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Understanding Oral Cancer

Overview of Hong Kong

Incidence and Survival Rates of Oral Cancer

The term “oral cavity” encompasses multiple areas, including the lips, tongue, floor of the mouth, hard palate, gums, inner cheek lining, and salivary glands. Malignant tumours developing in any of these regions are collectively termed oral cancer, which falls under the head and neck cancers category.

The global incidence of oral cancer varies significantly across regions. According to the World Cancer Research Fund, among countries with the highest oral cancer rates in 2018, Papua New Guinea in Oceania ranked first, followed by four South Asian nations: Pakistan (12.2 cases per 100,000 people), Bangladesh (9.5), India (9.1), and Sri Lanka (7.6). In contrast, European countries like the UK, Luxembourg, Poland, and Belgium reported rates below 5 cases per 100,000.

Notably, gender disparities in oral cancer incidence are pronounced. Data from the Taiwan Cancer Foundation reveals a 9:1 male-to-female ratio for oral squamous cell carcinoma. Similarly, the American Cancer Society estimates that men in the U.S. face twice the risk of developing oral and oropharyngeal cancers compared to women. While regional rates differ, males consistently exhibit higher susceptibility globally.

Survival rates, however, show no significant gender gap. Instead, the stage at diagnosis is pivotal. UK Public Health England statistics indicate that patients diagnosed with stage 1–2 oral cancer have over 90% one-year survival and approximately 80% three-year survival rates. For stage 3–4 cases, these figures drop to around 70% and 50%, respectively. Early detection and treatment are thus critical for optimal outcomes.

Oral Cancer Symptoms

Common Oral Cancer Symptoms: Be Alert for Oral Ulcers That Don't Heal

Like other types of cancer, oral cancer is linked to DNA (deoxyribonucleic acid) mutations. When the DNA in lip or oral cavity cells undergoes abnormal changes, these cells grow and divide uncontrollably, while healthy cells die. The accumulation of these abnormal cells eventually forms a tumour, leading to oral cancer, which may spread to the head or neck.

While the exact cause of these DNA mutations remains unknown, medical research has identified several risk factors that increase the likelihood of developing oral cancer, including but not limited to oral conditions:

  • Long-term and heavy use of tobacco products (e.g., cigarettes, cigars, pipes)
  • Chronic betel nut chewing, especially when combined with tobacco (e.g., Gutka, common in Southeast Asia)
  • Excessive alcohol consumption (the American Cancer Society notes that about 70% of oral cancer patients have a history of heavy drinking)
  • Prolonged exposure of lips to strong sunlight
  • Poor oral hygiene or tooth decay
  • HPV (human papillomavirus) infection through sexual contact
  • GVHD (graft-versus-host disease) following stem cell transplantation
  • Weakened immune system

In the early stages of oral cancer, patients may experience the following persistent and unhealed symptoms:

  • Pain in the lips or inside the mouth
  • White or red patches on the gums, tongue, or other areas inside the mouth
  • Swelling in the cheeks
  • Loose or painful teeth
  • Difficulty chewing or swallowing
  • Numbness in the tongue
  • Ear pain

However, these symptoms may not always indicate cancer and could be related to other conditions. If any of these signs persist for more than two weeks without improvement, immediate medical consultation is advised to determine whether oral cancer or another disease is present.

Common Diagnostic Methods

Oral Cancer Diagnosis Methods: Oral Examination and Biopsy Process

If oral cancer is suspected, doctors may perform the following examinations:

  • Physical examination – The doctor will inspect the lips and oral cavity for white patches or swelling abnormalities.
  • Biopsy – If suspicious areas are found, a small tissue sample will be removed for laboratory analysis to detect cancer cells or related abnormalities.
  • Endoscopy – A thin, lighted tube may be inserted into the throat to check for signs of cancer spread.
  • Imaging tests – To assess tumour development or treatment effectiveness, various imaging techniques may be used:
    • CT scan – Uses X-rays to create detailed images of soft tissues, helping determine tumour size, location, and potential spread to nearby tissues, lymph nodes, or lungs;
    • MRI – Similar to CT but uses radio waves and strong magnets, providing more explicit images of soft tissues and detecting potential spread to the neck, brain, or spinal cord;
    • PET scan – Involves injecting radioactive sugar solution to highlight areas with high metabolic activity (like cancer cells), helping identify distant metastases.

Based on these tests, doctors will determine the cancer stage by evaluating the tumour size and spread:

StageDescription
0Cancer is confined to the surface layer of oral cells, with no lymph node or distant spread.
ITumour ≤2 cm without invasion of nearby tissues, lymph nodes, or distant sites.
IITumour>2 cm but ≤4 cm, without regional or distant spread.
IIITumour>4 cm without lymph node or distant metastasis.
IVTumour of any size that has invaded adjacent structures (jawbone, deep tongue muscles, facial skin) or spread to lymph nodes/distant sites.

