Oral Cancer: What It Is, Causes, Symptoms, and Treatment

Oral cancer is a global health problem and ranks second in frequency among head and neck cancers in our country, with developed countries being the most affected. As with many conditions, early diagnosis and treatment are crucial for this type of cancer. Oral cancer, which is classified under head and neck cancers, refers to cancers that develop in any part of the mouth area, including the inside of the cheeks and gums. This malignant tumor, also known as oral cancer, typically originates from the squamous (flat) cells in the mouth, tongue, and lips. To learn more about this cancer type, you can continue reading the article.

What Is Oral Cancer?

Oral cancer refers to malignant neoplasms (new tissue formation) that occur on the lips or inside the oral cavity. When examining the cellular differentiation of oral structures, it is found that approximately 90% of them are composed of squamous cells and originate from the epithelial tissue of the region. However, this cellular origin may undergo various degrees of changes depending on the progression of the disease. Over time, as it gains invasive properties, it can spread to surrounding tissues and lymph nodes, so caution is required.

What Are the Types of Oral Cancer?

The areas considered under oral cancer can be summarized as follows:

• Lips,
• Tongue,
• Floor of the mouth,
• Inner surface of the cheeks,
• Gums,
• Roof of the mouth or palates.

The tongue and floor of the mouth are the most common sites. Given that oral cancer types are typically found within the oral cavity and early diagnosis is critical, it is clear how important regular checkups with dentists are. Dentists are usually the first healthcare providers to detect tumor formations in these areas.

What Are the Causes of Oral Cancer?

Oral cancers occur as a result of mutations in the DNA of cells in the lips or oral cavity. The DNA structures within the nuclei of cells contain the genetic codes that plan, initiate, and terminate all metabolic functions of a cell. Due to mutations, the cell cycle can become disrupted. The loss of this cycle leads to uncontrolled cell growth and division. As healthy cells' spaces and nutritional resources are invaded, surrounding healthy cells can no longer survive. This causes cancer cells to continue spreading. Through this mechanism, cancerous cells first produce abnormal tissue growth (tumors). Subsequently, they can spread to other parts of the body, starting with the head and neck area.

The cells from which oral cancer originates are the flat cells that line the surface of the mouth and lips. Although it is not yet fully understood what triggers mutations in these cells, there are several risk factors that may play a role in the development of oral cancer:

• Use of tobacco and various tobacco products,
• Infection with certain strains of the Human Papillomavirus (HPV), especially "HPV types 16 and 18," which can trigger cancer development,
• A history of head and neck cancer in the individual,
• Poor oral hygiene.

In addition to these basic risk factors, it can be said that some individuals may have a predisposition to oral cancer. The following risk factors can increase susceptibility:

• Increased UV (ultraviolet) radiation exposure due to sunlight or other sources (the primary trigger for lip cancer),
• Gastroesophageal reflux disease,
• Previous radiation treatments in the head and neck region for various reasons,
• Exposure to chemicals such as asbestos, sulfuric acid, or formaldehyde,
• The formation of long-term sores in the mouth due to dental and gum problems.

What Are the Symptoms of Oral Cancer?

As with all diseases, the symptoms of oral cancer can vary from person to person. Generally, common symptoms observed in this patient group include non-healing sores and pain inside the mouth. Some types of oral cancer may also appear as red or white patches on the gums, tonsils, or inside the mouth. In addition to these, other symptoms that may occur alongside oral cancer are as follows:

• Swelling in the neck,
• Lump development in the cheeks,
• Problems with swallowing or chewing,
• A constant sensation of something being stuck in the throat,
• Difficulty moving the jaw and tongue,
• Weight loss,
• Persistent bad breath,
• Unchanging ear pain,
• Tooth loss,
• Bleeding in the mouth,
• Numbness in the lower lip, face, and neck area,
• Tongue pain.

It should be noted that many of these symptoms can also occur in some other less serious conditions. If you observe any of these symptoms and they persist for more than three weeks, it is crucial to seek medical attention without delay.

How is Oral Cancer Diagnosed?

After presenting with oral cancer symptoms at a healthcare facility, doctors first conduct a medical history and physical examination. During these procedures, the patient's symptoms and family history are reviewed, while also observing the oral structures. In addition to the floor of the mouth, palate, back of the throat, tongue, and inner cheeks, the lymph nodes in the head and neck area are also evaluated. If suspicious structures are detected during the examination, a "tissue biopsy" is performed. A biopsy typically involves painlessly collecting cell samples. Small tissue samples can also be examined under a microscope to check for signs of cancer.

In addition to the biopsy, several imaging methods may be used to diagnose oral cancer:

• X-ray: X-ray imaging of the jaw, chest area, and lungs can help detect the spread of cancer cells. However, due to more advanced techniques, its use has significantly decreased today.
• CT scan: A computerized tomography scan is useful in determining whether cancer has spread to other parts of the body.
• MRI: Magnetic resonance imaging, another radiological imaging method, provides more accurate and detailed images about cancer spread.
• PET-CT: A PET scan is highly effective in investigating whether oral cancer has spread to other areas of the body and lymph nodes.
• Endoscopy: In some cases, endoscopic procedures may be used to examine structures such as the nasal cavity, sinuses, throat, and trachea.

How Is Oral Cancer Treated?

The treatment of oral cancer varies depending on how advanced the disease is, its stage, and its location. In early stages, surgical interventions may be used to remove cancerous structures. In some cases, various oral and neck structures may also be removed surgically. Radiotherapy, also known as radiation therapy, is another treatment method for cancer. This method targets tumor tissue using radiation at specific intervals to destroy it. Chemotherapy, which involves using chemical agents to eliminate cancer cells instead of radiation, is another treatment method. These drugs can be administered orally or through an intravenous line. Chemotherapy aims to damage the DNA of cancer cells using potent chemicals. However, these strong chemicals can also damage various healthy cells, leading to side effects such as fatigue, nausea, vomiting, hair loss, and a weakened immune system. Due to the location of oral cancer, maintaining proper nutrition can sometimes be challenging. Therefore, it is essential to create nutrition plans for patients during their treatment to ensure they do not lack essential nutrients.

Oral cancer is a disease where early diagnosis and appropriate intervention are crucial for survival. Therefore, if you observe any symptoms or signs of oral cancer, it is advised to seek help from medical professionals by visiting a healthcare facility.