Oral cancer, despite its rarity ( about 3% of the total number of patients), still poses a serious danger. This disease also occurs in people who do not use tobacco products, but smokers are the main risk group. The main cause of cancer is the smoking of all types of tobacco products, as well as pipe and chewing tobacco.
In Russia, up to 30,000 cases of oral cancer are registered annually. In the countries of Southeast Asia, where they not only smoke and chew regular tobacco, but also use betel nut and practice “reverse smoking” with the lit end of a cigarette directly into the mouth, the incidence is 50 percent or more of all cases of cancer. Alcohol abuse is an aggravating factor.
Forms
Oral cancer can take many forms visually. All varieties of this disease can be divided into 3 groups according to the appearance of the tumor.
Ulcerative form
In 50% of cases of oral cancer, the pathological focus is a non-healing sore on the oral mucosa, which rapidly increases in size.
Knotty shape
With this form of oral cancer, a seal forms in a certain area. The mucous membrane above it is either unchanged or covered with whitish spots. These seals - nodules have a clear shape, quickly increase in size.
Papillary form
The tumor is a dense outgrowth hanging down into the oral cavity. The surface of the outgrowth is covered, as a rule, with an unchanged mucous membrane. This type of tumor responds better than others to treatment, since it does not spread to the surrounding tissue.
Symptoms
The appearance of a pathological focus in the mouth, as a rule, is the first symptom of oral cancer. These manifestations are often painless. The tumor can be located on the tongue, the inner surface of the cheeks, in the salivary glands. Lip cancer looks different from oral cancer, it looks more like skin cancer and is more often caused by sun exposure. Pipe smoking is one of the possible risk factors for lip cancer.
In the initial period of tumor formation, the patient may be disturbed by pain in the area of the affected area. As the tumor grows, the pain may intensify, radiate to the temple or ear, and become excruciating for the patient. In addition, there may be increased salivation, difficulty in chewing and swallowing food. And in the later stages, a sign of a tumor can be bad breath, which indicates the decay and infection of the tumor.
Stages
- T1 - tumor less than 2 cm in diameter
- T2 - tumor diameter 2-4 cm
- Т3 - 4 cm or more in diameter
- T4 - massive tumor involving the surrounding organs and tissues
- N1 - a single metastasis to a regional lymph node on the affected side up to 3 cm in diameter
- N2 - metastases in one or more lymph nodes up to 6 cm in diameter
- N3 - metastases in lymph nodes over 6 cm in greatest dimension.
- M - indicates the presence of distant metastases
Grouping by stages. Stage 0: TisN0M0... Stage I: T1N0M0... Stage II: T2N0M0... Stage III: T1-3N1M0... Stage IV .. T4N0-1M0 .. T1-4N2-3M0 .. T1-4N0-3M1.
Diagnostics
For the timely diagnosis of oral cancer, it is necessary to conduct a self-examination. However, there are areas that are difficult to inspect. It is recommended to be examined by a dentist once every six months. In case of alarming symptoms, an unscheduled examination of the oral cavity is necessary. If the dentist finds suspicious factors, he should refer the patient to a specialist ( maxillofacial surgeon). On his recommendation, a biopsy may be prescribed. In this case, the biopsy does not require significant surgical intervention, therefore, the selection of a tissue sample for further research is carried out in an office setting.
The presence of metastases in the cervical lymph nodes is determined by palpation, confirmed by a biopsy.
Treatment
Oral cancer, like other cancers, is better treated the sooner it is diagnosed. Small lesions are treated with radiation or surgery. Large lesions require a combined treatment approach. But the best method of preventing oral cancer is, of course, timely prevention and elimination of risk factors - tobacco and alcohol.
Forecast
The prognosis depends on the form of cancer: the most unfavorable and difficult to treat is the ulcerative form of oral cancer. Papillary form - gives the highest percentage of complete cure. Cancer of the lip and front of the mouth is less cancerous than cancer of the back of the mouth.
The five-year survival rate for oral cancer is quite high - about 65%, and for lip cancer - 90%.
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A bump on your cheek can be caused by simple causes or a sign of a serious medical condition. If the lump persists, you should see your doctor. Usually, an examination is sufficient to diagnose the disease, but if necessary, the doctor prescribes an x-ray, angiography, and biopsy. A lump or sore can cause inflammation of the mucous membrane, as they are susceptible to mechanical damage.
