1.What does oral cancer include? Oral cancer mainly includes tongue cancer, cheek cancer, gum cancer, palate cancer, lip cancer, maxillary and mandibular cancer, and floor of mouth cancer. It involves important organs of human body such as cheek, tongue, lip, palate, floor of mouth and upper and lower jaw, and it is very easy to occur cervical lymph node metastasis. Oral cancer often causes facial deformation, eating, speech and other functional disorders until life threatening. 2.What are the factors related to oral cancer? Most experts believe that oral cancer is the result of the interaction of multiple causes and conditions. Secondly, ultraviolet light and ionizing radiation are also the culprits of oral cancer; in addition, not paying attention to oral hygiene creates conditions for the breeding and propagation of bacteria or mold in the mouth, which can easily contribute to the formation and development of cancer; while sharp crests, root remnants and bad prostheses (such as dentures), chewing irritating foods, eating hot food and other long-term In addition, the immune status, mental and endocrine factors, and genetic factors are also related factors that cause tumor. 3.How to detect oral cancer in early stage? Early detection, early diagnosis and early treatment are the fundamental ways to cure malignant tumors and improve the quality of life. If you find the following conditions, you should go to hospital as soon as possible. Firstly, the color of oral mucosa becomes white, brown or black, especially the oral mucosa becomes rough, thick or hard, and there are white spots and red spots of oral mucosa. Second, lumps on lips or in the mouth. In the early stage of oral cancer, it only appears as localized small lumps, often without special discomfort. Third, ulcers do not heal. The duration of oral ulcers usually does not exceed two weeks. If symptoms such as burning sensation and pain do not heal for more than two weeks, it is necessary to be alert to the possibility of oral cancer. Oral cancer is often manifested in the form of ulcers with elevated surrounding edges and uneven center, covered with necrotic tissue and obvious pain. In the early stage, it is usually painless or only has a local abnormal rubbing sensation, and the pain is obvious after ulceration. As the tumor further invades the nerves and surrounding tissues, it may trigger ear, throat pain or toothache. Fourthly, neck lump. This is also one of the common symptoms of oral cancer. Oral cancer mostly metastasizes to the nearby lymph nodes in the neck, sometimes the primary lesion is small or even the symptoms are not obvious yet, but the cancer cells have metastasized to the lymph nodes in the neck. Therefore, if the lymph nodes in the neck are suddenly enlarged, the oral cavity should be examined. Finally, there is dysfunction. The tumor may invade the opening and closing mouth muscles and jaw joint, resulting in limited opening and closing mouth movement. 4.How to prevent oral cancer? The main measures to prevent oral cancer are: 1. Avoid unnecessary prolonged exposure to light to prevent lip cancer. 2. 2. Avoid smoking and drinking. 3.Patients wearing dentures should repair the uncomfortable denture in time, and if pain and inflammation are found in the tissue under the denture, they should seek medical attention in time. 4.Balanced diet, coarse and fine, reasonable nutrition, do not drink or eat too hot water and food to avoid stimulating oral tissues. 5.Treat diseases in the oral cavity in a timely manner, remove the residual roots and crowns (teeth that cannot be restored), wear good dentures and do not stimulate the tissues. 6.Cultivate good oral hygiene habits and brush your teeth frequently. 5.Why is quitting smoking and alcohol an important measure to prevent head and neck cancer? Besides lung cancer, tobacco is also a recognized carcinogenic factor for oral cavity and oropharynx cancer, and a possible carcinogenic factor for laryngopharyngeal cancer. The cancer-causing factor in tobacco is mainly the chemical benzopyrene, which may cause cancer throughout the upper digestive respiratory tract. Not only are smokers susceptible to oral cancer, but if they continue to smoke after the cancer has been cured, the chance of a second primary cancer is greatly increased. Alcohol itself is not proven to be carcinogenic, but alcohol can be used as a solvent for carcinogens, which can cause carcinogens to enter the oral cavity and oropharyngeal mucosa and damage the liver, thus affecting the chemical detoxification and biotransformation of the liver; at the same time, heavy drinkers often have high suppression of cellular immunity. Some data show that the incidence of oral cancer in those who have smoking and drinking habits is 15.5 times higher than that in those who do not smoke or drink. Therefore, quitting smoking and alcohol is an important measure to prevent head and neck cancer. 