What is Oral Cancer?

Oral Cancer is a type of cancer that develops in the mouth or oral cavity, which includes:

• Lips
• Tongue
• Cheeks
• Gums
• Floor and roof of the mouth
• Throat (oropharynx)

It usually starts in the squamous cells lining the inside of the mouth.

What are the symptoms of Oral Cancer?

Common Symptoms

• Mouth sore that doesn’t heal (lasting more than 2 weeks)
• Red or white patchesinside the mouth or on the tongue
• Persistent painin the mouth or throat
• Unexplained bleedingin the mouth

Other Warning Signs

• Lump, thickening, or rough spot in the cheek or gums
• Loose teeth without clear reason
• Difficulty or pain while chewing, swallowing, or speaking
• Sore throat or feeling that something is stuck in the throat
• Ear pain(without ear infection)
• Numbnessin tongue, lips, or other parts of the mouth

Advanced Symptoms

• Swelling in the jaw
• Change in voice
• Weight loss
• Enlarged lymph nodes in the neck

How to detect Oral Cancer?

1. Physical Examination

• Who does it: Dentist or doctor.
• What happens:
• Checks the mouth, tongue, gums, cheeks, and throat for lumps, sores, discolouration, or unusual tissue changes.
  • When to do:
• During routine dental check-ups or if symptoms last 2 weeks.

2. Oral Cancer Screening

• Done by dentists during regular visits.
• Uses light or dye to highlight abnormal tissues.

3. Imaging Tests

• X-rays: To see if cancer has spread to the jaw or chest.
• CT Scan / MRI: Shows tumour size and spread to other areas.
• PET Scan: Detects cancer spread to distant organs.

4. Biopsy (Definitive Diagnosis)

• Types:

• Incisional biopsy: Removal of a small sample from a suspicious lesion.
• Exfoliative cytology: Scraping cells for examination under a microscope.
  • Purpose: Confirms if cancer cells are present and identifies the type.

5. Endoscopy

• Flexible scope used to examine deeper areas like the throat and larynx if cancer is suspected to have spread.

6. Human Papillomavirus Testing

• If oropharyngeal cancer is suspected, testing for HPV (a major risk factor) may be recommended.

What are the available treatments for Oral Cancer?

1. Surgery

• Goal: Remove the cancerous tissue and a margin of healthy tissue.
• Types:

• Primary tumour removal: Removes cancer from mouth or throat.
• Neck dissection: Removes lymph nodes if cancer has spread.
• Reconstructive surgery: Restores appearance and function (speech, swallowing) after large tissue removal.
  • When used: Early stages or as part of combined treatment.

2. Radiation Therapy

• Uses high-energy X-rays or particles to kill cancer cells.
• When used:
• Early-stage cancer (sometimes as the only treatment).
• After surgery to destroy remaining cancer cells.
  • Techniques:
• External Beam Radiation Therapy (EBRT)
• Brachytherapy: Radioactive material placed near the tumour.

3. Chemotherapy

• Uses drugs to kill cancer cells, usually combined with radiation for advanced stages.
• Common drugs: Cisplatin, 5-fluorouracil, Docetaxel.
• When used:

• Advanced or metastatic oral cancer.
• Along with radiation (chemoradiation).

4. Targeted Therapy

• Drugs that attack specific molecules in cancer cells.
• Example: Cetuximab (targets EGFR protein).
• Often combined with radiation or chemotherapy for advanced cancer.

5. Immunotherapy

• Helps the immune system fight cancer.
• Common drugs: Pembrolizumab, Nivolumab.
• Usually for recurrent or metastatic oral cancer that does not respond to other treatments.

6. Palliative Care

• Focused on improving quality of life, managing pain, and helping with eating or speech difficulties.