
Prognosis	Approximately 65% five-year survival rate (US, 2015)
Frequency	355,000 new cases annually (2018)
Deaths	177,000 deaths annually (2018)

Oral cancer is a type of carcinoma that arises in the tissues of the oral cavity, which includes the lips, tongue, gums, the floor of the mouth, and the roof of the mouth. It is a significant health concern worldwide, particularly in regions with high tobacco and alcohol use.

Overview

Oral cancer typically develops as a squamous cell carcinoma, originating from the flat cells lining the mouth and throat. It often presents as persistent sores, patches, or lumps that do not heal. Early detection and treatment are crucial for improving survival rates.

Risk Factors

• Tobacco use: Smoking cigarettes, cigars, or pipes; chewing tobacco.
• Alcohol consumption: Chronic and excessive use increases risk.
• HPV infection: Human papillomavirus, particularly HPV-16.
• Sun exposure: Prolonged exposure increases the risk of lip cancer.
• Poor oral hygiene: In some cases, poor dental hygiene and chronic irritation are associated risk factors.

Symptoms

Common symptoms include:

• Non-healing ulcers or patches in the mouth.
• Persistent pain or discomfort in the oral cavity.
• Difficulty swallowing or speaking.
• Lumps or swelling in the neck.
• Loose teeth without an apparent cause.

Diagnosis

Diagnosis is primarily based on:

• Physical examination: Identifying lesions or abnormalities in the oral cavity.
• Biopsy: Examination of tissue samples to confirm malignancy.
• Imaging studies: CT scans, MRI, or PET scans to determine the spread of the cancer.

Types

The most common type of oral cancer is squamous cell carcinoma, accounting for more than 90% of cases. Other less common types include:

• Mucoepidermoid carcinoma
• Adenocarcinoma
• Sarcoma (rare)

Treatment

The treatment approach depends on the stage of cancer:

• Surgery: Removal of tumors and affected tissues.
• Radiation therapy: Used post-surgery or as a standalone treatment.
• Chemotherapy: Often combined with radiation for advanced stages.
• Targeted therapy: Emerging treatments targeting specific cancer pathways.

Prognosis

The overall survival rate for oral cancer is approximately 65% at five years, but it varies significantly based on the stage at diagnosis and the individual's health.

Prevention

Preventative measures include:

• Avoiding tobacco and excessive alcohol consumption.
• Regular dental check-ups for early detection.
• Vaccination against HPV.
• Protective measures against sun exposure, such as wearing hats and using lip balm with SPF.

See Also

• Lip and oral cavity carcinoma
• Squamous cell carcinoma
• HPV-associated cancers