Oral Cancer Treatment

In recent years, the annual global deaths due to malignant tumors are nearly ten million. Among all cancers, oral cancer incidence amounts for 1.45% ～ 5.6% of systemic malignant tumors. 5 years survival rate of oral cancer is not very high, usually amounts for 60%, so it is one of the malignant tumors that seriously threat to health of human-being. Therefore, oral cancer treatment methods are very important.

Conventional treatments

Conventional treatment methods are surgery resection, radiotherapy, chemotherapy, Chinese medicine treatment.

Integrated application of surgery resection and radiotherapy is superior to single application. Chemotherapy is still a kind of auxiliary therapy which can be adopted prior to surgery or cooperated with radiotherapy.

Either used alone or integrated application with surgical operation, radiotherapy has been playing an important role in the treatment of oral cancer. For advanced lesions, especially those with cervical lymph nodes metastasis, the therapeutic effect of radiotherapy alone is poor. The ideal treatment option shall rely on the cooperation by radiologists and surgeons, so that they can work out the integrated treatment programs according to the anatomic location of the lesion, invasion scope, severity of lymph node metastasis as well as systemic condition of the patient, etc.

Chemical treatment: the majority of head and neck cancers are squamous cell carcinomas which have low sensitivity to chemotherapy. It is seldom to apply chemotherapy alone for the treatment of cancers in head and neck, and often chemotherapy is applied together with radiotherapy or surgical operation.

Chinese medicine treatment: usually oral cancer patients have poor physical quality with weak physical fitness. When patients cannot bear radiotherapy and chemotherapy, Chinese medicine treatment can be adopted to strengthen body immunity and enhance antitumor strength of oral cancer patients.

Minimally invasive treatment

For tumor with comparatively large scope of metastasis or lymph node metastasis, the traditional surgery, radiotherapy and chemotherapy have many big side effects, but the minimally invasive surgical treatment using modern high-tech means, can precisely kill cancer cells with small trauma, quick recovery and therapeutic effects, etc. so more and more patients prefer such treatment.

Nutrition and diet therapy

A large amount of vitamin A can prevent the occurrence or recurrence of oral cancer, but too much vitamin A intake is also toxic, so vitamin A can only be supplemented under the supervision of doctor.

Home treatment

During radiotherapy, mouth open, secretion of gland and teeth brushing, all these have difficulties, so patients should try to do gentle stretching exercises and often flush the mouth with soft toothbrush and moderate effective gargle. Patients can also try reed sprout juice or cool chamomile tea to increase secretion of the glands and eliminate dry of mouth, or use acidophilus solution to clean mouth so as further facilitate the supply of more health foods. Repeat these steps several times each day.

Modern Cancer Hospital Guangzhou reminds you that besides patient’s actual condition, choosing which kind of treatment still relies on the doctor's clinical experience and skills as well as on hospital’s facilities. Patient’s condition should be assessed objectively and treatment plan shall be relied on multidisciplinary consultations. Success or failure of oral cancer treatment is largely relied on whether proper treatments have been chosen or not.

Oral Cancer Diagnosis

Oral Cancer Diagnosis

The formation of oral cancer is a chronic pathological process: it may take several years, even decades to develop into typical or obvious cancer lesions. Therefore, regular oral check can timely and effectively prevent the occurrence of oral cancer.

1. Imaging examinations

(1) Radioactive nuclide inspection can provide information related to bone metastases of tongue thyroid or oral cancer.

(2) B-ultrasound.

3) X-ray plain film and fault photography can provide more valuable information if oral cancer has invaded maxillary bone, mandible or accessory nasal paranasal sinus.

(4) CT inspection can observe tumor size, scope and surrounding tissues and the relationship with carotid artery, so that help to understand whether there is neck lymph node metastasis.

