Early detection, diagnosis and staging of Oral Cancer

By Dr. Raj Nagarkar, MD & Chief of Surgical Oncology, Robotic Services, HCG Manavata Cancer Centre, Nashik.

Oral cancer refers to a group of cancers that can affect any part of the mouth, including the lips, tongue, gums, and lining of the cheeks. While oral cancer can be a severe and life-threatening disease, early detection, diagnosis, and staging are crucial to improving outcomes and reducing mortality rates.

Early detection of oral cancer is essential for improving treatment outcomes and increasing survival rates. The earlier the cancer is detected, the more effective the treatment options will likely be. In addition, early detection can also help to reduce the need for more extensive and invasive treatment options, such as surgery or radiation therapy. Regular dental check-ups are crucial for the early detection of oral cancer. During a dental examination, if your mouth has any signs of abnormalities or changes, such as lumps, sores, or changes in the tissue’s colour or texture, it is recommended to undergo a biopsy to confirm the presence of cancerous cells. 

Symptoms of Oral Cancer

In addition to regular dental check-ups, awareness of the signs and symptoms of oral cancer is essential. The most common symptoms of oral cancer include:

1. Persistent mouth sores or ulcers that do not heal
2. A lump or thickening in the mouth or throat
3. Red or white patches on the tongue, gums, or lining of the mouth
4. Difficulty swallowing or speaking
5. Hoarseness or changes in the voice
6. Ear pain or persistent sore throat
7. Numbness or pain in the mouth or lips

Diagnosis of Oral Cancer

If oral cancer is detected by a dentist at an initial stage, referring to an oral and maxillofacial surgeon or an ear, nose, and throat (ENT) specialist is the next step. This moved to a more detailed examination of your mouth and throat, and you may order additional tests, such as imaging scans or a biopsy. A biopsy is a procedure in which a small tissue sample is removed from the affected area and sent to a laboratory for analysis. The laboratory will analyse the tissue to determine whether cancerous cells are present and, if so, what type of cancer it is. 

Staging of Oral Cancer

Once a diagnosis of oral cancer has been confirmed, the next step is determining the cancer stage. Staging determines the extent and spread of cancer, which is crucial for selecting the most appropriate treatment options. The staging of oral cancer is typically based on several factors, including the size and location of the tumor, whether cancer has spread to nearby lymph nodes, and whether it has metastasised (spread) to other parts of the body. The most common staging system used for oral cancer is the TNM system, which stands for Tumor, Node, and Metastasis. 

Treatment of Oral Cancer

The treatment of oral cancer depends on several factors, including the cancer stage, the tumour’s location, and the patient’s overall health. Treatment options may include surgery, radiation therapy, chemotherapy, new targeted therapies and immunotherapy options or a combination of these treatments.

• Surgery is often the primary treatment option for early-stage oral cancer. Surgery aims to remove the cancerous tissue while preserving as much healthy tissue as possible. In some cases, surgery may be followed by radiation therapy or chemotherapy to destroy any remaining cancer cells.
• Radiation therapy uses high-energy radiation to kill cancer cells. It is often used in combination with surgery or as the primary treatment option for advanced-stage oral cancer.
• Chemotherapy uses drugs to kill cancer cells throughout the body. It may be combined with radiation therapy or surgery or as a stand-alone treatment for advanced-stage oral cancer.
• The treatment of oral cancer has also witnessed significant advancements with the emergence of newer targeted therapies and immunotherapy options, providing promising outcomes for patients. These therapies specifically target cancer cells by interfering with specific molecules involved in the growth and development of the cells. Immunotherapy harnesses the body’s immune system to recognize and attack cancer cells. It has shown remarkable success in some cases by enhancing the immune response against oral cancer cells.

Early detection, diagnosis, and staging are crucial for improving outcomes and reducing mortality rates for oral cancer. Regular dental check-ups and awareness of oral cancer’s signs and symptoms can help detect the disease at an early stage when treatment is most effective. Taking proactive steps towards oral health leads to better outcomes and a higher likelihood of successful treatment and recovery.