Oral Cancer PDF

Oral Cancer Dr. Muhammad Reihan, MD Associate Professor Internal Medicine Department  Epidemiology Risk Factors Clinical Features Diagnostics Treatment Complications of Treatment Dental Care Considerations  Oral Cancer Definition: Oral cavity cancers refer t...

Oral Cancer Dr. Muhammad Reihan, MD Associate Professor Internal Medicine Department  Epidemiology Risk Factors Clinical Features Diagnostics Treatment Complications of Treatment Dental Care Considerations  Oral Cancer Definition: Oral cavity cancers refer to malignant tumors of o Oral mucosa o Tonsils o Salivary glands Epidemiology: Peak incidence: 55–60 years Sex: > 2:1 The most common form of head and neck cancer  Oral Cancer Aetiology: Types of cancers in the oral cavity Oral mucosal cancer: squamous cell carcinoma (most common); ulcerative or verrucous growth Salivary gland cancer: usually mucoepidermoid carcinoma (see Malignant tumors of the salivary glands) Tonsillar cancer: squamous cell carcinoma (most common, > 70%), lymphoma  Oral Cancer Risk factors: Tobacco consumption Alcohol Chronic mechanical irritation (e.g., badly positioned dentures) Human papillomavirus Precancerous lesions (leukoplakia, erythroplakia, erythroleukoplakia)  Oral Cancer Clinical Manifestations: Halitosis Pain Dysphagia Non-healing ulcer Unusual bleeding in the mouth Facial swelling Lymphadenopathy  Oral Cancer Common signs and symptoms  Oral Cancer Stages The stages for oral cavity cancer are: TI: The tumor in the mouth measures 2 centimeters or less. T2: The tumor is 2 centimeters or more but isn’t larger than 4 centimeters. T3: The tumor is larger than 4 centimeters.  Oral Cancer Diagnostics: Biopsy and histopathology of the lesion Panendoscopy: assessment of tumor extent HPV testing Chest x-ray, axial CT: assess tumor spread PET-CT Tumor markers  Oral Cancer Management: Localized tumor: surgical resection Tumors with local spread : surgery (usually with neck dissection) + radiation therapy, with or without chemotherapy Inoperable tumors: radiation therapy with adjuvant chemotherapy Surgical procedures Maxillectomy, mandibulectomy Glossectomy , laryngectomy Neck dissection  Oral Cancer Complications of treatment: Altered oral flora Dysphagia Candida infection Lymphedema Mucositis Radiation carries Stomatitis Trismus Xerostomia  Oral Cancer Prognosis Early diagnosis and treatment usually result in a good curative rate. HPV-positive tumors have a good prognosis since they respond better to chemo- and/or radiotherapy.  Oral Cancer Prevention What can a patient do to prevent developing oral cancer? Stop smoking , chews tobacco or uses a water pipe. Stop alcohol drink. Remember sunscreen. Use UV-AB-blocking sunscreen on the face and sunblock. Vaccination for human papillomavirus. Eat a well-balanced diet. Have regular dental check-ups. People between ages 20 and 40 should have an oral cancer screening every three years and annual exams after age 40.  Oral Cancer Dental care for the patient with oral cancer Regular recall visits (3-6 months) Monitor for disease oRecurrence oprogression Recognize complications of treatment  Practice Questions A 60-year-old man with longstanding history of smoking presents to the dental clinic for a routine scaling. The dentist notes a 5 cm neck swelling which is non- painful. The patient didn’t notice this before. What is the best course of action? A. Referral to a medical doctor for further evaluation B. Reassurance as it will most likely resolve on its own C. Referral to a cosmetician to hide it with make up D. Attempt a bedside fine needle aspiration  Oral Cancer Care Foundation References & Harrison’s Principles of Internal Medicine further reading 20th edition Burkett's Oral Medicine 12th edition Thank You