6.What are the clinical symptoms of laryngeal cancer? Hoarseness: In the early stage, it is vocal fatigue or hoarseness without other discomfort, which is often mistaken for cold or laryngitis. Anyone over 40 years old, especially men and long-term smokers, with hoarseness for more than 3 weeks, who does not improve by vocal rest and general treatment, must go to hospital for laryngoscopy. Pharyngeal discomfort and foreign body sensation: this is the early symptom of supraglottic laryngeal cancer, but should be distinguished from the symptoms of chronic pharyngitis. Pharyngeal pain: When the tumor invades deeper, it is intermittent pain at first, then persistent pain, and causes simultaneous reflex ear pain and difficulty in swallowing due to pharyngeal pain. Cough and coughing blood: Early stage is mostly cough with no sputum or only a small amount of sputum and no coughing blood, with the development of lesion, blood in sputum or even coughing blood may appear. Enlarged lymph nodes in the neck: Especially for patients with supraglottic laryngeal cancer, enlarged lymph nodes in the neck are easy to appear in the early stage. Difficulty in breathing: Difficulty in breathing is often a symptom of laryngeal cancer in late stage. 7.What are the treatment means of laryngeal cancer? The treatment of laryngeal cancer includes surgery, radiotherapy, chemotherapy and biotherapy, among which surgery is the main treatment means. At present, the surgical treatment of laryngeal cancer emphasizes on the preservation of patient’s functions, especially breathing and articulation functions. For early stage vocal cord cancer with limited scope, CO2 laser resection under laryngoscope can not only achieve the purpose of eradicating the tumor, but also preserve the function of larynx completely. For tumors with large lesions, partial laryngectomy with external cervical approach or even total laryngectomy is required. However, these two types of surgeries have a certain impact on the quality of life of patients because some or all of the larynx is removed, and functional reconstruction is needed to restore the function of the larynx. 8.What are the salivary glands? There are two types of salivary glands in the oral cavity: major and minor. The minor salivary glands are scattered in the oral mucosa of each ministry (such as the labial glands, buccal glands, palate glands, and tongue glands). The major salivary glands include three pairs of parotid, submandibular and sublingual glands, which are separate organs located around the oral cavity, but whose ducts open into the oral mucosa. The parotid gland: the largest, slightly triangular wedge-shaped, is located just below the anterior aspect of the external auditory canal, on the surface of the posterior part of the occlusal muscle, and the posterior part of the gland is particularly hypertrophic, penetrating deep into the posterior fossa of the mandible. The parotid duct emanates from the anterior end of the gland near the upper edge, and travels anteriorly through the surface of the occlusal muscle about one finger below the zygomatic arch, bypassing the anterior edge of the occlusal muscle and turning deeper, crossing the buccal muscle and opening in the buccal mucosa, forming a mucosal papilla at the opening, just opposite to the maxillary second molar. Submandibular gland: slightly oval in shape, located in the submandibular triangle, between the body of the mandible and the lingual muscle of the hyoid bone. The submandibular ducts emanate from the inner surface of the gland and run deep anteriorly along the mucosa of the floor of the mouth, opening at the sublingual meatus. Sublingual gland: the smallest, elongated and slightly flattened. It is located on the deep surface of the mucous membrane at the floor of the mouth. Its excretory duct has two kinds of small and large ducts, about 5-15, opening directly in the mucous membrane of the floor of the mouth; the other large duct often converges with the submandibular gland duct or opens separately in the sublingual meatus. Salivary glands secrete saliva, which can moisten the mouth and facilitate swallowing and speaking. Human saliva contains amylase, which can initially break down the starch in food. 9.What are the symptoms of common salivary gland tumors? Most of them occur in large salivary glands, and their common symptoms are: ① Lumps: Painless lumps are the most common symptoms of most salivary gland tumors. It can be in the parts below the front of earlobe (parotid gland), mandibular area (submandibular gland), and under the tongue (sublingual gland). (②Mouth and eye distortion: This is the manifestation of facial muscle paralysis caused by tumor involving facial nerve, mainly seen in malignant tumor. ③Pain: Pain may be present when the tumor invades nerves and skin. Some types of carcinoma, such as adenoid cystic adenocarcinoma and mucous epidermoid carcinoma (pathological type of salivary gland carcinoma), can have pain as the first symptom. Neck lumps: Salivary gland cancer may have ipsilateral lymph node metastasis (a few may metastasize to the opposite side) and neck lumps may appear. 