Varieties of tumors on the inner side of the cheek c photo
Sealing usually begins with mechanical damage. The appearance of a tumor on the inside of the cheek is caused by a number of reasons:
The most common viral infection leading to the formation of hardened tissue is the human papillomavirus. In children, tumors can be the result of tissue differentiation disorders during the prenatal period.
- Seals, consisting of epithelial cells, are called epithelial. The most common are papillomas, nevi and Serra's glands.
- The proliferation of connective tissues leads to the formation of fibroids, myomas, mixes, pyogenic granulomas, epulis and neuromas. The dense tissue is formed from cells of mucous membrane, muscle tissue, nerve fiber sheath.
- Tumors of vascular origin are represented by hemangiomas and lymphomas. This type of tumor is soft and shrinks when pressed.
The causes of the seal
A dense ball on the inner surface of the mucosa is often the result of inflammation, the process is caused by dental reasons. Redness and swelling occur after tooth extraction, when the "wisdom tooth" erupts, as a result of gum disease.
An infection that affects the root of the tooth with insufficient quality treatment leads to the formation of a focus of inflammation in the pulp chamber. The development of infection occurs more actively in a weakened body.
Inflammation of the salivary gland or lymph nodes can also lead to a dense formation in the mouth (we recommend reading: inflammation of the salivary glands: signs with a photo and treatment). Edema is provoked by various infections, colds, mechanical blockage of the salivary duct. The process can spread to the entire cheek, eye area.
A small, progressively larger bump on the inside of your cheek may be a lipoma. A characteristic sign of a lipoma is a rolling ball under the fingers. Different types of seals on the oral mucosa are shown in the photo.
Bite trauma
A cheek injured by a bite is susceptible to pathogens that enter the mouth with food. By penetrating into the mucous membrane through the damaged area, they can cause a number of diseases:
- aphthous stomatitis is caused by pathogens of herpes, measles, influenza, diphtheria, as well as adenovirus and L-form staphylococci, with relapses;
- herpetic stomatitis causes the formation of small painful sores, heals within a week;
- in children, Bednar's aphthae may develop, the formations have a yellowish tint, develop with poor-quality oral hygiene;
- a traumatic ulcer is formed both as a result of a bite and due to brushing teeth (we recommend reading: methods of treating a traumatic ulcer in the mouth: drugs and folk remedies).
The swelling or ulcer after the bite will go away on its own within 1 to 2 days. The disease develops in case of infection. The result of a bite is sometimes a blood ball that forms on the surface of the mucous membrane.
In the normal course of the process, the blood ball is absorbed within a week, but if this does not happen, you should consult a doctor.
Papilloma virus
The growth caused by the papillomavirus attaches to the mucous membrane of the leg. First, there is one or more papillomas, scattered over the palate, gums, tongue, inner side of the cheeks. However, the protruding papilloma often bites, a bleeding wound is formed. The papilloma grows, turning into a lump.
A lump that has grown from a papilloma is surgically removed (see also: papilloma on the tongue: treatment methods and photos). It is not recommended to use chemical agents to eliminate it, as this can lead to the degeneration of the tumor into a malignant form.
Cyst or injury to the sebaceous gland
Swelling can form on the inside of the mouth when the sebaceous gland is blocked. The result will be the accumulation of the secretion of the gland in the duct, its swelling, and the formation of a capsule. The cyst is painless on palpation, resembles a ball.
Despite the significant size that the cyst can reach, the skin color does not change, the discomfort depends on the size of the formation. The cyst must be removed, for this, in addition to the aesthetic, there is another reason. The capsule with sebaceous secretion is easily inflamed. Inflammation is accompanied by pain, fever, and the formation of pus. Excision of the cyst is necessary to remove the capsule. A well-performed operation will prevent further cyst growth and the formation of an inflammation focus.
If a growth appears in the mouth from the inside, the cause could be frequent trauma to the salivary gland. A secret accumulates inside such a cyst. The lump is soft to the touch and does not cause pain, but must be surgically removed. Like a sebaceous cyst, it can cause purulent inflammation.
The growth requires attention also because this is how cancer manifests itself at the initial stage. The symptoms of salivary gland cancer cannot be recognized on your own. At the first stage, there may be no pain. An exception is the case when the branches of the trigeminal nerve are compressed. The patient experiences discomfort, pain gradually intensifies, radiating to the tonsils. Diagnostics is carried out by a doctor, the main method of research is a biopsy (tissue samples are taken from the patient and checked for the presence of cancer cells). The effectiveness of treatment depends on the time the disease is detected.
