oral:cancer surgeries

overview

  • Oral cancer begins in the mouth, also called the oral cavity. This region of the body includes the lips, the inside lining of the lips and cheeks (called the buccal mucosa), the teeth, the gums, most of the tongue, the bottom of the mouth, and the bony roof of the mouth, or hard palate.
  • In addition, oral cancer may also develop in the oropharynx, which is the part of the throat that is just behind the mouth. When cancer occurs here, it is called oropharyngeal cancer or throat cancer, and can include the back of the tongue, the back of the roof of the mouth, the tonsils, and the walls of the upper throat.
  • The oral cavity and oropharynx are key to the healthy functioning of the body. They help us breathe, eat and speak. Salivary glands in the oral cavity start breaking down food as we chew, an essential part of digestion.
  • Cancer can develop in any part of the oral cavity. Because each part of the oral cavity is different, oral cancer encompasses a wide variety of cancer types that are treated in different ways.
  • The American Cancer Society estimates that 53,260 people in the United States will be diagnosed with oral cavity or oropharyngeal cancer in 2020.
  • Dr. Shilpi Sharma Best Oral Cancer Doctor in Gurgaon.

Types of Oral cancer

  • Squamous cell carcinoma: More than 90 percent of cancers that occur in the oral cavity are squamous cell carcinomas. Normally, the throat and mouth are lined with so-called squamous cells, which are flat and look like fish scales on a microscopic level. Squamous cell carcinoma develops when some squamous cells mutate and become abnormal.
  • Verrucous carcinoma: About 5 percent of all oral cavity tumors are verrucous carcinoma, a type of very slow-growing cancer made up of squamous cells. This type of oral cancer rarely spreads to other parts of the body, but it may invade nearby tissue.
  • Minor salivary gland carcinomas: This disease includes several types of oral cancer that may develop on the minor salivary glands, which are located throughout the lining of the mouth and throat. These include adenoid cystic carcinoma, mucoepidermoid carcinoma and polymorphous low-grade adenocarcinoma.
  • Lymphoma: Oral cancers that develop in lymph tissue, which is part of the immune system, are known as lymphomas. The tonsils and base of the tongue both contain lymphoid tissue.
  • Benign oral cavity tumors: Several types of non-cancerous tumors and tumor-like conditions may develop in the oral cavity and oropharynx. Sometimes, these conditions may develop into cancer. For this reason, benign tumors are often surgically removed. 
  • Leukoplakia and erythroplakia: These non-cancerous conditions develop when certain types of abnormal cells form in the mouth or throat. When leukoplakia develops, a white area is visible, while erythroplakia is marked by a red area, which may be flat or slightly raised and often bleeds when scraped. Both conditions may be precancerous, meaning they may develop into various types of cancer. When these conditions occur, a biopsy or other test is performed to determine whether the cells are cancerous. About 25 percent of leukoplakias are either cancerous when first discovered or become precancerous. Erythroplakia is usually more serious, with about 70 about of cases deemed to be cancerous, either at the time of diagnosis or later.
  • Persistent mouth sores that do not heal
  • Persistent mouth pain
  • A lump or thickening in the cheek
  • A white or red patch on the gums, tongue, tonsil, or lining of the mouth
  • A sore throat or persistent feeling that something is caught in the throat
  • Difficulty swallowing or chewing
  • Difficulty moving the jaw or tongue
  • Numbness of the tongue or other area of the mouth
  • Jaw swelling that makes dentures hurt or fit poorly
  • Loosening of the teeth
  • Pain in the teeth or jaw
  • Voice changes
  • A lump in the neck
  • weight loss
  • Persistent bad breath

Developing a treatment plan for oral cancer generally takes into account quality of life issues, because oral cancer and its treatments may affect a patient’s ability to perform everyday functions like breathing and eating. In general, surgery is the first-line treatment for oral cancer that is caught early. Other treatment options typically include chemotherapy, radiation therapy and targeted therapy.

Chemotherapy:

may be used to treat oral cancer patients whose disease has spread. It may be given alone or in combination with other treatments.

Radiation therapy:

Oral cancer patients are often treated with two primary types of radiation therapy:

External beam radiation therapy:

This treatment delivers high doses of radiation to tumor cells from outside the body, using a variety of machine-based technologies. We also use EBRT to help relieve some of the symptoms of oral cancer, such as pain, bleeding, trouble, swallowing and problems that arise if cancer spreads to the bone. Two examples of oral cancer EBRT include:

  • Accelerated and hyperfractionated radiation therapy: This type of radiation therapy is typically given twice a day, and at a higher frequency than normal EBRT.
  • Intensity modulated radiation therapy (IMRT): Compared to standard radiotherapy, IMRT delivers higher radiation doses than traditional therapies would allow. IMRT also helps to spare more of the surrounding healthy oral tissue from harmful doses of radiation.
Brachytherapy (internal radiation):

Delivers high or low doses of radiation from implants placed close to, or inside, the tumor(s) in the body. Brachytherapy may be an alternative to surgery for some oral cancer patients. Because it requires no incision and leaves no surgical wound to heal, recovery from the procedure is generally rapid.

Targeted therapy:

  • One potential target in oral cancer is the epidermal growth factor receptor (EGFR). Studies have shown that many oral tumor cells contain too many copies of EGFR. This excess hormone allows the cancer cells to grow faster and to become resistant to radiation and/or chemotherapy. Treating oral cancer with a drug that targets EGFR may help kill cancer cells without harming normal tissues.
  • Your oncologist may recommend an EGFR-targeted drug in combination with chemotherapy or radiation therapy to treat oral cancer. If the cancer has stopped responding to radiation and chemotherapy,targeted therapy may be used on its own to help control the disease.