10.Why does the mouth and eyes become distorted sometimes after parotid cancer surgery? The tilted mouth and eyes are caused by paralysis of one side of the facial muscles. The nerve that governs the facial muscles is called facial nerve, and one section of it is located between the deep and superficial lobes of parotid gland, and it branches out into 5 groups of branches, namely temporal branch, zygomatic branch, buccal branch, mandibular margin branch and cervical branch, which innervate the muscles in the corresponding areas. When the parotid tumor is removed, once the above mentioned nerves are damaged, muscle paralysis of the corresponding innervated area will be manifested. This kind of damage is sometimes unavoidable, such as the tumor invades the nerve and has to be removed. 11.Are all lumps in the neck malignant? No. There are many types of head and neck lumps, which can be broadly divided into four categories: first, inflammatory tissues, such as enlarged lymph nodes in the neck caused by acute inflammation of the oral and maxillofacial areas and the pharynx; specific infections, such as cervical lymphatic tuberculosis, require drug treatment. The second is congenital developmental abnormalities, such as thyroglossal cysts and parotid cleft cysts are caused by and can often be completely removed surgically. Third, tumor-like diseases, such as nodular goiter of the thyroid gland (all the above three categories are benign) Fourth, tumors, which can be classified as benign/malignant tumors by nature and metastatic/primary tumors by origin. Tumors are usually divided into two categories, benign and malignant, according to the characteristics of their growth and the degree of damage to the human body. Regardless of benign or malignant tumors, they can be further classified into epithelial tissue, mesenchymal tissue, neural tissue, lymphopoietic tissue and other tissue tumors according to their tumor tissue source and tissue type. Usually, malignant tumors that occur in epithelial tissues are called “cancer”. The difference between benign and malignant tumors is not based on the size of the tumor or whether it is painful or not. Some authors distinguish between benign and malignant tumors based on the age of the patient and the location of the tumor: in young children or adolescents, the first type of inflammatory disease and congenital developmental abnormalities are the most common, but they may also be benign tumors such as thyroid adenoma or malignant tumors such as lymphoma. Both benign and malignant tumors are possible in middle-aged and elderly people, and one must be alert to the possibility of malignant tumors. This classification is only a guess as to the size of the chance of occurrence. If a lump in the head and neck has been there for a long time and still does not go away, whether it is painful or not, consult a head and neck surgeon as soon as possible. Usually, the specialist will first understand your medical history, living habits and previous diseases, then do head and neck examination and palpation, and perform ultrasound, blood sampling, skin test, endoscopy, X-ray, CT, magnetic resonance imaging (MRI), fine needle aspiration, etc. as needed to determine the nature of the disease and guide further treatment. 12.Do all head and neck tumors require surgery? No. Benign head and neck tumors often require surgery. Most of the malignant tumors are mainly treated by surgery, while lymphoma and nasopharyngeal cancer are mainly treated by radiotherapy. 13.Is all metastatic cancer of head and neck advanced? No, it is not. The lymphatic tissue in the neck is extremely rich, and it receives lymphatic convergence from the nose, throat, larynx, oral cavity, thyroid gland and other places. Therefore, once a malignant tumor occurs in these tissues, it often metastasizes to the neck first, causing the corresponding lymph nodes to swell. These metastatic cancers of head and neck origin may not be advanced if there is no metastasis outside the lymph nodes of the neck. For example, thyroid cancer with simple neck metastasis can be cured by surgery and other treatments. Since the lymph nodes in the supraclavicular fossa are also connected with the internal organs of the chest and abdomen, the masses in the lower neck may also come from the metastases of malignant tumors in the chest and abdomen, such as lung, breast, gastrointestinal, thoracic esophagus, ovary, kidney, etc., which are often in advanced stage.