Other reasons
Diagnosis of the disease
If foreign formations appear in the mouth, you need to contact your dentist. He examines the oral mucosa and refers the patient to a doctor who can identify and treat the disease. Some types of growths are treated by a dermatologist or otolaryngologist.
Diagnostics, in addition to visual examination, includes X-ray, computed or magnetic resonance imaging, biopsy with sending tissues for histological examination. Perhaps the appointment of an ultrasound examination, angiography.
Treating a bump on the cheek
Any neoplasm on the inside of the cheek interferes with chewing and is constantly injured. The patient is indicated for surgical treatment to get rid of discomfort and prevent cancer. Removal is done in several ways:
- cryodestruction - destruction of neoplasms using low temperatures (liquid nitrogen);
- sclerotherapy - the introduction of a drug into the vessel, causing the walls to stick together, and then resorption;
- laser - layer-by-layer removal of a cyst and its contents with a laser scalpel;
- radio wave method - removal of high-frequency radio waves by a beam;
- surgical excision with a scalpel.
If the cause of the neoplasm was a viral infection, surgical methods are supplemented with antiviral drug therapy. Sometimes folk remedies help, but they cannot cope with the cause of the disease.
Medicines
The development of a tumor on the mucous membrane, which is of a viral nature, is treated with drugs based on interferon. They help the body to cope with the disease, have a general strengthening effect.
- These drugs include: Viferon, Intron, Altevir, Roferon.
- The intake of vitamins is shown, antiviral treatment is carried out with Lavomax, Cycloferon and others.
- To stop tumor growth, cytostatics may be prescribed.
Compresses
Hot and cold compresses cannot be used to treat growths: they can worsen the situation, contribute to the exacerbation of the disease. From home remedies, you can try applications with castor oil, they are advised to repeat them twice a day. It is also suggested to wipe the overgrowth with a cut garlic clove, but in case of ulcers or erosion, such treatment is more likely to harm.
Rinses
Rinsing is useful only at the initial stage, after a bite or the appearance of a small dense area.
- To cope with inflammation, to defeat the infection will help a decoction of oak bark, which needs to be rinsed out at least 7 times a day for a week.
- Pine needles will also help. They must be crushed, steamed in a thermos and used after brushing your teeth.
Preventive measures
Prevention of the formation of ulcers, growths, inflammation in the mouth consists in quitting smoking, limiting alcohol intake, and proper nutrition. You should not be in the sun for a long time in the summer.
Oral hygiene and a timely visit to the dentist play an important role. The appearance of wounds or erosion requires immediate action to prevent infection.
Formed from mucosal cells, oral cancer affects the surrounding tissues, manifesting itself as ulcers and germinations. I must say that oral cancer includes a number of cancers, including cancer of the lips, soft and hard palate, tongue, throat, cheek mucosa. In all cases, early diagnosis of the disease gives a chance for a positive treatment outcome.
The five-year survival rate of patients with oral cancer is 41%, the three-year survival rate is 56%, and the average annual survival rate, regardless of the type of oral cancer, is 81%. In general, this type of cancer occupies a small percentage of all human oncological diseases; it accounts for 1.5% of all malignant tumors. The most susceptible to this disease are men aged 40 to 60 years, while women get sick 4 times less often. Interestingly, this type of cancer takes 6th place among male oncological diseases.
As it develops, oral cancer is divided into three periods, these are initial, advanced and advanced.
Early signs of oral cancer
Cancer at the initial stage of development manifests itself as a feeling of slight discomfort in the area of its formation. During the examination, you can see white spots, seals in the mucous membrane, papillary neoplasms, tissue compaction.
Often, patients come to the initial examination due to the occurrence of pain, which, I must say, begin to bother the patient at the very beginning of the development of cancer in only a quarter of cases. Such painful sensations are often mistaken for a symptom of other diseases, such as sore throats.
Oral cancer is usually divided into three main forms: ulcerative, nodular and papillary. Each form of cancer also has its own symptomatology.
The most common form of oral cancer is the ulcerative form, which is manifested by characteristic ulcerative formations on the mucous tissues.
With the nodular form, specific seals appear inside the mucous membrane. This type of cancer develops more rapidly than the previous one and may be accompanied by the appearance of white spots around the lump.