2. Cytological examination and biopsy Exfoliative cytological is suitable for asymptomatic precancerous lesions or early squamous carcinoma that has not clear lesion range, and also suitable for screening inspection, and after that biopsy can be further performed to confirm the positive or suspicious cases. Diagnosis of oral squamous carcinoma is usually conducted through pliers-taken or chipped biopsy. Because of its surface mucous membrane have been run broken or not normal, and also in superficial position; it should avoid the dead keratinized tissue, and also take samples in the boundary area between the tumor and surrounding normal tissue to guarantee that the sample has both tumor tissue and normal tissue. Although the above biopsy rarely discovers tumor cell proliferation and metastasis, however, for some cases whose treatments have been delayed too long, local tumor growth acceleration can be found, so the interval between biopsy and clinical treatment shall be as short as possible. Besides, biopsy should be performed in the hospital that is capable of giving effective treatments.

3. Self-check

1) Conduct symmetry observation on the head and neck and pay attention to the change of skin color. 

(2) Touch neck from ear hind to clavicle and pay attention to whether there is pain and mass. 

(3) Open lower lip, observe red labial part and inner mucous membrane, use forefinger and thumb to open the lips towards outside as well as from left towards right; do the same to the upper lip to touch lump and observe if there is trauma. 

(4) Observe gums and touch genal region.

(5) Tongue and the base of the mouth: stick out tongue, observe the tongue color and texture; use sterile gauze encase the tip of tongue, and then pull the tongue toward left or right to observe the edge of the tongue; use forefinger and thumb touch tongue body and pay attention to whether there is abnormal mass; check the mouth floor with tongue being licked at palate, in order to look for the color and shape change, and then use forefinger touch the month floor;

(6) Palatine: use toothbrush pin tongue to check the palatine with head slightly backward so that observe the color and shape of soft palate as well as hard palate. Modern Cancer Hospital Guangzhou remind that periodical oral check can contribute to early detection of disease; if early treatment is given, the treatment effects will be greatly enhanced.

Oral Cancer Symptoms

Oral Cancer Symptoms

Oral cancer is a common malignant tumor of the oral cavity. Early symptoms of oral cancer are more like oral ulcer, thus a lot of early stage oral cancer patients may easily mistake oral cancer as oral ulcer or other oral diseases, so that miss the best time for treatment. In order to guarantee your own healthy, people somehow should know cancer suspicious symptoms.

Symptoms of oral cancer

1. Pain: in early stage there will be no pain or just local abnormal friction feeling; if oral ulcer appears, patients would feel obvious pain. As tumor invades to adjacent nerves, it causes ear pain or sore throat, etc.

2. Color change: if mucous membrane of oral cavity becomes white, brown or black, it means that mucosal epidermal cells have changed. Especially if oral mucosa becomes rough, thickening or show callosity, and even manifests white spotting, erythema, then it probably has already produced canceration.

3. Unhealed ulcer: the course of oral ulcer usually won’t exceed two weeks; if burning sensation and other symptoms such as pain have lasted more than two weeks without any sign of recovery, you should be alert to the possibility of oral cancer.

4. Lump: there is lump inside the mouth or in neck for unknown causes (when touch it, there will be not necessarily pain). Oral cancer often spread to adjacent lymph nodes of neck. Sometimes the primary lesion is very small, even the symptoms are not obvious, but the neck lymph nodes appear metastatic cancer cells. Therefore, if neck lymph node suddenly enlarges, oral check is required.

5. Oral cavity often appears repeated and unexplained bleeding with difficulty in mouth close or open. Bleeding is a big risky sign of oral cancer. Because slightly touch on the tumor grew in the oral cavity will lead to bleeding. The tumor may also invade masticatory muscles and mandibular joint, which would lead to opening and closing movement restriction or difficulty of mouth.

6. Jawbone and teeth: localized swelling of jawbone would result in facial asymmetry. Patients who suddenly suffer from loosen or fallen off teeth, poor dental malocclusion when chewing food, denture discomfort (if any), numbness or pain of oral cavity and pharynx, and with no improvement after general symptomatic treatment, need to be alert of oral cancer.

7. Tongue movement and perception: the tongue activity is restricted, which results in difficulty in chewing, swallowing or speaking, unconsciousness or numbness of tongue hemi, all these need to be identified with definitive reasons.  

