Dr Jawaid Zargar
MBBS, MS (ENT & HNS)
Introduction
Oral cancers represent a significant global health burden affecting millions of people each year. This type of cancer encompasses a group of malignancies that can develop in various parts of the mouth including the lips, tongue, cheeks, gums and throat. While oral cancers are often treatable when detected early, they can be deadly if left unchecked. This essay delves into the world of oral cancers discussing their prevalence, causes, risk factors, symptoms, diagnosis, treatment options and prevention strategies.
Prevalence
Oral cancers are among the most common cancers worldwide. According to the World Health Organization (WHO) there were approximately 350,000 new cases of oral cancer diagnosed globally in 2020. The incidence of oral cancer varies by region with higher rates reported in Southeast Asia, South Asia and parts of Central and Eastern Europe.
Causes
The primary cause of oral cancer is the uncontrolled growth of abnormal cells in the oral cavity. These cells can form tumors which can then invade nearby tissues and in advanced stages spread to other parts of the body. Several factors can contribute to the development of oral cancers including:
a. Tobacco Use: The use of tobacco in various forms such as smoking cigarettes, cigars or pipes as well as chewing tobacco is a major risk factor for oral cancer. The harmful chemicals in tobacco can damage the cells in the mouth and lead to cancer.
b. Alcohol Consumption: Excessive alcohol consumption is another significant risk factor for oral cancer. When combined with tobacco use the risk of developing oral cancer is even higher.
c. Human Papillomavirus (HPV) Infection: Certain strains of HPV particularly HPV-16 and HPV-18 have been linked to an increased risk of oral cancer. HPV is a sexually transmitted infection that can affect the oral cavity.
d. Sun Exposure: Prolonged exposure to ultraviolet (UV) radiation from the sun can increase the risk of lip cancer.
e. Poor Diet: A diet low in fruits and vegetables may increase the risk of oral cancer. Nutrient deficiencies can weaken the immune system and make the body less capable of fighting off cancerous cells.
Risk Factors
In addition to the specific causes mentioned above there are several risk factors that can increase an individual’s likelihood of developing oral cancer:
a. Age: Oral cancer is more common in people over the age of 45 although it can affect individuals of any age.
b. Gender: Men are more likely to develop oral cancer than women.
c. Genetics: Family history and genetic factors may play a role in predisposing some individuals to oral cancer.
d. Weakened Immune System: A compromised immune system due to conditions like HIV/AIDS or organ transplantation can increase the risk of oral cancer.
Symptoms
Recognizing the early signs and symptoms of oral cancer is crucial for early detection and treatment. Common symptoms include:
a. Persistent mouth sores that do not heal.
b. Red or white patches in the mouth.
c. Swelling or lumps in the mouth, throat or neck.
d. Difficulty swallowing or chewing.
e. Persistent hoarseness or sore throat.
f. Unexplained weight loss.
g. Pain in the mouth or ear.
It is important to note that these symptoms can also be indicative of other non cancerous conditions but if they persist for more than two weeks a healthcare professional should be consulted for further evaluation.
Diagnosis
Diagnosing oral cancer typically involves a combination of clinical examinations and diagnostic tests. The following steps are commonly taken in the diagnostic process:
a. Physical Examination: A healthcare provider will conduct a thorough examination of the oral cavity, throat and neck to look for any abnormalities or signs of cancer.
b. Biopsy: If suspicious lesions or abnormalities are found a biopsy is performed. This involves removing a small sample of tissue from the affected area for laboratory analysis to determine whether cancer cells are present.
c. Imaging: Imaging tests such as X-rays, CT scans, MRI scans or PET scans may be conducted to determine the extent of cancer and whether it has spread to other parts of the body.
Staging
Once a diagnosis of oral cancer is confirmed the cancer is staged to determine the extent of its spread. Staging helps guide treatment decisions and provides valuable prognostic information. The stages of oral cancer typically range from Stage 0 (carcinoma in situ) to Stage IV (advanced cancer that has spread to distant organs).
Treatment Options
The choice of treatment for oral cancer depends on various factors including the stage of the cancer, its location and the overall health of the patient. Common treatment modalities include:
a. Surgery: Surgery involves the removal of cancerous tissue and nearby lymph nodes. In some cases reconstructive surgery may be necessary to restore the appearance and function of the mouth and throat.
b. Radiation Therapy: Radiation therapy uses high energy beams to target and destroy cancer cells. It can be used alone or in combination with other treatments.
c. Chemotherapy: Chemotherapy involves the use of drugs to kill cancer cells or stop their growth. It is often used in advanced cases or in combination with radiation therapy.
d. Targeted Therapy: Targeted therapy drugs specifically target cancer cells while minimizing damage to healthy cells. These therapies are sometimes used in cases where standard treatments have been ineffective.
e. Immunotherapy: Immunotherapy drugs boost the body’s immune system to fight cancer cells. This is a promising approach in the treatment of oral cancer.
Prevention
Prevention is a crucial aspect of reducing the incidence of oral cancer. Here are some preventive measures that individuals can take:
a. Avoid Tobacco and Alcohol: Avoid or quit smoking and limit alcohol consumption.
b. Practice Safe Sex: Reducing the risk of HPV infection through safe sexual practices and HPV vaccination is important.
c. Sun Protection: Use lip balm with sunscreen and wear hats when exposed to excessive sunlight.
d. Maintain a Healthy Diet: A balanced diet rich in fruits and vegetables can help reduce the risk of oral cancer.
e. Regular Dental Check ups: Regular dental examinations can help in the early detection of oral cancer and pre -cancerous lesions.
Conclusion
Oral cancers pose a significant health challenge globally affecting millions of people each year. While risk factors like tobacco and alcohol use continue to contribute to the prevalence of this disease the emergence of HPV related oral cancers highlights the importance of vaccination and safe sexual practices. Early detection through regular dental check-ups and awareness of symptoms can significantly improve the chances of successful treatment. Advances in treatment options including targeted therapies and immunotherapies offer hope for improved outcomes for individuals diagnosed with oral cancer. Ultimately a comprehensive approach to prevention, early detection and treatment is essential in the fight against oral cancers.
About the Author
(The author is an ENT Specialist and has recently started a You Tube channel by the name of DOCTORJ which will feature latest and knowledgeable scientific videos on health related topics.
You Tube link: https://www.youtube.com/@Drjawaidzargar
Facebook link: https://www.facebook.com/jawaid.zargar.9?mibextid=ZbWKwL
For any queries the author can be reached at [email protected])