The presence of dense outgrowths above the mucous membrane indicates a papillary form of cancer. This tumor also tends to progress very quickly.
It is worth noting that oral cancer at the initial stage of its development always forms first in the outer layer of the mucous membrane, and then later grows either further outward or into the tissues.
Oral cancer during development
Along with the development of a cancerous tumor in the oral cavity, new, more vivid symptoms appear. First of all, it is a growing neoplasm itself, which begins to cause considerable discomfort to the patient. Interestingly, even with the advanced stage, pain may not occur. Nevertheless, in most cases, pain is still present and becomes quite excruciating. In addition, they can radiate to other areas of the head, for example, to the ear.
In addition, a characteristic symptom of the advanced stage of oral cancer is bad breath, which indicates the decay of the neoplasm and its infection.
In addition, in medicine, such cancer is divided into two of its anatomical forms, each of which is also subdivided into several types.
The exophytic form is divided into papillary, in which the neoplasm takes on a mushroom or plaque-like form, and ulcerative, when the ulcer that forms over time develops into a kind of crater.
The endophytic form is also divided into two groups, these are ulcerative-infiltrative tumors and infiltrative. The first include ulcers localized on a massive infiltrate that grows into the tissue. In this case, the ulcers can look like rather deep cracks. The second group includes tumors that do not belong to ulcers, while there is a diffuse lesion of the mucous membrane.
Symptoms of advanced oral cancer
First of all, it should be said that oral cancer is considered one of the most aggressive and malignant cancers among other cancers. It grows rather quickly, rapidly destroying the tissues located near it.
Cancer of the root of the tongue behaves most aggressively, in which the tumor quickly affects the palatine arches and pharynx. However, cancers in the back of the mouth are much more aggressive and difficult to treat than cancers in the front.
Like many other types of cancer, malignant neoplasms in the oral cavity at more advanced stages of development are characterized by the process of metastasis.
Metastases in this type of cancer mostly spread to the lymph nodes of the neck. However, the location of metastases directly depends on the location of the primary malignant tumor. So, for example, cancer of the tongue, located in its front part, most often spreads not only to the lymph nodes of the neck, but also to the submandibular lymph nodes.
It must be said that metastases of oral cancer very rarely reach distant regions of the body.
Most often, patients seek help from a doctor already at rather advanced stages of the development of the disease, when an infection joins the malignant neoplasm itself. At the same time, in one third of patients at the time of the initial examination, the tumor had already metastasized.
In cancer of the mucous tissues of the cheeks at an advanced stage of the disease, the tumor infiltrates from the skin, tonsils and lips. When the mucous membrane of the palate is affected, rather strong pain and significant discomfort are noted.
In the case of a tumor of the small salivary glands, patients seek help for pain in the oral cavity, which is usually caused by the addition of an infection and the formation of a site with ulceration.
The number of patients with malignant lesions of the oral cavity is increasing every year. Doctors associate this phenomenon with bad habits, unfavorable environmental conditions, as well as unhealthy diet. According to statistics, in the male part of the population, this type of cancer occurs 4 times more often than in the female.
The danger of this pathology lies in its rapid metastasis. A similar development of events is associated with an excellent blood supply to the tissues of the oral cavity, as well as with a large number of lymph nodes in this area. In addition, the brain, organs of the respiratory system, and nerve trunks are located in the immediate vicinity.
Forms and types of cancer in the oral cavity - stages of oncology development
Carcinoma of the oral cavity in its formation goes through three periods:
1. Beginner
At this stage of development, small neoplasms appear, which can be presented in the form:
- Ulcer. They grow in size quite quickly and rapidly. Conservative measures are ineffective. In this case, they speak of an ulcerative form of oral cancer.
- Papillary growths. On the mucous membranes of the mouth, dense growths appear, which are characterized by rapid growth rates. With such neoplasms, papillary cancer is diagnosed.
- Dense nodules that are dotted around with white spots. Nodular cancer progresses faster than ulcerative cancer.
Such neoplasms are practically the only manifestation of the cancer under consideration. Most patients have no complaints of pain.
2. Developed (Active)
The most common reasons for visiting a doctor are:
- Bad breath. Indicates the process of disintegration of the tumor and the addition of infection.
- Weight loss.
- Painful sensations that can spread to the temples, ears, head.
- Drowsiness and fatigue.
- Increased salivation... They are the result of irritation of the oral mucosa by the components of the disintegration of a malignant neoplasm.
