Some time ago, a patient came to the outpatient clinic, a man in his thirties, with ulcers on his tongue. He thought it was a common mouth ulcer at first and sprayed some watermelon cream on himself, thinking that it could be cured, but it dragged on for two months, so he came to the hospital for medical treatment, and the pathological biopsy clearly showed that it was oral squamous cell carcinoma. Mouth ulcers that do not heal for a long time, beware of oral cancer! In daily life, mouth ulcers are a frequent affliction for many people, but because they are so common, many people often do not pay attention to them when they appear, thinking that they can tolerate them or rub some watermelon cream, or they think they are caused by “fire” and take traditional Chinese medicine or prescriptions to cure them. Of course, the majority of ulcers are ordinary ulcers, which can generally heal themselves within 1 to 2 weeks, so there is no need to be too nervous. However, if it is a long term ulcer that does not heal, such as not healing for more than 2 weeks or even for several months, then you must be alert to the possibility of oral cancer. In oral cancer, ulcers are the most common manifestation, such as tongue cancer, and the early symptoms are often manifested as small ulcers. Generally speaking, cancerous ulcers in the oral cavity are usually found in the belly of the tongue, the edge of the tongue, the cheek, the corner of the mouth and the gums, etc. They are mostly shallow or deep ulcers with elevated edges and uneven center, hard texture and covered with necrotic tissue, and may also be accompanied by enlarged lymph nodes under the chin, under the jaw or in the neck. Usually, if it is found that the mouth ulcer does not heal for a long time, or there are other abnormalities in the mouth, such as red spots that cannot be erased, white spots, erosion, unexplained pain in the mouth, numbness of the lips, loose teeth, or hard lumps, it is best to seek prompt medical examination. Cancer does not appear all at once, from normal state to precancerous lesion and then to cancer, it may take several years or even longer, and the same is true for the occurrence of oral cancer. Many people think that oral problems are trivial and can be endured just fine, so they live to delay until the late stage and miss the best time for treatment. In fact, in daily life, if you pay more attention to abnormal symptoms of oral cavity and actively seek medical examination when necessary, you can increase the detection rate of oral cancer, and early detection can also have higher cure rate. Oral cancer is most preferred by these 3 types of people Oral cancer itself is a kind of cancer with low incidence rate, but the incidence rate of oral cancer has increased in recent years due to poor living habits or bad habits such as betel nut chewing. In our department, we treat more than 1,000 patients with various types of oral cancer every year, and many of them need to remove part of tongue, tooth bed or cheek because of tumor invasion, and recently several of my patients even had their eyes or throat removed by the tumor. Among the oral cancer patients, the following three types of people are at high risk: 1. People who have the habit of chewing betel nut: Betel nut contains harmful substances such as betel nut alkali and betel nut tannin, which have been classified as Class I carcinogen by the World Health Organization as early as 2003. The harmful substances in betel nut are not only carcinogenic, but also due to the hard texture of betel nut itself, long-term consumption can also lead to oral mucous membrane damage, which leads to the occurrence of oral precancerous lesions. 2.Smokers and drinkers: Studies have shown that long-term smokers and/or drinkers have a much higher risk of cancer than non-smokers/alcohol drinkers. Tobacco smoke contains many harmful substances that can lead to cell cancer. Alcohol, on the other hand, can increase the risk of oral cancer due to its toxicity to normal cells, damage to liver function, and suppression of immunity. Moreover, the oral cavity is the first stop for smoke and alcohol to enter the body. The carcinogenic substances in smoke and alcohol can cause damage to the oral mucosa, which can develop into pre-cancerous lesions after a long time. 3. People with chronic stimulation and damage in the oral cavity: For example, if there are sharp tooth tips, residual roots, residual crowns and bad restorations in the oral cavity, there is a possibility of cancer in the corresponding parts after long-term chronic stimulation, especially in the oral cancer of tongue and cheek. Some statistics show that 1/5 of oral cancer patients have sharp irritation factors in the cancerous area. In addition, precancerous states such as white spots, red spots or flat moss in the mouth are also one of the high risk factors that increase the risk of developing oral cancer and should be alerted. How to treat oral ulcers? Apart from ulcers caused by cancer, the most common ulcers in the mouth are recurrent oral ulcers (also known as “recurrent aphthous ulcers”). Recurrent ulcers can be caused by local trauma (e.g., traumatic ulcers caused by irritation of stump roots, stump crowns, etc.), stress, drugs, malnutrition, altered hormone levels, and certain vitamin or trace element deficiencies, or certain systemic diseases, genetic disorders, and microbial infections such as leukoaraiosis, radiation stomatitis, Crohn’s disease, and AIDS. Common ulcers can be clinically divided into primary and secondary ulcers, with primary ulcers including traumatic ulcers and recurrent ulcers. Since traumatic ulcers have a history of trauma or chronic irritants, the ulcers do not usually heal on their own until the irritants are removed. Recurrent ulcers, on the other hand, usually heal on their own in about 1 to 2 weeks, and cannot be cured at this time because their cause has not yet been determined. However, the healing time can be shortened by eliminating the cause, enhancing physical fitness, treating some other systemic diseases related to mouth ulcers, and reducing local irritation to prolong the interval between ulcer recurrences. In general, the treatment of ulcers mainly includes elimination of causes, symptomatic treatment and enhancement of physical fitness. In addition, during the onset of ulcers, damage to the oral mucosa should be avoided to prevent recurrence of the disease, and the diet should avoid stimulating foods such as too spicy and too hot, and mouth rinses such as light saline, saline, or mouthwash can be used to reduce oral bacteria and prevent secondary infections aggravated by bacteria.