In addition, some other symptoms like facial nerve abnormalities, numbed sensation, unexplained meatus bleeding, should also be identified with causes or for early treatment. 　　Experts of Modern Cancer Hospital Guangzhou remind that the above symptoms are common symptoms of oral cancer, but they cannot completely determine whether you have cancer or not, because oral inflammation would also cause these symptoms. No matter how, it is the best to go to hospital timely for definitive diagnosis and receive corresponding treatments.

Oral Cancer

What is mouth cancer?

 Mouth cancer is malignant cancer that starts in the mouth. It may occurs in the lips, gum, tongue, palate, jaw bone, floor of the mouth, oral pharynx, salivary glands, maxillary sinus and mucous membrane of the facial skin.
 What is the incidence of mouth cancer? 

 The incidence of mouth cancer accounts for 1.45% to 5.6% of all the malignant cancers with a higher percentage among males than females.

 What are the causes of mouth cancer?

 1. Long-term addition to smoking or drinking: most mouth cancer patients have long history of smoking or drinking. Non-smoking and Non-drinking are seldom found with mouth cancer.

 2. Bad oral hygiene: bad oral hygiene provides a nourishing environment for the growth and multiplication of bacteria and mycetes, which are beneficial to the formation of nitrosamine.

 3. Long-term stimulation of foreign body: long-term stimulation to the mucous membrane of the oral cavity by root of teeth, sharp teeth cusps or unsuitable false teeth, can cause chronic ulcer and cancerous lesion.

 4. Innutrition: lack of elements like vitamin A1, vitamin B2 and trace element zinc, arsenic, can raise the organism’s sensitivity to carcinogen and causes mouth cancer.

 5. Leukoplakia and erythroplakia: oral leukoplakia and proliferative erythroplakia are signs of cancerous lesion.

 6. Ultraviolet rays: for outdoor workers, long-term exposure to direct sunlight can raise the risk of mouth cancer.

 7. Ionizing radiation: ionizing radiation can cause changes of DNA and activate the cancer genes, thus, causes cancer.

 8. Others: diseases like chronic hepatitis, cirrhosis and virus infection, which can cause decrease of the organism’s immunity, also have relation to the incidence of mouth cancer.

 What are the symptoms of mouth cancer?

 1. Change of color: the abnormality of oral cavity that its color changes into white, brown and black suggests the change of epithelial cell of mucous membrane. Especially when the mucous membrane becomes rough, thick or has nodules, and cavity leukoplakia or erythroplakia occurs, it may suggest cancerous lesion has happened.

 2. Unhealed ulcer: course of mouth ulcer usually is less than two weeks. Therefore, if you have symptoms like burning feeling and pain for more than two weeks without getting better, you should look out for them, as they may be signs of mouth cancer.

 3. Obvious pain: usually, mouth cancer has no pain but only local abnormal friction feeling in the early stage, while obvious pain occurs after the ulcer cracks. As the cancer further invades the nerves, the patient may feel pain in the ears and throat.

 4. Swollen lymph nodes: most mouth cancers can invade the nearby lymph nodes of the neck, causing swelling of lymph nodes.

 5. Dysfunction: mouth cancer can invade the masticatory muscles and mandibular joint, causing limitation to the activity of the mouth.

 Self-examination of mouth cancer 

 1. Face and neck examination: when examining the neck, try to raise your head backwards as much as you can and check whether there are abnormalities in the inferior maxilla area and neck. Touch both sides of your neck and the inferior maxilla area with your hands to feel the difference between the inferior maxilla area and the two sides of the neck.

 2. Lip examination: observe the outer side of both lips, touch them with your hands, lightly pull down the lower lip with your fingers and check its inner side, and then check the inner side of your upper lip.

 3. Gum examination: observe your gums and touch them with your fingers to see whether there are abnormalities.

 4. Cheek examination: keep you mouth closed, lightly pull both corners of your mouth oppositely towards the direction of your ears, touch both your cheeks and see whether there is abnormality.

 5. Check your tongue: stretch out your tongue, hold it with your hand, touch and observe the surface, pull it to the left and then right side to check whether there are abnormalities on lateral borders.