3. Launched
The pathological formation grows into nearby healthy tissues. If the focus of the disease is located in the region of the root of the tongue, the pharynx is involved in the pathological process, the skin on the mucous membrane of the cheeks, and the jaw and muscle tissue in the hyoid area at the bottom of the oral cavity.
In addition, doctors classify the indicated oncopathology according to the stages of development:
- Stage 1. The tumor is limited to the mucous and submucous layers, and its diameter is no more than 10 mm. Degenerative transformations in the lymph nodes are not observed.
- Stage 2A. Cancer cells grow into nearby tissues by a maximum of 10 mm, and its diameter increases to 20 mm.
- Stage 2B. The characteristics of the tumor are the same as in stage 2A. One regional lymph node undergoes a destructive phenomenon.
- 3A stage. The lymph nodes are not involved in the cancer process, and the parameters of the tumor reach 30 mm in diameter.
- Stage 3B. Diagnostic measures confirm active metastasis in regional lymph nodes.
- 4A stage. Cancer cells spread to the soft and bony structures of the face. There are no regional metastases.
- 4B stage... The parameters of the malignant neoplasm are arbitrary. Studies reveal distant metastasis.
Video: Oral Cancer
Causes of cancer in the mouth - who is at risk?
Often the ailment in question is diagnosed in men over 50... This is due to the fact that the male part of the population is more susceptible to bad habits than the female. It is extremely rare, but still sometimes this oncopathology occurs in children.
The exact causes of oral cancer have not yet been established.
However, in the course of observations, a number of factors were found that provoke the appearance of this disease:
- Smoking cigarettes, cigars, tobacco pipes, as well as using tobacco for other purposes (chewing). Passive smokers are also at risk. The main culprit in this situation are carcinogenic components, which, due to regular contact with the oral mucosa, cause inflammatory processes in it, which eventually become chronic.
- Drinking alcoholic beverages, as well as using oral hygiene products that contain alcohol.
- Hereditary factor.
- Excessive consumption of hot and spicy foods. Such food injures and irritates the oral mucosa.
- Deficiency of vitamin A in the body. This condition negatively affects the condition and functions of the epithelium.
- Regular trauma to the oral cavity with poor-quality dental structures, tooth fragments and / or sharp fillings.
- Poor hygiene (or complete lack of it) of the teeth. Unsealed teeth, plaque and calculus, periodontitis - all these can trigger the development of cancer in the mouth.
- Work in dusty rooms, with paints and varnishes or asbestos, as well as in high / low temperatures.
- Human papillomavirus. It does not always lead to cancerous processes, but it increases the risk of their occurrence.
Video: 3 warning signs in the mouth. Reasons to see a doctor
The first signs and symptoms of oral cancer - how to notice a dangerous pathology in time?
This oncopathology, regardless of its location, at the initial stages of development is characterized by the following manifestations:
- The presence of swelling and induration in the affected area, which do not hurt at first. Periodic or persistent pain makes itself felt later.
- Complete / partial loss of sensitivity, as well as numbness of the components of the oral cavity - with damage to the nerve fibers.
- Bleeding of unknown etiology.
- Difficulty eating, speaking.
- Poor mobility of the tongue, jaws.
- Change in the consistency of saliva.
When cancer cells spread, they make themselves felt pain in the temples, head, ears, the parotid and submandibular lymph nodes are enlarged.
The ailment in question can be called collective.
The symptomatic picture will be determined by the exact location of the tumor formation:
1. Cancer of the mucous membrane of the cheeks
Often it has an ulcerative nature and is localized in the place where the teeth join.
The symptomatic picture is limited to pain when talking, eating, swallowing. When a neoplasm grows, it is problematic for the patient to open his mouth.
2. Cancer of the sky
The hard palate can be affected by adenocarcenoma or squamous cell carcinoma (extremely rare).
In the first case, the disease practically does not manifest itself for a long time. The growth of the tumor is fraught with infection. The degenerative process involves nearby tissues, incl. and bone. Squamous cell carcinoma of the hard palate makes itself felt in the early stages of the disease, which makes therapeutic measures more effective.
The presence of a tumor in the soft palate negatively affects speech and swallowing. Patients complain of pain and constant discomfort in the mouth.
3. Gum cancer
Among oncological diseases of the oral cavity, it occurs most often. The gum swells, changes its color to whitish, sores appear on it.