Primary Treatment Methods

Oral Cancer Treatment Methods: Surgical Resection and Flap Reconstruction

Early-stage oral cancer may be cured through various treatments, while advanced cases focus on controlling tumour growth, relieving symptoms, and improving quality of life. Treatment plans are tailored based on cancer stage, progression, and the patient’s overall health. Common approaches include:

Surgery

This direct method aims to obliterate cancerous tissue. Minor procedures or laser therapy may suffice for small tumours, often without hospitalisation. Larger tumours require general anaesthesia and may leave facial/neck scars.

Notably, surgeons often excise some surrounding healthy tissue as a precaution. If cancer has spread to lymph nodes, affected nodes and adjacent tissues may also be removed.

Radiation Therapy

Typically combined with surgery or chemotherapy (except for very early-stage cancers), this treatment uses high-energy beams (X-rays or protons) to destroy cancer cells. External beam radiation involves lying still under a machine for minutes per session. Internal radiation (brachytherapy) requires anaesthesia to implant radioactive materials near the tumour for several days. Common side effects like skin/oral pain, taste loss, dry mouth, or hair loss usually resolve post-treatment; persistent issues warrant medical attention.

Chemotherapy

Drugs are administered orally or intravenously to target cancer cells throughout the body, shrinking tumours and alleviating symptoms. Chemotherapy is sometimes paired with radiation for enhanced efficacy. Side effects—fatigue, infections (due to low blood cell counts), nausea, or mouth sores—require close medical supervision.

Photodynamic Therapy (PDT)

A photosensitising drug is injected intravenously and absorbed by cancer cells. Laser light activates the drug, producing oxygen molecules that destroy tumours. Post-treatment, patients develop temporary light sensitivity and must avoid sunlight exposure to skin and eyes.

Healthy Living

Post-Oral Cancer Surgery Care: Oral Hygiene and Speech Rehabilitation

Even after completing the treatments above, patients must continue to maintain personal care to aid recovery and reduce the risk of cancer recurrence. The most critical step is to immediately quit all forms of tobacco and alcohol, as these are significant risk factors for oral cancer. Additionally, patients may seek medical advice for methods such as massage or acupuncture to alleviate fatigue caused by various treatments.

Prevention Methods

What is the Prevention Methods of Oral Cancer?

As the causes of genetic mutations in oral cells remain unclear, the medical community has not identified a foolproof way to prevent oral cancer. However, addressing the various risk factors can help reduce the likelihood of developing cancer:

  • Refuse or quit smoking
  • Control alcohol intake and avoid excessive drinking
  • Protect lips from prolonged sun exposure
  • Regularly check teeth to detect any abnormalities in the mouth early

Frequently Asked Questions

Oral Cancer FAQs

What is the difference between oral cancer and throat cancer?

Oral cancer refers to cancer cells that grow in areas such as the lips, tongue, and hard palate, while throat cancer refers to cancer cells that grow in the soft palate, back of the tongue, and tonsils. Due to their proximity, the causes, risk factors, and treatment methods for both are pretty similar. Patients should seek professional advice based on their circumstances.

What should I do if I notice early signs of oral cancer?

As mentioned, symptoms of oral cancer include difficulty swallowing, tooth pain, and facial swelling, which may not necessarily be caused by cancer; common conditions can also lead to these symptoms. Therefore, if you notice such issues, there’s no need to panic. However, if symptoms persist or worsen, you should seek medical attention to understand the underlying causes and assess the risk of cancer.

What should I pay attention to after being diagnosed with oral cancer?

Cancer can affect emotions, but with medical guidance and appropriate treatment, there is a chance for recovery or improvement. Thus, patients should avoid excessive anxiety and seek professional advice from doctors regarding prognosis and treatment recommendations to help make better arrangements. If necessary, communicate with family, friends, or social workers to help them understand your situation and feelings, aiding you through difficult times.

Will eating be affected after oral cancer treatment?

Surgical procedures and radiation therapy can affect the movement of the mouth, tongue, and throat, leading to difficulties in eating, which is a normal phenomenon. Patients can try soft foods like scrambled eggs and yoghurt while avoiding spicy or salty foods. As the tissue heals, swelling will gradually subside, and patients can return to a regular diet. If eating difficulties persist, consult a doctor to understand the reasons.

Will speech be affected after oral cancer treatment?

Oral cancer and its treatments involve changes to the lips, teeth, tongue, or soft palate, which can affect speech ability. However, these effects are generally not profound; some individuals may struggle to produce one or two sounds accurately, but speech ability will typically return to normal or near-normal as the body heals. If problems persist after treatment, patients should consult their doctor or a speech therapist for professional advice.



▣ The information on this website has been reviewed by the HEAL Medical Team and is regularly updated according to the most recent clinical evidence. All content is provided for general informational purposes only and should not replace professional medical advice. Please consult your doctor or another qualified healthcare professional for personalized medical guidance.

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