Oral Cancer: What is it, Causes, Symptoms and Treatment

Oral cancer is a worldwide health problem and is the most common head and neck cancer in developed countries and the second most common cancer in our country. As with many diseases, it is a type of cancer for which early diagnosis and treatment is extremely important. Oral cancer, which is considered among head and neck cancers, describes the types of cancer that develop in any part of this region, including the inside of the cheek and gums. These malignant tumoral structures, also called oral cancer, generally originate from squamous (flat) cells in the mouth, tongue and lips. You can follow the rest of the article to get more detailed information about this type of cancer.

What is Oral Cancer?

Oral cancer describes malignant neoplasms (new tissue formation) that occur on the lips or within the oral cavity. When the cellular diversity of intraoral structures is examined, 90% of them consist of squamous cells and originate from the epithelial tissue in the region. However, this cellular origin may change to varying degrees depending on the course of the disease. Care should be taken as it may become invasive over time and spread to surrounding tissues and lymph nodes.

What are the Types of Oral Cancer?

The areas evaluated for oral cancer can be summarized as follows:

• Lips,
• Language,
• floor of mouth,
• Inner surface of the cheeks,
• gums,
• Floor of the mouth or palate.

The tongue and floor of the mouth are the most common sites. Considering that oral cancer types are generally found in the oral cavity and the importance of early diagnosis, it can be understood how important regular check-ups by dentists are. Dentists are usually the first physicians to detect tumor formations that may occur in this area.

What are the Causes of Oral Cancer?

Oral cancers occur as a result of mutations in the DNA of cells in the lips or oral cavity. DNA structures located within the nuclei of cells contain genetic codes related to the planning, initiation and termination of all metabolic functions of a cell. As a result of mutations, disruption of the cell cycle may occur. Loss of the cycle causes the cell to grow and divide uncontrollably. As a result of occupation of healthy cells’ areas and food sources, healthy cells in the surrounding area cannot survive. Thus, cancer cells continue to spread. With this mechanism, cancerous cells first form abnormal tissue growth (tumor). It may then spread to other parts of the body, primarily the head and neck.

The cells from which oral cancer originates are the flat cells lining the surface of the mouth and lips. Although it has not yet been fully revealed what triggers the mutation in these cells, there are various risk factors that may be effective in the development of oral cancer:

• Use of tobacco and various tobacco products,
• Being infected with types of human papillomavirus that can trigger cancer development, especially “HPV types 16 and 18”,
• The person has a previous history of developing cancer in the head and neck area,
• Poor oral hygiene.

In addition to these basic risk factors, it can be said that some people are predisposed to oral cancer. Risk factors that increase susceptibility can be listed as follows:

• Increased UV (ultraviolet) ray exposure due to the sun or other sources (the main initiator for lip cancers),
• Gastroesophageal reflux disease,
• Previous radiation has been applied to the head and neck area for various reasons,
• Exposure to various chemicals such as asbestos, sulfuric acid or formaldehyde,
• Long-term wound formation in the mouth due to tooth and gum problems,

What are the symptoms of mouth cancer?

As with all diseases, the symptoms of oral cancer may vary from person to person. In general, the most common symptoms in this patient group are complaints such as persistent wounds and pain in the mouth. Some types of oral cancer can also appear as red or white patches on the gums, tonsils, or inside the mouth. Apart from these situations, other symptoms that may occur with oral cancer are as follows:

• Swelling in the neck,
• Development of lumps on the cheeks,
• Problems with swallowing or chewing,
• Constant feeling as if there is something in the throat,
• Difficulty in jaw and tongue movements,
• weight loss,
• Persistent bad breath,
• Earache that does not change its course,
• tooth loss,
• Bleeding in the mouth,
• Numbness in the lower lip, face and neck area,
• Tongue pain.

It should not be forgotten that many of these symptoms may also occur in some other diseases that are considered simple. It is very important that you observe any of these complaints in yourself and if your complaint lasts longer than 3 weeks, you should consult a health institution without wasting time.

How is Oral Cancer Diagnosed?

After applying to health institutions with complaints of oral cancer, physicians first take a medical history and perform a physical examination. In these procedures, the patient’s symptoms and family history are examined, while the intraoral structures are also observed. In addition to the floor of the mouth, palate, back of the throat, tongue and inside of the cheeks, the lymph nodes of the head and neck region are also among the parts evaluated. If suspicious structures are detected during this examination process, an examination called “tissue biopsy” is performed. A biopsy involves collecting cell samples, usually painlessly. At the same time, small tissue samples can be taken and examined under a microscope for signs of cancer.

In addition to the biopsy process, there are various imaging methods that can be used in the diagnostic approach to oral cancer:

• X-ray: X-ray radiographs are among the radiological examinations that can be used to detect the spread of cancer cells to the jaw, chest area and lungs. However, today their use has decreased due to more advanced techniques.
• CT: Computed tomography scans are useful in distinguishing whether cancer has occurred in other parts of the body.
• MRI: Magnetic resonance imaging, another radiological imaging method, provides more accurate and detailed images of the spread of cancer.
• PET-CT: PET scan is very effective in examining in which parts of the body oral cancer has spread and whether it has spread to the lymph nodes.
• Endoscopy: When necessary, endoscopic interventions may be used to examine structures such as the inside of the nose, sinuses, inner parts of the throat and trachea.

How is Oral Cancer Treated?

Treatment of oral cancer varies depending on how advanced the disease is, its stage and the region where it is located. Surgical interventions may be used to remove cancer structures detected in the early stages. In some cases, various intraoral and neck structures are surgically removed. Radiotherapy applications, also known as radiation therapy, are another method used in the treatment of cancer. In this method, it is aimed to destroy the tumor tissue by targeting it with rays at various time intervals. The treatment method that eliminates cancer cells with chemical agents instead of radiation is called chemotherapy. These medications can be given orally or intravenously. Chemotherapy treatment aims to damage the DNA of cancer cells by using strong chemicals. However, these powerful chemicals can damage various healthy cells other than cancer cells, causing side effects such as fatigue, nausea, vomiting, hair loss and weakening of the immune system. Maintaining nutrition can be challenging in some cases due to the location of the oral cancer. Therefore, it is very important to create nutrition plans that will ensure that patients are not deprived of various nutrients throughout their treatment.

Oral cancer is a disease in which early diagnosis and appropriate intervention are very important for survival. For this reason, if you observe signs and symptoms of oral cancer in yourself, it is recommended that you contact health institutions and get support from specialist physicians.