Initially, patients are worried about toothache, which makes them seek help from a dentist. Removing a tooth in such a case is not the best idea: it leads to an increase in tumor parameters and a deterioration in the general condition.
4. Cancer of the tongue
It accounts for 40% of the total number of patients with oral cancer. Most often, cancer cells affect the lateral part - or the root of the tongue. Much less often, malignant neoplasms are diagnosed at the tip and back of the tongue.
The disease manifests itself as redness, swelling, numbness of the tongue, the appearance of plaque. A similar phenomenon affects the quality of speech, the process of chewing and swallowing.
Pain in the trigeminal region may also occur. With cancer of the root of the tongue, patients have difficulty breathing.
5. Cancer of the floor of the mouth
Has the most unfavorable prognosis. The pathological process involves a large number of blood vessels, muscles, as well as salivary glands that are located in this area.
At the initial stage of the development of the disease, the patient feels the presence of a foreign neoplasm. In the future, the general picture is supplemented by painful sensations, which are intensified by movements of the tongue, strong salivation, and difficulty in swallowing.
Modern diagnostic methods for suspected oncology of the oral cavity - which doctor should they contact, and what tests can they prescribe?
If there are problems with the oral cavity or teeth, patients, first of all, go to the dentist... After the examination, this specialist can send you for a consultation with an oncologist.
Diagnostic measures that the oncologist prescribes include:
- Visual method. The doctor listens to the patient's complaints, clarifies his lifestyle, the presence of concomitant diseases. When examining the oral cavity, the parameters of the neoplasm, the state of the mucous membrane and lymph nodes, and the structure of the tongue are assessed.
- Laboratory research. In particular, the patient is referred for a general blood test, as well as a blood test for tumor markers.
03.03.2017
Among cancer diseases, cancer of the oral mucosa was recorded infrequently (3% of cases), but the number of cases is growing.
Early diagnosis increases the success of treatment. At an early stage, the disease is curable, especially if the tumor has not had time to infect neighboring organs.
Men are more susceptible to this disease than women. Previously, the disease was recorded in patients over 50 years old, now in young people, and in some cases even in children. The risk of problems with the oral mucosa is associated with bad habits and lifestyle, personal hygiene, food, harmful working conditions and an unfavorable external environment.
Often, signs of the disease are detected by a dentist when examining or treating teeth and gums. Deviations in the state of the oral mucosa can be noticed on their own. Having felt the first symptoms of the disease, you need to see a doctor for help.
Forms of cancer of the oral mucosa
Cancer of the oral mucosa has the following forms:
- Nodular - the appearance of a seal on a healthy mucous membrane, which begins to grow rapidly. Whitish spots may appear near a lesion with dense edges.
- Ulcerative - an ulcer appears on the mucous membrane, which worries the patient, does not heal for a long time, but begins to progress. Occurs in 50% of cases.
- Papillary - a seal hanging from the mucous membrane in the oral cavity, growths on the mucous membrane can grow rapidly. With this form of cancer, tumor growth into adjacent tissues is not observed, so the treatment is successful.
Depending on the location of the tumor, the following types are distinguished:
- Cheek cancer.
The mucous membrane of the cheeks is most often prone to injury for various reasons. Neoplasms (seals, ulcers) appear on the inner surface of the cheeks, on the line or in the corners of the mouth. With large ulcers. Discomfort and pain appear when talking and chewing, opening the mouth. When diagnosed, histological cancer is most often found. It is observed in 7.2% of cases.
- Oral floor cancer.
This area of the mouth is made up of many muscles, blood and lymph vessels, and salivary glands. The neoplasm captures these tissues and quickly metastasizes. The patient feels the induration like a foreign body. Salivation, pain, decreased mobility of the tongue, difficulty in swallowing appear. (24.6%) cases.
- Swelling of the tongue.
The tumor often appears on the lateral surfaces of the tongue, this pathology is more common. Less commonly - on the upper or lower part of the tongue, its tip or root. The mobility of the tongue decreases, there is pain when swallowing, difficulty in speaking. (43.5% of cases).
- Tumor in the alveolar processes.
The alveolar processes are the part of the jaw on which the teeth are located. The tumor appears on the upper or lower jaw and affects the teeth. May cause bleeding and pain in the area. (16%).
- Cancer in the area of the palate.
The hard palate contains many small salivary glands. It is they who are struck by adenocarcioma or cylindroma - a tumor of the glands.
