ORAL CANCER NAJWA I. AZEEZ

HMU . College of Dentistry

TOPICS: • Oral cancer definition • Risk factors• Warinng signs and symptoms• Risk area • Precancereous lesions &conditions • Diagnosis & clinical features • Management • prevention & complications • Points to remember

ORAL CANCER

• Cancer : malignant neoplasm • Is an abnormal tissue that growths by cellular proliferation more rapidly

than normal tissue and continuous to grow after stimuli that initiated the new growth cease.

• Oral cancer : malignant neoplasm of oral tissues

RISK FACTORS

• Tobacco• Alcohol use• Sunlight exposure (UVL…) • Age ,…Gender ,…Race • Nutrition ( low fruit & veg…)

• Immunodeficiency /suppression

• Habits ,…Chronic irritation • occupations • Fungal & viral infections

WARNING SIGN & SYMPTOM

1. White /red patches anywhere in mouth (leukoplakia /erythroplakia)

2. lump or thickening of oral soft tissues 3. Pain & burning sensation 4. A lump in the neck.5. Soreness or lump of throat 6. Unusual bleeding or numbness in the

mouth or tongue

7. Pain and difficulty when chewing or swallowing.

8. Difficulty moving jaw or tongue 9. Swelling of jaw and mobility of teeth10. Dentures not fitting properly.11. A change in voice, or speech problems.12. Weight loss.13. Bad breath

RISK AREA• Lateral border of the tongue • Floor of the mouth • Angle of the mouth • Alveolus • Lower buccal sulcus

PRECANCEROUS LESIONS & CONDITIONS

LUEKOPLAKIA & ERYTHROPLAKIA

DIAGNOSIS

1. History :• General health history :chest pain, limited exercise tolerance, shortness of breath ,

anemia • History of lesion: (mass or ulcer):onset of occurrence ,duration ,pain …2. clinical examinations:Extra oral : 1-inspection of head ,face, & neck for any asymmetry or changes in the color

of skin II-examination of regional lymph nodes bilaterallyIntra oral :appropriate soft tissue examination , inspection and palpation of tumor for

checking borders, shape , size , tenderness

3. Radiological examinations: OPG , CT scan , MRI for evaluation of primary site & regional lymph nodes

4. Laboratory investigations : blood( Hb , blood sugar , blood urea) , enzymes (liver function test) , electrolytes

5. Biopsy

CLINICAL FEATURES OF ORAL CANCER LESION

Classically present either as non- healing ulcer , with very degree of pain & occasional episode of bleeding of lesion usually have an irregular edge and indurations' of underlying soft tissues

Exophytic growth of duration may be several weeks to few months , before patient seeks treatment exophytic growth may present as a cauliflower like irregular or may be flat

More advanced lesions can present with pain , bleeding or fixity of surrounding structures Involved infratemporal fossa present with recent onset of trismus ….& must distinguished from

long standing trismus ..which is sign of oral mucosal fibrosis Occationally lesions of alveolus in or around non- healing extraction sockets can manifest with

unexplaned loosing of the involved teeth

MALIGNANT CONDITION

MANAGEMENT Surgery Radiotherapy Chemotherapy ……andCombination

• The management depends:• site and severity• Patient preference • General health• Biological health

PREVENTION :

• Primery :• Advice on stop smoking , tobacco chewing & alcohol intake • Dietary advice

• Secondery • Screen entire oral mucosa

• Recognize abnormalities • Identify candida infection • Refer any suspicious lesion to hospital

• Tertiary : importance of routine intraoral & extra examination • Regular review • Low threshold for referral • chemoprevention

COMPLICATION : • Stem either the cancer itself or from treating the cancer , if cancer

spread to other tissue often to neck or throat my prove fatal…..

• How ever the surgery , radiation and chemotherapy used to treat the oral cancer can it self cause complication including difficulty swallowing and dry mouth , , an inablity to produce enough saliva for good oral health …surgery may disfigure the face, head and neck

POINTS TO BE REMMEMBER

1. Most of the cancer are located of lateral border of tongue ,floor of the mouth and lip so a special attention should be focused in this area

2. Tell your patient what you are doing with every procedure and why 3. Always note any changes in color and texture of all soft tissue or any swelling ,if detecting any

abnormality ,determine a history of the lesion , if the abnormality has been of more than 2 weeks duration ,take appropriate action to doing biopsy

4. Follow up to ensure definitive diagnosis of an abnormality 5. Remove all removable prosthesis before staring the examination 6. Tech your patient the sign and symptom of oral cancer7. If the patient uses tobacco products provide appropriate counseling or refer patient for counseling

THANK YOU

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