Oral cancer

Also known as oral cancer or a malignant oral tumour, oral cancer presents as a swelling or a lesion on the oral mucosa that does not heal, caused by the uncontrolled growth and division of cells. According to Dent Estet specialist Vanda Popa, a Doctor of Medical Sciences and specialist in Periodontology, oral cancer can occur in several areas of the oral cavity. It can be found on the surface, edges or back of the tongue, on the inside of the cheeks, on the hard or soft palate, on the upper lip, as well as on the gums or inside the jaws. The symptoms of this type of cancer are not visible to the naked eye in the early stages, and its spread is rarely associated with acute pain.

Detected at the dentist’s surgery, sometimes even during dental treatment, oral cancer can affect men and women of any age, but is particularly common in people over the age of 45.

Carcinoma

One of the most common types of cancer is squamous cell carcinoma. In this case, the flat cells that normally line the inside of the cheeks, tongue, gums, palate and throat appear abnormal. Most often, this cancer affects men aged between 55 and 65, as well as women aged 50–75.
 

Adenocarcinoma

Formed in glands that secrete substances into or outside the body, oral adenocarcinoma mainly affects the minor salivary glands lining the mouth and throat.
 

Sarcoma

Approximately 80% of all these malignant tumours are found in soft tissues. Developing in the submucosa of the oral cavity, this type of malignant tumour is also known as Kaposi’s sarcoma. Found in older people, particularly men, sarcoma has a slow progression that can last for up to 15 years. The presence of HIV in the body is a factor that increases the risk of developing this type of cancer.
 

Melanoma

Located in the cells that produce skin pigment, also known as melanocytes, this type of cancer manifests as swollen, dark-coloured malignant lesions, which may sometimes be accompanied by bleeding.
 

Lymphoma

Although this cancer usually occurs in the cells of the lymph nodes, it can also be found in the oral cavity. Developing in lymphoid tissue, these oral cancers also affect other areas containing lymphoid tissue, such as the tonsils and the base of the tongue.

Twice as common in men as in women, oral or oropharyngeal cancer typically develops at an average age of 62. Two-thirds of those affected by this serious condition are over 55. The causes of oral cancer include both lifestyle factors and genetic predisposition. 

Predisposing factors

Fanconi anaemia is a blood disorder caused by congenital abnormalities, which can lead to leukaemia or aplastic anaemia. The risk of oral cancer in a person who already has Fanconi anaemia is up to 500 times higher than normal. Congenital dyskeratosis is another genetic syndrome that can cause aplastic anaemia and may lead to oral cancers from an early age
 

Smoking

The habit of smoking cigarettes, cigars and even pipe tobacco is not only harmful to the lungs, but also to the health of the tissues in the oral cavity. The immediate effect of smoking is a weakened immune system and a slower recovery following surgery. The larynx, throat, oesophagus, as well as the membranes lining the tongue, throat and lips are 50% more likely to develop cancer in smokers.
 

Excessive consumption of alcoholic beverages

Reducing alcohol consumption or even eliminating it from one’s lifestyle is one of the factors that reduces the risk of oral cancer. The ethanol and acetaldehyde in alcohol have a direct effect on the development of cancer cells in the tissues of the oral cavity.
 

Unbalanced diet

The lack of a varied, healthy and balanced diet is one of the risk factors that contribute to the development of oral cancer. Including a variety of fruit and vegetables in your diet, as well as avoiding highly processed foods, is a simple way to reduce the risk of developing oral cancer.
 

Prolonged exposure to the sun

Spending too much time in strong sunlight is one of the most dangerous risk factors for oral cancer. The incidence of lesions on the lips is higher among younger people.
 

Papillomavirus

The human papillomavirus affects the skin and the moist membranes lining the organs, the mouth and the throat. HPV infection, which can be transmitted through normal or oral sexual contact, as well as through skin-to-skin contact, causes uncontrolled cell proliferation in the tissues and is another factor that can lead to oral cancer.
 

