- BACKGROUND WITH HISTORY
- DEFINATION
- CAUSES WITH PREVENTION
- SIGN & SYMPTOMS
- DIAGNOSIS
- TREATMENT
- PROGNOSIS
BACKGROUND WITH HISTORY
Tonnes of happiness convert into sorrow as soon as we hear that any of our near & dear one is diagnosed with cancer. Q Why this happens & why is it so that even hearing the name of this disease shatters all our hopes even before the start of the treatment? I would start explaining about this deadly disease with a small prayer before almighty to keep everybody healthy and cancer free.
Cancer as we all know comes from a zodiac sign and in the previous times called kankarous. In the historical times cancer was not known as a disease but it was considered as a punishment by God. Hippocrates who is also called Father of Medicine was a Greek and he believed that the body was composed of four fluids: blood, phlegm, yellow bile and black bile. Black bile in any given site in the body causes cancer. This was a general thought for next 1400 years till in 17th century the lymph theory replaced it which believed that the abnormalities in the lymphatic system caused cancer.
It wasn’t until the late 19th century that Rudolf Virchow recognized the cells, even cancerous cells, derived from other cells. In 1926 AD the Nobel Prize was wrongfully awarded for the discovery of the cause of stomach cancer as a worm.
Question now arise what is Cancer?
DEFINATION
Uncontrolled multiplication of cells which previously underwent very slow multiplication or no multiplication is called cancer in lay man terms.
Head & Neck cancer represents 6th most common cancer in the world, with oral cancer accounting for the majority of cases. From about 40,000 people diagnosed with oral cancer every year, about 8000 will die every year. Worldwide, new cases exceed 640,000 annually & the incidence (number of new cases) is on an increase. The misery behind oral cancer is that 50% cases are not diagnosed till they are not spread to surrounding tissues, at which stage 5 years survival rate is only 53%. Oral cancer is among the most understudied cancers as no molecular markers are available to inform decisions about treatment of the disease.
CAUSES: Oncogenes or cancer causing genes are activated as a result of mutation (sudden change) of the DNA.
Risk factors are:
- Tobacco
- Chewing pan
- Betel nut
- Areca nut
- Smoking
- Alcohol (heavy drinks),
- HPV 16.
ALCOHAL Acetaldehyde a breakdown product of alcohol is implicated in oral cancer.
HPV 16 Human papilloma virus is a primary risk factor of oral cancer victims.
TOBACCO Contains over 60 known carcinogens, and the combustion of it and the by products from this process, is the primary mode of involvement .Use of chewing tobacco or snuff cause irritation from the direct contact with the mucous membranes.
PREVENTION
However, you can reduce your risk factors of mouth by:
- Stopping tobacco use
- Drinking alcohol only in moderation, if at all.
- Eating a variety of fruit and vegetables because they are antioxidants and enhances our immunity.
- Avoid excessive sun exposure to your lips.
- See your dental surgeon regularly.
*** However evidence does not support a connection between oral cancer & alcohol based mouthwashes as per the studies done.
SIGNS & SYMPTOMS OF ORAL CANCER:
EARLY STAGE SYMPTOMS ARE: Persistent Red or white patches, non healing ulcer, progressive swelling or enlargement, unusual surface changes, sudden tooth mobility without apparent cause, unusual oral bleeding, Epistaxis (bleeding from nose) and prolonged hoarseness of voice.
LATE STAGE SYMPTOMS ARE: Indurated area, Parasthesia, Dyesthesia of tongue or lips, airway obstruction, chronic serous Otitis media, Otalgia, Trismus, Dysphagia, Cervical lymphadenopathy, persistent pain or referred pain & altered vision.
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DIAGNOSIS: Early diagnosis of oral cancer patients would decrease mortality and help to improve the treatment. Oral &Maxillofacial surgeons and dental surgeons can diagnose this disease at an early stage simply by intraoral and extra oral examination.
1) Lip
2) Tongue
3) Floor of the mouth
4) Palate is the common site of oral cancer
Lateral/ Ventral sides of the tongue are the most common sites for intraoral Squamous cell carcinoma (the most
common cancer) of the oral cavity.
Benign (No tendency to produce cancer) and malignant (cancer producing) tumours look identical, so there is no way
to tell by looking alone.
A non invasive brush biopsy (brush test) can be performed to rule out the presence of dysplasia (precancer) and cancer on the areas of mouth that exhibit an unexplained colour variation or lesion. A tissue biopsy should be done for confirmation.
There are 6 common species of bacteria found at significantly higher levels in the saliva of patients with oral squamous cell carcinoma (OSCC) than in saliva of oral free cancer patients. Three of the 6 are C.gingivalis, P.melaninogenica, & S.mitis , can be used as a diagnostic tool to predict more than 80% of oral cancers.
TREATMENT
- Medical
- Surgical
- Combination of both Medical & Surgical.
- Radiotherapy
- Chemotherapy
PROGNOSIS:
Postoperative disfigurement of face, head & neck
Complications of radiotherapy include dry mouth & difficulty in swallowing.
Other metastasis (spread of cancer)
Significant weight loss and loss of hair loss with chemotherapy and radiotherapy.
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Dr Ramandeep Singh, Consultant Oral & Maxillofacial Surgeon
ramansingh6301@gmail.com
Phone No. : 7973164408
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