There are over 300,000 cases of oral and lip cancer worldwide. Oral cancer, also known as mouth cancer, develops in the mouth’s tissues (oral cavity). Men are at a higher risk of getting it than women.

WHAT IS ORAL CANCER?

This is a life-threatening condition if not diagnosed and treated early. It presents itself as growths or sores in the mouth that do not go away. Many cases are discovered when it has already spread to the neck lymph nodes. It is essential to have regular dental visits, which involve an examination of the mouth, lips, throat, and face. Additionally, your doctor may also screen you for oral cancer. To be safe, it is essential to know the early signs of oral cancer should they occur.

Oral cancer occurs in the following areas of the body;

• Roof of the mouth
• The last part of the tongue
• Lips
• Cheeks
• Tonsils
• Gums
• The sides and back of the throat
• Sinuses
• Inner lining of the cheeks mouth
• Floor of the mouth

There are several types of mouth cancers, categorized as head and neck cancers Cancer that affects the mouth and the oropharynx is known as oropharyngeal cancer.

GRADES AND STAGES OF ORAL CANCER

The stages and grade of oral cancer help determine your treatment. It also lets the doctors know how cancer might behave or present itself. The three grades include:
Grade 1: This means that the cancer cells look like typical mouth cells. It is a low grade of oral cancer.
Grade 2: This is the intermediate grade. It looks slightly different than typical mouth cells.
Grade 3: This is the highest grade, and the cancer cells look abnormal, unlike the normal mouth cells.

A physical examination and the results of your tissue biopsy will determine the stage of your cancer. The following are the basic stages of oral cancer:
Stage 0 Mouth Cancer: It is also known as carcinoma in situ (CIS), the very early stage of oral cancer. In this stage, the abnormal cells in the lip lining and oral cavity are likely to become oral cancer.

Stage I Mouth Cancer: This describes the earliest stage of invasive cancer, meaning the tumor has not spread to the lymph nodes, tissues, or other organs. The tumor is not more than 2 centimeters and is 5 millimeters deep or less.

Stage II Mouth Cancer: In this stage, cancer has not spread to the nearby lymph nodes or organs, and the tumor is 2 centimeters or smaller but not more than 4 centimeters, deeper than 5 millimeters, but not deeper than 10milimetres.

Stage III Mouth Cancer: The cancer is any size, but one lymph node contains cancer cells, and the tumor is larger than 4 centimeters.

Stage IV Mouth Cancer: This means cancer has advanced. It may be any size and has spread to nearby tissues, other parts of the oral cavity, and areas beyond the mouth such as the lungs. The lymph nodes are more than 3 centimeters in size.

ORAL CANCER SYMPTOMS

Common symptoms include:

• Mouth pain
• Chronic bad breath
• Loose teeth
• Ear pain
• Dramatic weight loss
• Mouth sores that do not heal
• Unexplained bleeding in the mouth
• Numbness, loss of feeling in the face area, mouth, or neck
• Soreness or feeling like something is caught at the back of the throat
• White or red patch on the inside of the mouth
• Hoarseness, chronic sore throat, or change in voice
• A growth, swelling, bump, crusts, or lumps inside the mouth
• Pain or difficulty swallowing or chewing
• Lower lip, neck, face, or chin numbness

WHEN TO SEE A DOCTOR

You should make an appointment with your doctor as soon as you have persistent pain lasting more than two weeks or an infection.

ORAL CANCER CAUSES AND RISK FACTORS

The exact cause of oral cancer is not known. The following factors may increase the risk of oral cancer:
Most mouth cancers begin in the squamous cells lined up in the lips and the inside the mouth cavity. Mouth cancers develop when lips or mouth cells mutate their DNA. The mutation changes inform the cells to continue growing and multiply while the healthy cells continue to die. A tumor is formed by the accumulated abnormal cancer cells. The cancerous cells spread to other areas in your mouth and eventually other body parts.

Human papillomavirus (HPV) is a sexually transmitted virus and those sexually active get HPV at some time in life. This virus causes cancers of the mouth, especially in men over 50 years and those with multiple sexual partners.

Other risk factors include:

• Gender: Men are more likely to have oral cancer than women
• Age: Most people get it after 55 to 60 years
• Family history of oral cancer
• Smoking: Cigarette and cigar smokers are six times more likely to get it than nonsmokers.
• Tobacco users: Chewing tobacco, snuff, or dip users are 50 times more likely to develop cancers of the gum, cheek, and lining of the lips
• Alcohol consumption: Excessive alcohol can increase the risk of oral cancer six times more than nondrinkers.
• Poor diet: Studies link oral cancer with not eating enough fruits and vegetables.
• Excessive exposure to the sun’s ultraviolet rays (UV) especially when young, can cause lip cancer.
• A weakened immune system can increase the risk of oral cancer.

ORAL CANCER DIAGNOSIS

The determination of tests to be done is based on your condition. Tests include:
Physical examination: An oral screening exam is done by a dentist who will check and feel any lump or tissue changes in the neck, head, face, and oral cavity. They will look for any sores or discolored tissues and other abnormalities.

An endoscopy might be done to get a better look into your mouth. Cell samples may also be examined under a microscope. Your doctor may take biopsy samples depending on the nature of the problem.

Your doctor may order imaging tests to determine how far it spread. They include:

• X-rays to show the areas cancer cells have spread
• CT scan to reveal the tumors present and where
• MRI to show the head and neck images and determine the stage of cancer.
• PET (Positron emission tomography) to determine if the lymph has been affected, including other organs
• Endoscopy to examine the sinuses, inner throat, windpipe, nasal passages, and tracheas.

ORAL CANCER TREATMENT

Treatment depends on:

• Whether cancer cells have spread to other parts of your body
• Size and location of the main tumor
• Your overall body health
• Type of oral cancer
• Your age

Treatment options include:

• Radiation therapy and chemotherapy
• Drugs to destroy any remaining cancer cells
• Drugs like ibuprofen or acetaminophen and stronger ones like morphine for pain relief
• Nutritious food that is gentle and smooth to the throat because poor appetite and weight loss are common
• Mouth hygiene is crucial. Keep the mouth moist, gums and teeth clean
• Immunotherapy helps boost the immune system
• Targeted therapy for early and advanced stages of growth
• Surgery to remove the cancerous growth. The tumor’s location determines the type of surgery.

PREVENTION

There is no proven way to prevent oral cancer. However, you can minimize the risk by:

• Quitting smoking or use of any tobacco-based products
• Drink alcohol in moderation or stop drinking altogether
• Eat a well-balanced diet
• Limit excessive sun exposure and wear a UV-A/B-blocking sunscreen and wide-brimmed hats to protect your lips and face from the sun
• Make an appointment with your dentist regularly
• Practice good oral habits by brushing and flossing twice daily
• Conduct a self-examination test at least once a month, like feeling your lips and gums and looking at them to check for abnormalities.
• Oral cancer screening for people in the age bracket of between 20 -40 years is essential