 6. Check the roof of the tongue: raise your tongue, touch and observe it to check whether there are abnormities.

 7. Check the pharynx and palate: open your mouth and say “ah”, observe the pharynx under light, raise your head backwards, and touch the palate to see whether there is abnormality.

 Traditional treatment methods for mouth cancer

 Surgery: surgery is a common treatment method for mouth cancer. Early mouth cancer, if no lymph node swelling of the neck occurs, can be removed by individual surgery.

 Chemotherapy: individual chemotherapy is seldom used in treating head and neck cancers. In stead, it is usually accompanied with radiation therapy to improve the tumor’s sensitivity to radiation.

 Radiation therapy: whether it is used individually or combined with surgery, it plays an important role in mouth cancer treatment, after which the functions of chewing, swallowing and pronunciation can be retained and patient’s life quality is improved.

 Chinese characteristic treatment 

 Chinese medicine can not only nurse and balance the patient’s health, strengthen the patient’s physical constitution and resist cancer, but also eliminate the toxic side-effect from chemotherapy and radiotherapy and improve the patient’s immunity. Combination of Chinese medicine and Western medicine can get a better effect than any other individual therapies do. It is a kind of advanced comprehensive treatment mode of cancer.

 What is the postoperative care of mouth cancer?

 1. Provide liquid diet to the patient after surgery and change into semi-liquid diet about one week after the operation.

 2. Observe the color, temperature and elasticity of the patient’s skin flap, if it is low in temperature, greenish purple and increasingly aggravates, turn to the doctor instantly.

 3. Aspirate the patient’s secretions in the mouth, nasal cavity and pharynx to keep the airway unobstructed.

 4. If the patient is not able to talk, check whether there are symptoms of airway obstruction, such as fidget and nasal flaring, if any, inform the doctor.
 

Cancer symptoms

Cancer symptoms are changes in the body caused by the presence of cancer. They are usually caused by the effect of a cancer on the part of the body where it is growing, although the disease can cause more general symptoms such as weight loss or tiredness. It is advisable that anyone experiencing unusual symptoms that are not normal for them for more than a few weeks should seek medical attention. There are more than 200 different types of cancer with a wide range of different signs and symptoms, making it difficult to produce a definitive list. For information about the specific signs and symptoms of a specific type of cancer, 

• Typical symptoms of cancer include :
• The presence of an unusual lump in the body
• Changes in a mole on the skin
• A persistent cough or hoarseness
• A change in bowel habits, such as unusual diarrhea or constipation
• Difficulty in swallowing or continuing indigestion
• Any abnormal bleeding, including bleeding from the vagina, or blood in urine or faeces
• A persistent sore or ulcer
• Difficulty passing urine
• Unexplained weight loss
• Unexplained pain
• Unexplained tiredness or fatigue
• Skin changes such as an unexplained rash or unusual texture 
• Unexplained night sweats

Cancer

Cancer  known medically as a malignant neoplasm, is a broad group of various diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the body through the lymphatic system or bloodstream. Not all tumors are cancerous. Benign tumors do not grow uncontrollably, do not invade neighboring tissues, and do not spread throughout the body. There are over 200 different known cancers that afflict humans.

Determining what causes cancer is complex. Many things are known to increase the risk of cancer, including tobacco use, certain infections, radiation, lack of physical activity, obesity, and environmental pollutants. These can directly damage genes or combine with existing genetic faults within cells to cause the disease. Approximately five to ten percent of cancers are entirely hereditary.

Cancer can be detected in a number of ways, including the presence of certain signs and symptoms, screening tests, or medical imaging. Once a possible cancer is detected it is diagnosed by microscopic examination of a tissue sample. Cancer is usually treated with chemotherapy, radiation therapy and surgery. The chances of surviving the disease vary greatly by the type and location of the cancer and the extent of disease at the start of treatment. While cancer can affect people of all ages, and a few types of cancer are more common in children, the risk of developing cancer generally increases with age. In 2007, cancer caused about 13% of all human deaths worldwide (7.9 million). Rates are rising as more people live to an old age and as mass lifestyle changes occur in the developing world.