Oral cancer
Classification & external resources

Histopathologic image illustrating well differentiated squamous cell carcinoma in the excisional biopsy specimen. Hematoxylin-eosin stain.
ICD-10	C00.-C06.
ICD-9	140-146
DiseasesDB	9288
MeSH	D009959

Oral cancer is any cancerous tissue growth located in the mouth. It may arise as a primary lesion originating in any of the oral tissues, by metastasis from a distant site of origin, or by extension from a neighboring anatomic structure, such as the nasal cavity or the maxillary sinus. Oral cancers may originate in any of the tissues of the mouth, and may be of varied histologic types: teratoma, adenocarcinoma derived from a major or minor salivary gland, lymphoma from tonsillar or other lymphoid tissue, or melanoma from the pigment producing cells of the oral mucosa. Far and away the most common oral cancer is squamous cell carcinoma, originating in the tissues that line the mouth and lips. Oral or mouth cancer most commonly involves the tissue of the lips or the tongue. It may also occur on the floor of the mouth, cheek lining, gingiva (gums), or palate (roof of the mouth). Most oral cancers look very similar under the microscope and are called squamous cell carcinoma. These are malignant and tend to spread rapidly. Image File history File linksMetadata Download high-resolution version (2040x1536, 587 KB) Histopathologic image illustrating well differentiated squamous cell carcinoma in the excisional biopsy specimen. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // C00-D48 - Neoplasms (C00-C14) Malignant neoplasms, lip, oral cavity and pharynx (C00) Malignant neoplasm of lip (C01) Malignant neoplasm of base of tongue (C02) Malignant neoplasm of other and unspecified parts of tongue (C03) Malignant neoplasm of gum (C04) Malignant neoplasm of floor of mouth (C05) Malignant neoplasm of... // C00-D48 - Neoplasms (C00-C14) Malignant neoplasms, lip, oral cavity and pharynx (C00) Malignant neoplasm of lip (C01) Malignant neoplasm of base of tongue (C02) Malignant neoplasm of other and unspecified parts of tongue (C03) Malignant neoplasm of gum (C04) Malignant neoplasm of floor of mouth (C05) Malignant neoplasm of... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ... For other uses, see Mouth (disambiguation). ... For the musical composition, see Metastasis (Xenakis composition). ... The nasal cavity (or nasal fossa) is a large air-filled space above and behind the nose in the middle of the face. ... The maxillary sinus is the largest paranasal sinus. ... A thin section of lung tissue stained with hematoxylin and eosin. ... Look up teratoma in Wiktionary, the free dictionary. ... Adenocarcinoma is a form of carcinoma that originates in glandular tissue. ... The salivary glands produce saliva, which keeps the mouth and other parts of the digestive system moist. ... This article is about lymphoma in humans. ... This article or section contains too much jargon and may need simplification or further explanation. ... The human lymphatic system The lymphatic system is a complex network of lymphoid organs, lymph nodes, lymph ducts, lymphatic tissues, lymph capillaries and lymph vessels that produce and transport lymph fluid from tissues to the circulatory system. ... Biopsy of a highly differentiated squamous cell carcinoma of the mouth. ... The mouth, also known as the buccal cavity or the oral cavity, is the opening through which an animal or human takes in food. ... The mouth, also known as the buccal cavity or the oral cavity, is the opening through which an animal or human takes in food. ... For other uses, see Tongue (disambiguation). ... The gingiva (sing. ... Biopsy of a highly differentiated squamous cell carcinoma of the mouth. ... In medicine, malignant is a clinical term that means to be severe and become progressively worse, as in malignant hypertension. ...

Known risk factors

In 2007, in the US alone, about 34,000 individuals will be diagnosed with oral cancer. 66% of the time these will be found as late stage three and four disease. Low public awareness of the disease is a significant factor, but these cancers could be found at early highly survivable stages through a simple, painless, 5 minute examination by a trained medical or dental professional. United States may refer to: Places: United States of America SS United States, the fastest ocean liner ever built. ...

All cancers are diseases of the DNA in the cancer cells. Oncogenes are activated as a result of mutation of the DNA. The exact cause is often unknown. Risk factors that predispose a person to oral cancer have been identified in epidemiological studies. The structure of part of a DNA double helix Deoxyribonucleic acid, or DNA, is a nucleic acid molecule that contains the genetic instructions used in the development and functioning of all known living organisms. ... An oncogene is a gene that can cause a cell to develop into a tumor cell, possibly resulting in cancer. ...

Smoking and other tobacco use are associated with about 75 percent of oral cancer cases, caused by irritation of the mucous membranes of the mouth from smoke and heat of cigarettes, cigars, and pipes. Tobacco contains over 19 known carcinogens, and the combustion of it, and by products from this process, is the primary mode of involvement. Use of chewing tobacco or snuff causes irritation from direct contact with the mucous membranes. Shredded tobacco leaf for pipe smoking Tobacco can also be pressed into plugs and sliced into flakes Tobacco is an agricultural product processed from the fresh leaves of plants in the genus Nicotiana. ... The mucous membranes (or mucosae; singular: mucosa) are linings of mostly endodermal origin, covered in epithelium, and are involved in absorption and secretion. ... Unlit filtered cigarettes. ... For other uses, see Cigar (disambiguation). ...