With the growth of the tumor, infection and inflammation can join. There is pain and discomfort when eating and swallowing. The tumor can grow into the tissues and bones of the palate.
In the tissues of the soft palate, squamous cell carcinoma occurs more often, which affects the soft tissues. Usually diagnosed early, less aggressive and easier to treat. (8.7%).
- Cancer of the gums. Found on the gums of the lower jaw, is rare, associated with the neglected condition of the teeth. Squamous cell carcinoma is characteristic of the gums - its histological type.
- Metastases.
Malignant neoplasms grow into nearby areas, tissues and lymph nodes in the form of metastases.
Regardless of the location of the tumor, the first signs of its formation: the appearance of an ulcer, induration and swelling without pain. Then pain at the site of neoplasia, with nerve damage - decreased sensitivity, numbness. Then pains in the temples, ear, head.
Causes of mucosal cancer
Factors that increase the risk of oral diseases that provoke cancer:
- Smoking, drug and alcohol consumption.
- Consuming alcohol-based mouthwashes and mouth fresheners.
- Poor dental condition (sharp edges of the tooth or fillings, uncomfortable dentures).
- Prolonged sun exposure.
- Inadequate nutrition (lack of vegetables, fruits, vitamins A. C, E), the use of foods that irritate the mucous membrane (too hot, spicy food).
- Weakening of immunity, long-term use of medications.
- Contact with harmful chemicals (especially asbestos), paint and varnish products, dust, prolonged exposure to high temperatures.
- The entry into the body of the papilloma virus (HPV).
Currently, 600 strains (types) of papillomaviruses have been systematized. Some of them are harmless, some cause changes in tissues, the growth of warts, benign tumors and provoke cancer. In the human body, a virus can mutate from one species to another.
Oral cancer: symptoms
At first, the disease is similar to other, less dangerous diseases. On the mucous membrane, spots appear, red (erythroplakia) or white (leukoplakia), which soon turn into an ulcer, induration or growth. Nodules may form in the mouth. Cracks that do not heal for a long time, but at first do not really bother the patient. These are not signs of cancer yet. But, if left untreated, they can degenerate into cancerous growths.
With the further uncontrolled course of the disease, the symptoms become obvious and tangible:
- Long-term non-healing sores on the soft and hard areas of the palate.
- Bleeding and soreness of the oral mucosa.
- The pain begins to radiate to the jaw, ear, temple.
- Enlargement and numbness of the tongue.
- Poor gum health.
- Mobility, tooth loss.
- Swollen lymph nodes.
- Pain and swelling of the jaw.
- Weight loss.
Distant metastasis in cancer of the oral mucosa is extremely rare, alone in some advanced cases, even the lungs, liver, and bones can be affected.
Stages of mucosal cancer
Pretumor conditions of the mucosa:
Leukoplakia is a precancerous condition that can appear due to constant irritation and inflammation of the mucous membrane. It is manifested by keratinization of the mucous membrane and a red border on the lips.
Doctors consider external irritants to be the causes of the occurrence: hot tobacco smoke, burning lips when smoking a cigarette to the end, gastrointestinal tract pathology, lack of vitamin A, heredity, constant trauma due to poor dental health, the presence of dentures made of dissimilar metals in the mouth.
First, keratinization of a previously inflamed small area of the mucous membrane occurs. A sign of malignancy is a partial, irregularly shaped seal in the area of keratinization, a rapid increase in the size of erosion, and bleeding. Papillary growths.
Symptoms are similar to lichen planus, lupus erythematosus, syphilis. A biopsy is required for diagnosis. Prevention: tidying up the oral cavity (treatment of teeth and gums), treatment of gastrointestinal diseases, smoking cessation.
Erythroplakia
Small red foci with a large number of vessels appear on the mucous membrane. Half of these may be cancerous. Without delay, it is necessary to conduct examinations and start treatment.
Dysplasia (violation) - the appearance of violations in the process of maturation of cells: their irregular shape, change in size. With further development, dysplasia develops into cancer.
On the stratified epithelium of the oral mucosa, squamous cell carcinoma occurs, on the salivary glands - adenocarcioma (cancer of the glands).
Regardless of the location of the tumor and its shape, the development of cancer goes through three periods:
- Elementary.
- Developed.
- Launched.
