ORAL CAVITY CANCER Flashcards
What do you need to perform in examining the oral cavity?
Inspection and Bimanual palpation
What do you need to watch out for examining the oral cavity?
- Be conscious if you are causing any pain or discomfort when examining the px
- Protect yourself from infection (WEAR A MASK)
- When dealing with tumors, (especially malignant ones, or those for surgery), seek out the extent of the lesion
- Always check the neck for enlarged nodes when dealing with tumors suspicious for malignancy
- pre-malignant lesions
- A condition of the mouth that involves the formation of white leathery patches or spots on the mucous membranes of the oral cavity.
- Often caused by chronic irritation, tobacco use or infection.
Leukoplakia
- affects less than one percent of the population, and is most common in adults within the 50-70 years age group.
- A small proportion of cases is associated with a risk of cancer.
- Treatment is mainly involves avoidance of predisposing factors like smoking, tobacco and betel nut chewing, alcohol, and removal of chronic irritants like sharp edges of teeth.
- In suspicious cases, a biopsy is warranted.
Leukoplakia
- Flat red patch or lesion in the mouth with a soft and velvety texture that cannot be attributed to any other pathology.
- Many other conditions are similar in appearance and must be ruled out before a diagnosing
- more frequently associated with dysplasia, and is thus a more pre-cancerous condition.
- Mostly found in elderly men around the ages of 65 - 74.
- Commonly associated with smoking.
- Microscopically, the tissue exhibits severe epithelial dysplasia, carcinoma-in-situ, or invasive squamous cell carcinoma in 90% of cases.
- Treatment involves biopsy (complete excision of the lesion is sometimes advised).
- Recurrence is common and long-term monitoring is needed.
erythroplakia
Most commonly involves the tissues of the lips or the tongue.
Squamous Cell Carcinoma
- are associated with 75 % of oral SCCA
- These cause irritation of the mucous membranes of the mouth
Smoking and other types of tobacco use
is known to be a strong risk factor for developing oral cancer in many Asian cultures
betel nut chewing
- is another high-risk activity associated with oral cancer.
- There is known to be a strong synergistic effect on oral cancer risk when a person is both a heavy smoker and this. The risk is greatly increased.
Alcohol use
- exposure is a known risk factor and independent causative factor for oral cancer.
- Oral cancer in this group tends to occur on the tonsil and tonsillar pillars, base of the tongue, and the oropharynx.
Human papillomavirus (HPV) types 16 and 18
- Lesion, lump, or ulcer on the tongue, lip, or other areas
- Usually painless initially
- May develop poor oral hygiene and poor nutrition due to feeding problems when the tumor is advanced
- Additional symptoms that may be associated with this disease:
>Tongue mobility problems
> Problems with mouth-opening (trismus)
> Swallowing difficulties
> Articulation problems
> Pain and paresthesia are late symptoms
SCCA
OMINOUS SIGN OF SSCA
NECK NODES
definitive method for determining SSCA
BIOPSY of the primary tumor and microscopic evaluation of the cells
- of the tumor is usually recommended in SSCA
- is often used in conjunction with surgery, or as the definitive radical treatment, especially if the tumor is inoperable.
- may be required to give an acceptable cosmetic and functional result.
- Wide surgical excision
- Radiation therapy
- Reconstructive surgery
is useful in oral cancers when combined with radiation therapy. When cure is unlikely, it is implemented to prolong life (for palliative and not curative intent).
Chemotherapy
