Brief overview
- What is oral cancer? A malignant tumor that affects the mucosa of the inner wall of the cheek, floor of the mouth, palate, and tongue, as well as the jaw, salivary glands, and lips, among others
- Causes: Pathological transformation or new formation of cells of the skin or mucosa, triggered by carcinogenic substances (carcinogens).
- Risk factors: Nicotine (tobacco) and alcohol, human papillomaviruses (HPV), possibly genetic influencing factors, consumption of betel nuts
- Treatment: Depending on the tumor stage: surgical removal (resection) if possible with reconstruction, radiotherapy and/or chemotherapy.
- Course and prognosis: Depending on the time of diagnosis and treatment, cure is possible. The earlier the treatment, the better the prognosis of oral cancer. Recurrences may occur within five years of treatment.
- Prevention: refrain from the use of tobacco of any kind, drink little or no alcohol, careful oral and dental hygiene, awareness of dental check-ups.
What is oral cancer (oral cavity cancer)?
Frequency
Oral cavity cancer is one of the most frequently diagnosed cancers worldwide. In Germany, for example, an average of about 10,000 new cases occur each year. Men between the ages of 55 and 65 are more often affected than women, who are usually diagnosed with oral cancer between the ages of 50 and 75. In Western Europe, the number of new cases per 100,000 inhabitants is 6.9 in men and 3.2 in women.
Causes
Risk factors
The main risk factors associated with the formation of oral cavity cancer include tobacco and alcohol. Excessive or chronic use of tobacco or alcohol increases the risk of developing oral cavity cancer by six times. Those who use tobacco and alcohol at the same time increase their risk of oral cancer by as much as 30 times.
Some studies indicate that human papillomaviruses (HPV) pose a risk for oral cancer. However, the estimated proportion of people currently suffering from oral cancer in whom the disease is due to HPV infection is less than five percent.
It is also suspected that a genetic predisposition additionally promotes the development of oral cancer.
Where does oral cancer (oral cavity cancer) occur?
- Floor of the mouth (cancer of the floor of the mouth, medical: carcinoma of the floor of the mouth)
- Tongue (tongue cancer, medical term: tongue carcinoma)
- Inner wall of the cheek (colloquially: cancer of the cheek)
- Hard and soft palate (palate cancer, medical term: palate carcinoma)
- Jaw (e.g., cancer of the jawbone, medical term: carcinoma of the jawbone)
- Gums (cancer of the gums, medical: gingival carcinoma)
- Lips (lip cancer, medical: lip carcinoma)
- Tonsils (tonsil cancer, medical: tonsillar carcinoma)
How can you tell if you have oral cancer?
In addition to color changes, rough, thickened or hardened areas indicate possible disease, especially if they persist for more than two weeks and are painful. Patients with oral cancer also frequently report numbness of the tongue, teeth or lips, unclear bleeding, and chewing and swallowing difficulties. The latter are due, for example, to loosened teeth or swelling in the throat.
The symptoms mentioned are sometimes signs of other, less serious diseases and must therefore be clarified with a doctor.
Is oral cavity cancer curable or fatal?
More important, however, is the severity of the disease. Comprehensive diagnostics are therefore carried out before every intervention. The results provide information about the stage of the tumor and what treatment successes and risks can be expected in each case. The final treatment plan is drawn up by an interdisciplinary team of attending physicians together with the patient.
Classification of tumor stages
Surgery
In most cases of oral cancer, surgical removal of the tumor (resection) is the treatment of choice. The advantage is that surgery and removal of the tumor – if possible – allows the damaged tissue to be examined in detail. This makes it possible to delineate the tumor more clearly and to see whether and to what extent metastases have already formed.
After a resection, which also involves removing a large proportion of healthy tissue, the affected area is reconstructed. Either directly in an operation or in follow-up treatments. For reconstruction, the body’s own tissue such as skin, bone or muscle is taken from other regions of the body and reinserted (transplanted), as far as this is possible.
Radiation therapy and chemotherapy
Typically, surgery for oral cancer is followed by radiation therapy or chemotherapy to support treatment and prevent recurrences (relapses). Both forms of therapy are used in combination or each alone. The latter is particularly the case when surgery is not possible or to alleviate symptoms.
In radiation therapy, doctors distinguish between two basic procedures:
- brachytherapy (radiation is applied directly to the tumor from the inside)
Brachytherapy is used for oral cancer mainly for smaller tumors that are easily accessible. For larger tumors in later stages, radiation is usually administered from the outside through the skin. As a rule, the radiation is administered in several small individual doses in order to avoid or reduce further damage to the surrounding healthy tissue.
Prognosis
As with other cancers, recovery from oral cancer depends on a number of factors. However, the earlier it is diagnosed, the greater the chances of cure. If left untreated, the disease progressively worsens in most cases. This means that the further the oral cancer progresses, the poorer the prognosis.
Doctors speak of a median five-year survival rate of about 50 percent for oral cavity cancer. This means that half of the patients die within five years of diagnosis. The other half, however, live longer than five years or are cured.
Can a dentist detect oral cancer?
Oral cancer often leads to the formation of metastases (tumor metastases). Under certain circumstances, the lymphatic vessels or lymph nodes as well as blood vessels, nerves and bones may also be affected. For the diagnosis, it is therefore important to perform a comprehensive examination that also includes neighboring tissue.
Initial diagnosis
It is important to attend annual check-ups at the dentist – not only for dental health, but also to detect tumors in the oral cavity at an early stage.
How can oral cancer be prevented?
To prevent oral cancer, doctors recommend avoiding tobacco and excessive consumption of alcohol. On the other hand, it is advisable to attend regular preventive checkups at the dentist and to seek advice on careful oral and dental care.
