I. What is oral cancer?
As the name implies, oral cancer refers to tumors that occur in the oral cavity. In clinical practice, oral cancer includes lip cancer, gum cancer, tongue cancer, hard and soft palate cancer, jaw cancer, floor of mouth cancer, oropharyngeal cancer. Salivary adenocarcinoma and maxillary sinus cancer as well as cancers occurring in the skin mucosa of the face. Among them, tongue cancer is the most common.
Who is prone to oral cancer?
As we all know, the external carcinogenic factors of cancer include physical, chemical and biological factors, which work together with the internal factors such as immunity, genetics and metabolism to transform normal cells into malignant cells and cancer occurs. It is now mostly believed that carcinogenesis is the result of multifactorial, multi-stage and multi-gene effects. It is important to point out that the presence of carcinogenic factors does not necessarily lead to the development of cancer. Here we mainly introduce the external factors such as lifestyle habits, hobbies and environment that are related to the occurrence of tumor.
1.Tobacco and alcohol
The main carcinogenic factor in tobacco is the chemical benzopyrene. It is almost a certainty that tobacco causes cancer, especially oral cancer and lung cancer. It is generally believed that long-term smokers are much more likely to develop cancer than non-smokers; those who smoke paper cigarettes are more likely to develop lung cancer, while those who smoke pipes, cigars or chew tobacco mainly cause oral cancer. Alcohol increases the risk of oral cancer because of its toxicity to normal cells, damage to the liver and immune suppression, and its incidence can increase with the amount of alcohol consumed. More meaningfully, the risk of oral cancer is higher for those who have both tobacco and alcohol addiction, which is two to three times higher than those who are addicted to tobacco or alcohol alone. It is generally believed that those who smoke more than one pack/day or drink more than 25 grams/day are much more likely to develop oral cancer or other cancers than non-smokers or alcohol drinkers. About 2/3 of oral cancer patients are men, but in the last 10 years, as the number of women smoking increases, the gender gap in the incidence of oral cancer is gradually narrowing.
2.Diffuse irritation and injury
In the oral cavity, there are sharp cusps, residual roots, crowns, crests and bad restorations, and the corresponding parts have the possibility of cancer after long-term chronic stimulation, especially common in tongue and buccal cancer. Statistics show that 1/5 of oral cancer patients have sharp irritation factors in the cancerous area. In addition, the long-term chronic inflammatory stimulation of poor oral hygiene may also become a cancer-promoting factor.
3.Ultraviolet and ionizing radiation
Those who are engaged in outdoor workers and exposed to direct sunlight for a long time have a higher incidence of lip cancer and skin cancer. Ionizing radiation can cause changes in DNA of genetic material, activate tumor genes and lead to cancer, both r-rays or X-rays have carcinogenic effects. In Guangdong Province, due to the widespread use of radiation therapy for nasopharyngeal cancer, the risk of second primary cancer in any part of the oral cavity in the radiation area has increased.
4.Other
Microbiotin A and B2, as well as the deficiency of trace elements iron, zinc and arsenic will increase the body’s sensitivity to carcinogens.
In addition, chronic hepatitis, liver cirrhosis, viral infection and other diseases that lead to low immunity, mental stress or depression, endocrine disorders, genetic susceptibility and nuclear radiation may trigger oral cancer.
What are the precancerous diseases of oral cancer?
Pre-cancerous diseases are independent diseases that can become cancerous under the action of certain factors. The pre-cancerous diseases related to oral cancer mainly include the following.
1.White spots of oral mucosa is a recognized precancerous disease, which can be manifested as flat white lesions or wrinkled paper-like, granular or even ulcerated. It occurs in the cheek and lip mucosa. The cancer rate of oral mucosa white spots can be more than 5%.
2.Erythema oral mucosa erythema has been regarded as a disease with higher cancer rate than white spots in recent years. Although the incidence of erythema is much lower than that of leukoplakia, its risk cannot be ignored, and the cancer rate is as high as 90%. The tongue, floor of the mouth and the side of the pharynx are considered high risk areas for erythema.