Initial period... The patient complains of discomfort, sensation of a foreign body in the mouth, burning sensation, pain when eating. On examination, the doctor may find small ulcers, erosion, outgrowths or whitish spots on the mucous membrane, seals on the upper layer or in the submucosa.
Developed period. The reason for going to the doctor is pain of varying intensity, which can be given to the ear, temple. During this period, it is important to determine the form of cancer:
Papillary form. Seals rising above the epithelium in the form of a hemisphere or on a wide leg. In the thickness of the tissue, an infiltrate is palpable, which does not have clear boundaries. The tumor can be bumpy, fine-grained, bleeding with injury, with keratinized areas of the epithelium. When the infiltrate spreads (compaction, accumulation of unusual cells with blood and lymph), patients complain of increased pain, bleeding, difficulty speaking and chewing.
Ulcerative infiltrative. It occurs in 65% of cases. The tumor looks like an ulcer with roller-like, raised above the mucous edges. The crater-like bottom of the ulcer is covered with fine-grained tissue, bleeds when injured. Under the ulcer, a seal is palpable, which is larger in size and has a tendency to spread to adjacent tissues.
The period of neglect. Depending on the place of the initial focus, the tumor can spread to the cheeks, the floor of the mouth, the palate, the lateral parts of the pharynx, and bone tissue.
Diagnosis of mucosal cancer
If you suspect cancer of the oral mucosa, you should contact an otolaryngologist. A preliminary examination by a specialist can detect suspicious places in the oral cavity: spots, ulcers, seals; check for enlarged lymph nodes.
The examination is carried out by the doctor using a special mirror and lamp, and an endoscope is used to thoroughly examine the areas under the tongue, the floor of the mouth and the pharynx.
For a correct diagnosis, it is not enough just inspection and pilping. To check, the lymph nodes are enlarged, they are affected by a tumor - radiation diagnostics are performed: ultrasound examination, computed tomography. To detect the penetration of metastases into the lymph nodes and neighboring organs, a cytological examination is performed. Take a puncture, smear-imprint or scraping of the affected tissue. The type, shape and number of cells are examined under a microscope.
Malignant cells have a distorted size, shape, and an irregular ratio between the nucleus and the cell. Scintigraphy makes it possible to assess the condition of the jaws. A contrast solution is injected intravenously, an X-ray is taken.
The histological appearance of the tumor is determined by a biopsy. When diagnosed - cancer, do not take it as a sentence, do not panic. The mental attitude and desire to be cured increase the chances of a full recovery.
Mucosal Cancer Treatment
The main method of treatment today is surgical removal of the tumor. If the disease is not yet at the stage of neglect, resection of the tumor and healthy tissue surrounding it is performed. If the lymph nodes are already involved in the process, then they are also removed.
Bone tissue also has to be excised if metastases have affected the jaw. After extensive operations, it becomes necessary to reconstruct remote areas. Plastic and maxillofacial surgeons will help to reconstruct the affected parts of the face; parts of the bone can be replaced with an implant.
Using computed tomography data, the focusing of radiation is selected for conducting radiation therapy sessions. Special fixation devices and masks are used so as not to damage healthy tissues when the tumor is irradiated. For several hours or even days, thin radioactive rods and needles are inserted into the tumor to perform brachytherapy. The procedure is performed under local anesthesia.
Radiation therapy may cause side effects: the skin in the irradiated areas may blush and even ache, the voice wheezes, swallowing is difficult due to a lack of saliva, and the sensation of taste decreases. The doctor will prescribe the necessary medications to get rid of this. And after the termination of therapy, these phenomena gradually disappear.
Use medications to make radiotherapy more effective (eg Arbitox). This drug selectively destroys cancer cells. To destroy foci with metastases and remnants of cancer cells, as well as in case of relapses of the disease, chemotherapy is used.
In the treatment of cancer, in addition to surgeons and oncologists, a wide variety of specialists are involved. Rehabilitation may require the help of psychologists, dentists, speech therapists, physiotherapists, nutritionists and other specialists.
In medicine of our time, there are many treatments for cancer. For more effective treatment, traditional medicine can also help.
For the prevention of diseases of the oral mucosa, it is necessary:
- Monitor oral hygiene;
- Visit your dentist regularly to maintain healthy teeth and gums;
- Correctly, eat in a balanced way (do not eat too hot, spicy food);
- In the presence of chronic diseases, see a doctor;
At the first alarming symptoms in the oral cavity, contact your doctor. If necessary, undergo an examination.