Oral cancer can affect any part of the oral cavity and cases are expected to increase in the coming years. Although there are risk factors that enhance it, a good diagnosis and early treatment are essential.
Oral Cancer: What it is.
Oral cancer can be defined as any malignant tumor that affects the structures of the oral cavity (lip, tongue, floor of the mouth, jugal mucosa, retromolar trigone, alveolar gingiva and palate). It constitutes a real public health problem. According to the World Health Organization (WHO) there is an increase of 5,000 cases per year, and an even greater increase is expected in the coming years.
Oral cancer constitutes 2-4% of all malignant tumors in the body. In Spain the prevalence is 11-15 cases per 100,000 inhabitants in men and 2-6 cases per 100,000 inhabitants in women. It has the third highest prevalence in the European Union.
It predominantly affects a middle-aged population, with the average age of diagnosis being 62 years. The risk of developing oral cancer increases with age. In terms of gender, it is three times more frequent in men than in women. By race, it is more common in African-Americans and Southeast Asians than in Caucasians.
Areas where oral cancer usually manifests itself.
In terms of location, although it can develop in any oral structure, such as the lip, tongue, floor of the mouth, jugal mucosa, retromolar trigone, alveolar gingiva and palate, the lower lip is the most frequent site of presentation, followed by the tongue.
Risk factors that promote oral cancer. Diagnosis.
According to experts in Oral and Maxillofacial Surgery, there are known risk factors linked to the development of oral cancer: Tobacco, alcohol, betel and human papillomavirus (HPV) infection are the most frequent. Other factors with which it is related are:
– Certain infectious agents (Candida, Treponema pallidum, herpes simplex, HIV).
– States of immunosuppression.
– Nutritional deficiencies (iron, vitamin A).
– Poor oral hygiene.
– Oral trauma.
-Chemical irritants (silver nitrate).
In general, we find the highest rates of oral cancer in the sectors of the population with the worst socioeconomic situation, where poor oral hygiene, the use of maladjusted or defective dental prostheses, nutritional deficits, and a high consumption of tobacco and alcohol, increase the risk of developing this type of cancer. In contrast to this profile, there is the younger, non-smoking patient, who would develop oral cancer linked to infection of the epithelium of the mouth by the human papillomavirus, a cancer with a better prognosis than that produced by the classic risk factors (tobacco and alcohol).
In any case, early diagnosis is essential to improve the prognosis of these patients. The identification of flat lesions of white or reddish coloration, or painful ulcers or sores would be alarm signs. Any lesion of these characteristics in the oral cavity should be evaluated by a maxillofacial surgeon.
Treatment of Oral Cancer.
Regarding the treatment of oral cavity cancer, the multidisciplinary approach (maxillofacial surgeon, oncologist, radiologist, nutritionist, etc.) remains the treatment of choice. In all cases, the optimal treatment for each patient will be selected according to:
-Tumor characteristics (location, size, proximity to bone, cervical involvement, previous treatment, tumor histology).
-Patient idiosyncrasies (age, comorbidities, habits, profession, tolerance to the aggressiveness of the treatment).
– Means and experience of the medical team.
Depending on the above aspects, the therapeutic tools available will be surgery, radiotherapy and chemotherapy.
Quality of life of patients with oral cancer and success of treatment.
Regarding the quality of life of oral cancer patients, complete oral rehabilitation, including dental prostheses, is important. Good therapeutic planning will help the patient to recover his aerodigestive-digestive functions as soon as possible, accelerating social integration with the help of a speech therapist.
Regarding the prognosis of oral cancer, survival at 5 years in early stages is around 82%, while late diagnosis would decrease survival to 53%. The overall survival rate for oral cancer is 60%; that is, 40 out of every 100 patients diagnosed with cancer of the oral cavity die from this cause. As important as the treatment is the follow-up of the patient. Recurrences generally occur during the first year after initial treatment.
In conclusion, early diagnosis and optimal early treatment, individualized for each patient and performed by a qualified medical team, remain the keys to success against oral cancer.