Oral Cancer: Definition and Epidemiology

Study Notes

Oral cancer encompasses malignant tumors in the oral mucosa, tonsils, and salivary glands.
Peak incidence occurs between 55-60 years of age.
Men are twice as likely to develop oral cancer compared to women.
Oral cancer represents the most common form of head and neck cancer.

Oral mucosal cancer is primarily squamous cell carcinoma.
Salivary gland cancer often involves mucoepidermoid carcinoma.
Tonsillar cancer is predominantly squamous cell carcinoma, accounting for over 70%.
Tobacco consumption, alcohol use, chronic mechanical irritation (like poorly fitted dentures), human papillomavirus (HPV) infection, and precancerous lesions (leukoplakia, erythroplakia, erythroleukoplakia) are identified risk factors for oral cancer development.

Common signs and symptoms include halitosis, pain, difficulty swallowing (dysphagia), non-healing ulcers, unusual bleeding in the mouth, facial swelling, and enlarged lymph nodes (lymphadenopathy).

Biopsy and histopathology are essential for diagnosing and characterizing the lesion.
Panendoscopy helps assess the extent of tumor spread.
HPV testing can identify the presence of the virus, which is associated with oral cancer.
Chest x-ray, axial CT, and PET-CT imaging are used to determine the extent of disease spread.
Tumor markers can be evaluated for monitoring and management purposes.

Localized tumors are typically treated with surgical resection.
Tumors with local spread may require a combination of surgery (often with neck dissection), radiation therapy, and/or chemotherapy.
Inoperable tumors are treated with radiation therapy and adjuvant chemotherapy.
Surgical procedures include maxillectomy, mandibulectomy, glossectomy, laryngectomy, and neck dissection.

Complications of treatment can include alterations in oral flora, swallowing difficulties (dysphagia), Candida infections, lymphedema, mucositis, radiation-induced side effects (such as stomatitis, trismus, and xerostomia).

Early diagnosis and treatment generally lead to a high cure rate.
HPV-positive tumors often respond better to chemo- and/or radiation therapy, resulting in a favorable prognosis.
Prevention strategies involve cessation of tobacco use (smoking, chewing, pipes), alcohol avoidance, regular dental checkups, a balanced diet, and HPV vaccination.

Patients with oral cancer require regular dental visits, typically every 3 to 6 months.
These visits are crucial for monitoring disease recurrence or progression and recognizing any treatment-related complications.