Recurrent lesions of the oral mucosa

Oral cancer can, in some cases, be caused by persistent sores on the oral mucosa resulting from the sharp edges of damaged teeth or ill-fitting dentures. 

Signs that may indicate the development of oral cancer include the following:

• sores that do not heal;
• pain that does not improve;
• bad breath;
• tooth loss;
• swelling or inflammation of the lips;
• difficulty or pain when swallowing;
• bleeding or numbness in the mouth;
• difficulty speaking;
• sudden weight loss.

Physical examination

The Oral Cancer Screening test can detect oral cancer in its early stages in just three minutes. The procedure, which uses Sapphire Plus Lesion Detection and Velscope VX lights, is non-invasive, quick and completely painless. The dentist examines the oral cavity using a device fitted with a built-in digital camera, which provides a detailed image and allows for in-depth scanning of all areas that may contain pre-cancerous or cancerous cells that cannot be seen with the naked eye. The technologies used by the two types of lamps help to detect infections, abnormalities and tumours present in the oral cavity and oral mucosa. Screening for oral cancer also includes an additional clinical examination carried out by the dentist.
 

Biopsy

If symptoms suggestive of oral cancer are present in a section of tissue, a sample will be taken. The specialist will send the tissue sample to the laboratory for a biopsy. This procedure, which involves examining suspicious cells under a microscope, reveals any cancerous or precancerous changes that may be present.
 

Blood tests

Immunoglobulin electrophoresis helps detect abnormalities in immunoglobulins, and tests for tumour markers can reveal the presence of oral cancer. The results of these types of tests must be interpreted with care, and their accuracy varies depending on the patient’s current physical condition and the diet they are following during the testing period.
 

Imaging tests

Using conventional X-rays and CT scans, MRIs and positron emission tomography, the specialist can determine the extent to which cancer cells have spread within the oral cavity.

If tests confirm the presence of oral cancer, treatment for this condition must be administered in accordance with the specialist’s recommendations. The most commonly used methods include:

Surgery: this procedure removes the tumour, along with a portion of the surrounding tissue. Some people may require multiple surgical procedures, depending on the stage of the tumours and where they have developed.

Radiotherapy: used alongside surgery, radiotherapy involves external beam therapy, using high-energy X-rays or protons. Internal radiation therapy uses a radioactive implant placed within the target tissues affected by cancer. Regardless of the type of radiotherapy, it involves side effects such as difficulty speaking and chewing, as well as hearing loss, hypothyroidism and other similar symptoms.

Chemotherapy: in the case of advanced cancers, chemotherapy is administered before surgery or radiotherapy, over a period of several months. The drugs used in the treatment are administered orally or by injection, and they work by slowing down or even blocking the growth of cancer cells. 

Statistics and prognosis

Oral cancer ranks among the leading causes of cancer-related deaths worldwide. The areas currently most severely affected by this condition include the lips, gums, tongue and palate. According to an analysis by the National Centre for Health Assessment and Promotion, Europe accounts for 23.4% of cancer cases worldwide and 20.3% of deaths caused by this disease, despite comprising only 9.0% of the global population. Nationally, the estimated figure for cancer-related deaths stands at 50,902, but at least a third of the most common cancers can be prevented.  

 
What prevention methods can be applied

The grim reality of cancer is reason enough for major lifestyle changes. If you’re not sure where to start, to minimise the risks of such a disease as much as possible, you can follow a few simple steps:

• Give up smoking to stop the effect of chemical compounds on the cells of the oral cavity;
• Drink alcohol in moderation to reduce irritation of the cells in your mouth;
• Include fruit and vegetables in your diet for a steady supply of antioxidants;
• Avoid excessive sun exposure and protect your lips with a lip balm containing sun protection;
• Visit your dentist regularly for early detection of cancerous lesions.

No matter how severe an apparently incurable disease may be, the right preventive measures can help to drastically reduce the risks. Modern technology and specialists who keep constantly abreast of innovations in the medical world are a true guarantee of predictable health.