Oral cancer forms in tissues of the oral cavity (the mouth). More than 75% of mouth cancers of the world occur in India. Oral cancer is the sixth most common cancer among men. In India, around 555 000 people died of cancer in 2010 (The Lancet Today).
Causes and risk factors
• Smoking - Cigarette, cigar, or pipe smokers are six times more likely than non-smokers to develop oral cancers.
• Chewed tobacco/ “Gutka” users - Users of chewing tobacco products are 50 times more likely to develop cancers of the cheek, gums and lining of the lips.
• Excessive consumption of alcohol- Oral cancers are about six times more common in drinkers than in non drinkers.
• HPV Virus - Human Papilloma Virus (HPV) has been proven to be a causative factor for throat cancer. This is a sexually transmitted virus and oral infection by HPV occurs as a result of oral sex. The infection is generally asymptomatic but predisposes the person to develop a cancer later in life.
Symptoms of oral cancer
• Swellings/thickenings, lumps or bumps, ulcerated areas on the cheeks, tongue, gums, or other areas of the mouth
• Development of velvety white, red, or speckled (white and red) patches in the mouth
• Unexplained bleeding in the mouth
• Difficulty chewing or swallowing, speaking or moving the jaw or tongue
• Persistent ear pain
• Change in the way your teeth or dentures fit together
• Lump in the neck
Diagnostic tests for oral cancer
Biopsy is where a very small piece of tissue is taken for evaluation by the pathologists. A widely prevalent myth is that a biopsy will cause the cancer to grow faster. This is unproven and unscientific, as a biopsy will not change the natural speed of growth of the cancer.
Tests for detecting/staging of cancer
PET Scan is the most advanced test used for complete staging of the locally advanced oral cancers. As an addition to the other procedures, PET scanning detects tumors faster, even before they are visible anatomically through other studies.
MRI is a highly specialized imaging of the affected area. Medanta is among few top hospitals in the Delhi/NCR who have the latest technology in MRI called 3 TESLA MRI machine. It is the most powerful scanner available today.
CT Scan is done to determine the size, shape, and position of a tumor and whether the cancer has spread. At Medanta, we use a 256 slice "wide-area" computed tomography scanner, with four times the capacity of the previous generation of multi-slice scanners with significantly reduced dose of radiation.
Treatments available for oral cancer at Medanta
Oral cancer is treated with surgery to remove the cancerous growth. This may be followed by radiotherapy and/or chemotherapy (drug treatments) to destroy remaining cancer cells.
Surgery is a common treatment for oral cancer to remove the tumor in the mouth or throat. Sometimes the surgeon also removes lymph nodes in the neck. Other tissues in the mouth and neck may be removed as well.
Carbon dioxide Laser Resection - At Medanta, CO2 laser resection is performed for small oral cancer. It is a minimally invasive procedure, thus, results in minimal scarring, less pain and faster recovery. Medanta is one of the few centres with the expertise and equipment required to perform carbon dioxide laser resection.
Robotic Surgery - For patients diagnosed with benign or malignant tumors of the mouth and throat, Trans Oral Robotic Surgery (TORS) is performed at Medanta. It is a minimally invasive, virtually scarless treatment. This is performed utilizing state of the art da Vinci surgical system. Medanta is one of the two centres performing TORS in Delhi/NCR.
Free Flaps- In more advanced stages, large operations are required with complex reconstruction of major portions of the mouth. Today, using microvascular free flaps, excellent functional and cosmetic reconstruction of the tongue, jaw and cheek can be done. Medanta is one of the few centres to perform free flaps for oral cancer.
Radiation Therapy (also called radiotherapy) is a type of local therapy. It affects cells only in the treated area. Radiation therapy is used for small tumors or for patients who cannot have surgery. It may be used before surgery to kill cancer cells and shrink the tumor. It may also be used after surgery to destroy cancer cells that may remain in the area. At Medanta, we use Cyberknife Robotic Radiosurgery System to treat cancer. It is world's first system, designed to treat tumors of all kinds anywhere in the body. With its unique precision and accuracy, it treats both static and moving lesions and tumors, giving surgeons the power to treat patients non-invasively, with successful outcomes.
Chemotherapy uses anticancer drugs to kill cancer cells. It is called systemic therapy because it enters the bloodstream and can affect cancer cells throughout the body.
