Oral Cancer Screening, Biopsy and Excision

Oral Cancer Screening, Biopsy and Excision

What is oral cancer?

• Oral cancer is a type of cancer affecting the mouth and throat, including the lips, tongue, cheeks, floor of the mouth, hard and soft palate, sinuses, and pharynx. The most common type of oral cancer is oral squamous cell carcinoma, accounting for 90% of oral cancer. Head and neck cancer is the 6th most common cancer in the world.
• It is important to note that early detection and treatment of oral cancer can significantly improve outcomes and prognosis. So, it is important to see a healthcare professional if you notice any unusual symptoms in your mouth or throat.

Some facts about oral cancer:

1. Incidence: In 2020, it was estimated that there were approximately 657,000 new cases of oral cancer diagnosed worldwide. It is
2. Mortality: It is estimated that around 330,000 people die from oral cancer each year globally.
3. Age: Oral cancer can occur at any age, but it is most commonly diagnosed in people over the age of 50.
4. Gender: Men are reported more likely than women to develop oral cancer.
5. Risk factors: Tobacco use (including cigarettes, cigars, pipes, smokeless tobacco), bethel nut use, heavy alcohol consumption are the primary risk factors for oral cancer. Other risk factors include HPV infection, poor oral hygiene, and a diet low in fruits and vegetables.
6. Symptoms: Symptoms of oral cancer may include a sore or lump in the mouth that does not heal, difficulty chewing or swallowing, hoarseness or a change in voice, and persistent ear pain. Most early stage of oral cancer are asymptomatic.
7. Treatment: Treatment for oral cancer may include surgery, radiation therapy, chemotherapy, or a combination of these treatments.
8. Survival rates: The five-year survival rate for oral cancer varies widely depending on the stage of the cancer at diagnosis, ranging from as high as 94% for successfully treated early-stage cancers to less than 30% for advanced-stage cancers.
9. Prevention and early detection: Prevention efforts include reducing tobacco and alcohol consumption and improving oral hygiene. Early detection through regular oral cancer screenings and self-examination can also improve outcomes.

What might put me at an increased risk of oral cancer

• Tobacco is a significant risk factor for oral cancer
• Bethel nut use
• Heavy alcohol consumption is a risk factor for oral cancer, particularly if you are also a smoker
• UV radiation (most typically from the sun) is a risk factor for oral cancer, particularly on your lips
• Older age also increases the risk of oral cancer

Should I be screened for oral cancer?

• Your regular dental check-ups provide a good opportunity for your dentist to screen you for oral cancer
• It is a good idea to have regular screenings, whether you have an increased risk of oral cancer or not
• If there are any risk factors that increase your chance of oral cancer, you should discuss this with your dentist so that they can be even more vigilant with their monitoring and screening
• If your dentists notices anything suspicious during your screening, they might refer you to an oral surgeon for a second opinion and a biopsy to determine if the suspicious site is oral cancer or not

What are the signs and symptoms of oral cancer

• While the following signs and symptoms can indicate the presence of oral cancer, they can be caused by other conditions as well.
  • Mouth sores or ulcers that do not seem to be healing for more than two weeks
  • Red or white patches in the mouth
  • An uncomfortable/painful/scratchy feeling in your mouth or throat that might make it difficult to swallow or chew
  • A persistent hoarseness or unexplained change in your voice
• It is important to see your dentist if you ever notice such symptoms, as early detection of oral cancer can greatly improve the chance of successful treatment

What is a biopsy?

• Once suspicion has been raised, your dentist or oral surgeon might discuss performing a biopsy
• This procedure involves taking a small sample of tissue from the suspicious site.
  • To make sure you are not uncomfortable, the area of investigation will be numbed with local anaesthesia
  • A small portion of tissue will be surgically removed
  • Stitch(es) will be place to close up the small wound
  • This can usually be expected to heal uneventfully in 1-2 weeks
• The harvested tissue will be sent to the histopathology lab for testing.
• At the lab, histopathology tests will be performed and tissue slices checked under the microscopes to determine if there is any pathology or disease at that site. This will be able to confirm the diagnosis, and confirm or rule out presence of oral cancer or other pathology.