Oral cancers are most cancers in male population in Indian subcontinent and accounts for major morbidity and deaths across nation. They are commonly associated with habit of tobacco chewing in form of ( guttka, khaini)and various tobacco chewing products available in the country. The use of the tobacco chewing products was also associated with cultural habits in various parts of country.
Oral cancers can affect any part of oral cavity which includes cheeks, lips, gums, oropharynx, tongue and palate. This cancer usually arise from the damaged lining of the oral cavity because of constant irritation produced by use of oral chewing tobacco products
Common causes of oral cavity cancer
- chewing of tobacco products
- Smoking of bidi/cigarettes
- Reverse smoking
- Spicy food
- Sharp tooth and use of inappropriate dentures
Common symptoms of oral cavity cancer
- Non healing ulcer is most symptom
- Ulcer not responding to medications
- Pain in the ulcerated area of oral cavity
- Dental and facial pain due to involvement of nerves
- Swelling and multiple small lump in neck due to spread of tumour.
- Hoarseness of voice
- Inability to eat / alteration of taste
- Weight loss and weakness of the body
- Symptoms of spread like neck pain, bone pain, headache
- Ulcers extending to outer skin of the face and mandible.
Diagnosis and investigations
Once u discover any of these persistent symptoms it’s important to contact the surgeon/ clinician for further evaluation and management.Clinical examination remains the important assessment in case of oral ulcers to plan for further management. Usually surgeons obtain tissue biopsy to confirm the diagnosis. Further investigations like blood tests., x ray chest , contrast enhanced computerised tomography (CECT) neck and Magnetic resonance imaging ( MRI ) is done for assessment and spread of disease. Other investigations like PET scan and MRI can be used depending upon the spread of the disease.
Once the diagnosed is confirmed treatment planning is done by cancer specialists and surgeons. Surgery , chemotherapy and radiotherapy remain the mainstay of the treatment. Surgery is usually performed depending upon the site of the cancer along removal cancer tissue from the neck ( Radical Neck dissection) . Minimal access / robotic surgery has limited role and is confined to local disease in oral cavity and long term results results are still not available extensively.
Conventional surgery remains the mainstay of management. Extent of surgery depends upon the spread of the tumour and extensive oral cancer surgeries will require reconstruction of the neck and face by muscular and bone grafts. Chemotherapy and radiotherapy plays major role before and after surgery depending upon the stage of the disease.
After surgery, supportive care is important component as patient require to be supplemented with adequate nutrition via different modalities. The usual hospital stay is 7-14 days depending upon the extent of surgery and recovery of the patients. Additional cosmetic surgeries can be done to improve facial appearances after complete recovery of the patients from cancer.
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