Oral and Oropharyngeal Cancer: What You Should Know Part 2

In a previous article, we discussed the prevalence, development, and risk factors for oropharyngeal cancer. Today, we will tackle the signs and symptoms, treatment options, and preventive measures for the disease responsible for the death of at least one person per hour.

Possible Signs and Symptoms

For most cancers, the danger lies in its progression. In the case of oral cancer, one of its real threats is during its early stages since it can go unnoticed. This disease of the mouth can be painless, accompanied by zero evidence of physical change. The good news is, however, that your general practitioner or dentist can, in most cases, trace or feel the precursor tissue changes while it is still small.

The area infected with the disease may appear as a white or red patch of tissue in the mouth, or an indurated ulcer which resembles a common canker sore.

It is important to remember that several benign tissue changes frequently occur in your mouth. Some of these benign tissues could be as simple and harmless as a bite on the inside of your cheek, which may mimic the look of a dangerous and cancerous tissue change. If you possess any sore or discolored area inside or around your mouth that does not heal within two weeks, make sure to consult a professional as soon as possible.

More common and noticeable symptoms of oral cancer include a conspicuous lump inside the mouth or neck, which causes pain or difficulty in chewing, swallowing, or speaking. In addition, any wart-like masses, hoarseness that lasts for a long time, and any numbness in the facial region are forewarnings. Unilateral persistent earache or otalgia is also a rare, yet possible warning sign.

Where It Develops

The lips are not a major site for oral cancer occurrence, but it is possible to develop the disease around this external area. More common areas for the oral disease to develop are in the anterior (front) of the mouth, the floor of the mouth, and on the tongue. If you favor chewing tobacco, you are more likely to have cancer develop in the sulcus between the lips or cheeks, and the soft tissue (gingiva) covering the bottom jaw (mandible) where the plug of tobacco or cigars is repeatedly held.

There is also a small percentage of cancers unique to the salivary glands and the very dangerous melanoma. In the United States alone, cancers of the hard palate are quite uncommon, though not unknown. These include the base of the tongue located at the back of the mouth, the oropharynx, the pillars of the tonsils, the tonsillar crypt, and the tonsil itself. These cases usually develop in the mouths of young, non-smoking individuals.

If your doctor or dentist finds that an area is suspicious or in danger of oral cancer, the only way to determine whether it’s harmless or cancerous is to do a biopsy of the area. It is crucial to have a firm diagnosis as early as possible. Your general dentist or medical doctor may also refer you to a specialist to have the biopsy performed. This should not be cause for alarm since it is a normal and recurring part of medical referring — a standard practice between doctors of different specialties.

Treatment Options

There are varying treatments for oral cancer, which all depend on the tumor site and how far the disease has spread (stage). The approach may be different for each site, and your doctor may suggest a treatment option not mentioned in this list.

1. Stage 0 (carcinoma in situ)

There is a good reason why doctors say that early diagnosis is key to defeating nearly all types of cancer. Almost all patients at this stage survive without the need for more intensive treatment. Oral cancer in this stage has not become invasive, but it can grow into deeper layers of tissue if left untreated. The usual procedure undergoes surgical stripping or thin resection, where the top layers of tissue along with a small margin of normal tissue are surgically removed.

2. Stages I and II

Most patients with stage I or II oropharyngeal cancer are successfully treated with surgery or radiation therapy. Chemotherapy may be given alongside radiation, primarily to eliminate any traces of cancer cells left after surgery. As all radiation and chemo procedures, they have their fair share of side effects. These include the impact on your physical appearance, and how the treatment may hinder your ability to speak and swallow during the recovery stage.

3. Stages III and IVA

Stages III and IVA indicate that oral cancer has grown into nearby tissues and have spread to adjacent lymph nodes in the neck. These cancers are larger in size and often treated with a combination of surgery and radiation. Surgery is usually done first and includes the removal of neck lymph nodes.

4. Stage IVB

Like most chronic diseases, oropharyngeal cancer that has already spread and affected other parts of the body are commonly treated with chemotherapy, cetuximab, or a combination of both. Other treatments may include radiation to help relieve symptoms or to help in preventing problems from occurring.

Recurrent Oral or Oropharyngeal Cancer

Cancer coming back or recurrence can be local, meaning it could reappear in or near the same place it started. Recurrence can also be regional or near the lymph nodes, or distant and spreading to bones and organs such as the lungs. Treatment options for recurrent cancers highly depend on the location and size of the tumor, what treatments had been previously administered, and on the person’s general health.

Visit Your Dentist Today

Anyone can get oral cancer. Factors like your genetics, lifestyle, and a very rare case of bad luck may increase your likelihood of developing the disease. As with most cancers, the risk of development increases with age. If you have persistent signs and symptoms that bother you and last more than 14 days, make an appointment with Kyrene Family Dentistry. We will first assist in investigating other common causes for your signs and symptoms, such as an infection. Call us today at 480-705-9005.