Lichen planus is a common oral mucosal disease, and its cancer rate is about 1%, with vesicular type, atrophic type and plaque type more prone to malignant transformation, and the most common site is buccal mucosa.
4.Oral submucosal fibrous lesions oral submucosal fibrous lesions are considered to be related to betel nut chewing, and 1/3 of them can eventually develop into cancer. The main manifestations are burning pain when eating, dry mouth and atrophy of oral mucosa. It is commonly found in both sides of the buccal mucosa, lips and tongue.
4.What are the manifestations of early oral cancer?
1. New organisms appear on the oral and maxillofacial area, with granular surface, vegetable-like or early ulceration, pain and other symptoms.
2.Unexplained pain and numbness in tongue, cheek and other parts.
3.Unexplained pain, rapid loosening and loss of teeth, etc.
4.The ulcers in the oral or facial area still do not heal after two weeks.
5.White or red plaques and infiltrating lumps of oral mucosa that cannot be explained.
V. How to prevent oral cancer?
To prevent oral cancer, we must first understand the causes of the disease. However, the causes of cancer are very complex and not yet fully understood, so people can take some preventive measures according to the known factors.
1.Actively participate in the cancer prevention propaganda of oral cancer, understand the knowledge of oral cancer prevention, and recognize the harmfulness of oral cancer.
2.Reduce the local stimulation of the oral cavity. Choose soft toothbrush to brush teeth; do not eat spicy and stimulating food and overly hot food; strengthen oral hygiene and regular oral cleaning; ensure nutrition, pay attention to the balance of nutrition, quit smoking and drinking, timely treatment of root and crown remnants, correction of unsuitable dentures and removal of adverse stimuli. Treat long-term untreated mouth ulcers. Timely supplement vitamins; do not abuse antibiotics for a long time so as not to cause Candida albicans infection.
3. Actively deal with and treat pre-cancerous diseases.
4. Have regular checkups and do histopathological biopsy for clear diagnosis if high-risk signs are found.
5. Do not avoid the disease and seek medical treatment as early as possible to achieve early detection, early diagnosis and early treatment of cancer, and insist on regular checkups.
What should be done when oral cancer is found?
Undoubtedly, those who find oral cancer or suspect oral cancer should seek medical treatment as early as possible. If the diagnosis cannot be confirmed, the patient should go to a higher level hospital for treatment in time. At present, the five-year survival rate of early-stage oral cancer has exceeded 60%.
When the ulcer in your mouth has not healed for more than 2 weeks; when white, red and dark patches appear in your oral mucosa; when your mouth and neck are swollen and lymph nodes are enlarged; when your mouth bleeds repeatedly and your breath smells bad; when your mouth, throat, face and neck are numb or painful for unknown reasons, you should go to the hospital to see a dentist. People with high incidence or susceptible people should have regular checkups in dentistry.
At present, there are many treatment methods for oral cancer, mainly surgery, radiotherapy, chemotherapy and traditional Chinese medicine, and there are also special treatments such as laser treatment and cryotherapy. The treatment method should be considered according to the patient’s location, tumor type, size and body condition. Surgery is the most effective means to treat oral cancer, which generally adopts radical surgery, that is, to remove the tumor, the invaded tissues and the involved lymph nodes in the neck. Surgery is generally preferred for early oral cancer, and radiotherapy can also be considered for some early oral cancers. Late stage oral cancer is generally treated with surgery as the main treatment, and radiotherapy and chemotherapy as the auxiliary treatment, in order to improve the cure rate. The principles of Chinese medicine for cancer treatment are to support the righteousness and drive away the evil, clear heat and detoxify, activate blood circulation and remove blood stasis, and soften and disperse nodules. If oral cancer patients can also have surgery, radiotherapy, chemotherapy, supplemented by Chinese medicine, their condition can mostly improve.
Screening of oral cancer should be part of the whole medical and oral examination, because early detection is crucial. Cancers less than 12mm in diameter are usually easily cured. Unfortunately, however, most oral cancers have spread to the submandibular and cervical lymph nodes before a diagnosis can be made. Failure to detect it at an early stage results in the death of 25% of oral cancer patients.