Oral Cancer

Oral cancer is any malignant growth found in the mouth or throat. These cancers typically begin on the tongue or bottom of the mouth. Because of their location, they are highly treatable if caught early. It is important to be evaluated immediately if you experience any of the following symptoms.

Symptoms
Symptoms of oral cancer may include any of the following:

• White or red patches in your mouth
• Mouth sores that will not heal
• Bleeding in the mouth or tongue
• Dental problems
• Pain while swallowing
• A lump in your neck
• Persistent earaches

Risk Factors
No one knows why a malignant or cancerous growth begins to grow. However, there are certain risk factors for oral cancer. These may include:

• older than age 40
• males have a higher risk than females
• a history of smoking or heavy alcohol use
• family history of head and neck cancer

Diagnosis

1. Your doctor will ask for a complete medical history and will perform a thorough physical examination.
2. Your doctor will perform a complete head and neck exam to determine the type and nature of the growth. Your doctor may perform a biopsy, so a small piece of the growth can be studied in a lab. This will help determine the kind of cancer, how aggressive it is, and the best way to treat it. The most common type of oral cancer is squamous cell carcinoma, but there are other types of this cancer as well.
3. Different diagnostic studies may be ordered, including imaging studies, lab tests and detailed physical examinations. These may include:
   • X-rays
   • MRI  
   • CT scan  
   • PET scan
   • Panendoscopy - Panendoscopy includes direct laryngoscopy (look at voice box), esophagoscopy (esophagus), and bronchoscopy (bronchial tubes and lungs) used to stage the tumor and look for additional tumors within these areas

The purpose of the imaging studies is for your doctor to see if the cancer has spread, and to determine the best course of treatment.

Treatment
Treatment for oral cancers is dependent on when and where the cancer is found, as well as the type and grade of the tumor.

Almost all oral cancers are treated with a combination of any of the following:

• surgery
• chemotherapy
• radiation

Tongue cancer
Cancer of the mobile part of the tongue is usually treated with surgery and radiation. The surgery involves resecting the affected portion of the tongue. Skin grafts, radial forearm free flaps or anterolateral thigh flaps may be used to reconstruct the resected area.

Floor of the mouth cancer
This kind of cancer is usually treated with surgery and radiation. Surgery may require a partial mandibulectomy. Free flap reconstruction with bone that is taken from the fibula, rib or scapula is sometimes required.

Alveolar ridge
Cancer of the alveolar ridge (where the teeth are located) is usually treated by surgery alone. Radiation may also be required in some cases following surgery.

Monitoring
After your surgery and completion of chemotherapy and/or radiation, your doctor will want to monitor you closely to make sure the cancer has not reoccurred. The visits may be as frequently as once a month for the first year following treatment. These visits will typically consist of a physical examination, flexible endoscopy, a discussion of how you are feeling and any diagnostic tests needed to determine your health.