Oral cancer is cancer that occurs in the lining of the mouth, lips, tongue, gums, or palate. Oral cancer can also occur in the tissues in the throat (pharynx) and salivary glands.
Oral cancer is caused by the growth of abnormal tissue in the mouth. Symptoms of oral cancer that are generally felt are canker sores that do not go away, white or red patches appear, and pain in the mouth.
Oral cancer treatment methods can include radiotherapy, chemotherapy, surgery, and targeted drug therapy. The cure rate of oral cancer patients depends on the stage of cancer suffered and their health conditions.
Symptoms of Oral Cancer
In some people, the changes that occur in the oral tissues due to oral cancer can go unnoticed because they are considered harmless. Signs of change to watch out for include:
- Canker sores that don't go away for weeks.
- Canker sores accompanied by bleeding.
- Red or white patches in the mouth.
- A lump or thickening on the inside of the mouth that doesn't go away.
- Loose teeth for no apparent reason.
In addition to changes in the tissues in the mouth, symptoms that can be felt by people with oral cancer are:
- Pain in the mouth, especially in the mouth
- Difficulty or pain when swallowing and chewing.
- Jaw feels stiff or sore.
- Sore throat.
- Changes in voice or speech (eg being slurred).
- Has difficulty speaking.
Oral cancer that has entered an advanced stage does not only occur in the mouth. At this stage, cancer cells have spread and cause lumps in the neck due to swollen lymph nodes.
When to go to the doctor
To maintain the health of your teeth and oral cavity, you need to have regular check-ups with your dentist once every 1-2 years. However, examinations can be carried out more often, depending on the doctor's judgment based on the condition of your oral health.
Early symptoms of oral cancer, such as canker sores, are often considered harmless and ignored until the condition is severe. Stay alert to the symptoms of oral cancer above and immediately consult a dentist if the symptoms do not go away for more than 2 weeks.
Causes and Risk Factors for Oral Cancer
Oral cancer occurs due to the growth of abnormal tissue in the mouth. The cause is a change or genetic mutation in the cells in the tissue, but the cause of this genetic change itself is not known with certainty.
There are several factors that are thought to increase the risk of oral cancer, including heredity and age (over 50 years). Some behaviors and diseases are also thought to make a person more at risk of developing oral cancer. The behavior in question is:
- Smoke.
- Consuming alcoholic beverages.
- Often chew betel nut.
- Rarely eat vegetables and fruit.
- Not maintaining oral hygiene and health, for example leaving cavities.
- Frequent exposure to sunlight, for example field workers.
While the diseases that are thought to be at risk of causing oral cancer are:
- HPV infection.
- Oral herpes infection.
- Diseases that can lower the immune system, such as HIV/AIDS.
- Certain genetic diseases, such as Fanconi anemia or congenital dyskeratosis.
Oral Cancer Diagnosis
The doctor will conduct an examination to determine whether the patient really has oral cancer, as well as to determine the stage and spread of the cancer.
As a first step, the doctor will ask the patient's symptoms, then examine the condition of the patient's mouth. If you suspect oral cancer, the doctor will perform a biopsy, which is taking a sample of oral tissue for examination in a laboratory.
Oral tissue samples can be taken through a fine needle (fine needle aspiration) or through a small incision in the skin. A biopsy can also be done with an endoscope, using a tube-like instrument equipped with a camera and inserted through the mouth.
In addition to taking samples of oral tissue, endoscopy can also be used to see the condition of the oral cavity and the surrounding area. With an endoscope, parts that are difficult to see around the oral cavity, such as the throat or nasal cavity, can be seen clearly.
To see the spread of cancer, the doctor will perform several scanning methods, such as X-rays, CT scans, MRI, or PET scans.
Oral Cancer Stage
Oral cancer is divided into 4 stages, based on the size and extent of spread. Here is the description:
- Stage 1
At this stage, oral cancer is still very small, about 2 cm and has not spread to surrounding tissues.
- Stage 2At this stage, oral cancer is 2-4 cm in size, but has not spread to the surrounding tissue.
- Stage 3At this stage, oral cancer is more than 4 cm in size, or has spread to the lymph nodes.
- Stage 4At this stage, the lymph nodes have enlarged, and the cancer has spread to some tissues outside the mouth or to other distant organs, such as the liver.
Oral Cancer Treatment
Oral cancer treatment by an oncologist is determined by the stage, location, and type of oral cancer, as well as the patient's health condition. Treatment steps for oral cancer include surgery, chemotherapy, radiotherapy, and targeted drug therapy. These four types of treatment can be combined to get maximum results.
Operation
Early-stage oral cancer can be treated with surgery using laser light (photodynamic therapy). However, if the cancer has spread to several tissues around the mouth, it is necessary to remove the tumor with an incision. The surgeon may also perform facial reconstruction surgery to reshape the removed part or tissue.
Surgery can cause side effects in the form of bleeding and infection. In addition, surgery can also affect the way the patient eats and talks, and can change the patient's appearance.
Radiotherapy
Cancer treatment through radiotherapy is done by killing cancer cells using special rays, such as X-rays or protons. Radiation therapy can be done from outside or inside the body.
Radiotherapy is generally combined with chemotherapy or surgery. Radiotherapy performed before surgery aims to reduce the size of the cancer before it is surgically removed. While radiotherapy is done after surgery aims to eradicate the remaining cancer cells.
Radiotherapy for terminal cancer cannot kill all cancer tissue in the patient's body. However, radiotherapy is performed on late-stage cancer can help relieve the symptoms of cancer suffered.
Just like any other procedure, radiotherapy can also cause side effects. Side effects that can arise from radiotherapy include dry mouth, damage to the jawbone, and tooth decay.
Chemotherapy
In treating cancer that has spread widely or is at high risk of re-growing, doctors recommend that patients undergo chemotherapy. The drugs used in this process destroy the DNA of cancer cells so they can't multiply. Some of the types of drugs used are:
- cisplatin
- Carboplatin
- Fluorouracil
- Docetaxel
- Methotraxate
- Bleomycin
Although they can help cure cancer, radiotherapy and chemotherapy have the potential to cause side effects, such as nausea, vomiting, fatigue, canker sores, and pain in the mouth. These drugs can also lower the immune system so that the patient is susceptible to infection.
Targeted drug therapy
In addition to surgery, radiotherapy, and chemotherapy, oral cancer can also be treated with targeted drug therapy. This therapy serves to kill cancer cells and stimulate the immune system to kill these cells.
Targeted drug therapy can be given with chemotherapy drugs. One of the types of drugs that doctors give for this therapy is cetuximab. Targeted drug therapy can cause side effects such as itching, rash, diarrhea, and infection.
Oral Cancer Prevention
Because the cause is unknown, oral cancer cannot be completely prevented. But patients can still take simple steps to lower their risk of developing oral cancer, namely:
- Do not smoke.
- Avoid drinking
- Increase consumption of vegetables and fruits.
- Maintain oral hygiene by brushing your teeth regularly.
- Check your teeth regularly, at least once a year.