Oral Cancer

1. Oral Cancer Louis Collins. May 2018.

2. What is Oral Cancer? A malignancy found in the tissues of the lip, mouth or oral cavity.

3. How Common is Oral Cancer? • Oral Cancer is one of the ten most common malignancies in the world. ( this includes breast, pancreatic and testicular cancer) • In third world countries, it is the 3rd most common malignancies. • In Asia it accounts for over 40% of all cancers. • In 2013 it was reported that in the U.S alone, on average 100 people were diagnosed with Oral Cancer each day. • Unfortunately, most cases our diagnosed at late stages of development, where the survival rate is only 43%. • When diagnosed at the earlier stages, survival rate is a much higher 85%.

4. What Factors Increase the Risk of Oral Cancer? • Genetics. • Smoking-including cigars, cigarettes, pipes etc. Smokers are six times more likely to develop oral cancer than the average person. • Excessive consumption of alcohol. Drinkers are also six times more at risk than the average person. • The carcinogens in tobacco and alcoholic drinks permanently damage DNA of cells in the mouth including key genes that protects us against cancer. • Excessive sun exposure and sunbeds. The sun gives off UV rays which damage DNA of cells and supress the immune system. • Poor diet. Lack of minerals and vitamins such as iron and folic acid which can heighten chances. Poor diet can lead to a breakdown in oral mucosa, making it more prone to developing cancer.

5. Symptoms • Leucoplakia- a white patch anywhere in the mouth that cannot be rubbed off. • Erythroplakia- a red patch that is not any other identifiable condition. • Non-healing ulcers- Ulcers typically heal 10-14 days however if you have an ulcer which does not heal by 16 days seek medical attention. • Swollen lymph nodes on the throat region. • Lumps in the mouth • Difficulty swallowing + eating. • Unexplained weight loss. • Bleeding or numbness in the mouth.

7. Treatment Two types of treatment are used: • Surgery-Surgery (removing the cancer in an operation) is a common treatment for all stages of lip and oral cavity cancer. Surgery may include the following: • Wide local excision: Removal of the cancer and some of the healthy tissue around it. If cancer has spread into bone, surgery may include removal of the involved bone tissue. • Neck dissection: Removal of lymph nodes and other tissues in the neck. This is done when cancer may have spread from the lip and oral cavity. Although effective, surgery may affect speech, eating mechanisms and breathing. Plastic surgery may be required to reconstruct areas of the face, mouth or teeth. This opportunity can be provided by the NHS. After surgery, or if the tumour is minor (small), chemotherapy can be used to kill off any cancer cells. For those who smoke, the effectiveness of chemotherapy may be reduced.

8. Advancements in Treatment for Oral Cancer • Oral Cancer may arise from damage to the p53 gene which would normally produce a protein which prevents cells excessively growing. Without the gene abnormal cells grow rapidly and cancer can form. DNA can be checked early on to observe if there is any damage to the gene. This is beneficial as the earlier the cancer is detected the more likely overcoming it is. Also these tests may be used to define surgical margins and see if the tumour should be dealt with using surgery or radiotherapy. A drug called C225 is being clinically trialled- this drug supposedly makes radiation therapy more effective in killing cancer cells in the head and neck. Vaccines is another method being trialled- Its suggested vaccines would help the persons immune system to recognize and attack cancer cells. Papillomavirues ( a non enveloped DNA virus In humans )share similar genetic information to oral cancer cells.