In many Asian cultures chewing betel, paan and Areca is known to be a strong risk factor for developing oral cancer. In India where such practices are common, oral cancer represents up to 40% of all cancers, compared to just 4% in the UK. For other uses, see Asia (disambiguation). ... Binomial name Piper betle L. The Betel (Piper betle) is a spice whose leaves have medicinal properties. ... Betel pepper (Piper betle) vines Shopkeeper making Paan in an Indian store Paan, pan (in many Indic languages, हिन्दी : पान ), or beeda (in Tamil) is a type of Indian snack, which consists of fillings wrapped in a triangular package using leaves of the Betel pepper (Piper betle) and held together with a... Species (Betel nut palm) and about 50 more Areca is a genus of about 50 species of single-stemmed palms in the family Arecaceae, found in humid tropical forests from Malaysia to the Solomon Islands. ...

Alcohol use is another high-risk activity associated with oral cancer. There is known to be a strong synergistic effect on oral cancer risk when a person is both a heavy smoker and drinker. Their risk is greatly increased compared to a heavy smoker, or a heavy drinker alone. This article does not cite any references or sources. ...

Some oral cancers begin as leukoplakia a white patch (lesion), red patches, (erythroplakia) or non healing sores that have existed for more than 14 days. In the US oral cancer accounts for about 8 percent of all malignant growths. Men are affected twice as often as women, particularly men older than 40/60. Leukoplakia is a condition of the mouth that involves the formation of white leathery spots on the mucous membranes of the tongue and inside of the mouth. ... Erythroplakia is a flat red patch or lesion on the oral or pharyngeal surfaces. ...

Human Papilloma Virus, (HPV) particularly versions 16 and 18 ( there are over 100 varieties) is a known risk factor and independent causative factor for oral cancer. (Gilsion et.al.Johns Hopkins) A fast growing segment of those diagnosed does not present with the historic stereotypical demographics. Historically that has been people over 50, blacks over whites 2 to 1, males over females 3 to 1, and 75% of the time people who have used tobacco products or are heavy users of alcohol. This new and rapidly growing sub population between 20 and 50 years old is predominantly non smoking, white, and females slightly outnumber males. Recent research from Johns Hopkins indicates that HPV is the primary risk factor in this new population of oral cancer victims. HPV16/18 is the same virus responsible for the vast majority of all cervical cancers and is the most common sexually transmitted infection in the US. Oral cancer in this group tends to favor the tonsil and tonsillar pillars, base of the tongue, and the oropharnyx. Recent data suggest that individuals that come to the disease from this particular etiology have some slight survival advantage. Human papillomavirus (HPV) is a virus which affects humans. ... Cervical cancer is a malignant cancer of the cervix. ...

Symptoms

Skin lesion, lump, or ulcer: Endoscopic images of a duodenal ulcer. ...

• On the tongue, lip, or other mouth area
• Usually small
• Most often pale colored, may be dark or discolored
• Early sign may be a white patch (leukoplakia) or a red patch (erythroplakia) on the soft tissues of the mouth
• Usually painless initially
• May develop a burning sensation or pain when the tumor is advanced

Additional symptoms that may be associated with this disease:

• Tongue problems
• Swallowing difficulty
• Mouth sores that do not resolve in 14 days
• Pain and paraesthesia are late symptoms.

Paresthesia (paraesthesia in British) is a sensation of tingling, pricking, or numbness of the skin with no apparent physical cause, more generally known as the feeling of pins and needles. ...

Signs and tests

An examination of the mouth by the health care provider or dentist shows a visible and/or palpable (can be felt) lesion of the lip, tongue, or other mouth area. As the tumor enlarges, it may become an ulcer and bleed. Speech/talking difficulties, chewing problems, or swallowing difficulties may develop, particularly if the cancer is on the tongue. Skin lesions caused by Chickenpox A lesion is any abnormal tissue found on or in an organism, usually damaged by disease or trauma. ... For malignant tumors specifically, see cancer. ... Endoscopic images of a duodenal ulcer. ...

While a dentist, physician or other medical professional may suspect a particular lesion is malignant, the only definitive method for determining this is through biopsy and microscopic evaluation of the cells in the removed sample. A tissue biopsy, whether of the tongue or other oral tissues, and microscopic examination of the lesion confirm the diagnosis of oral cancer. Brain biopsy A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ...

Treatment

Surgical excision (removal) of the tumor is usually recommended if the tumor is small enough, and if surgery is likely to result in a functionally satisfactory result. Radiation therapy is often used in conjunction with surgery, or as the definitive radical treatment, especially if the tumour is inoperable. Varian Clinac 2100C Linear Accelerator Radiation therapy (or radiotherapy) is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). ...

Owing to the vital nature of the structures in the head and neck area, surgery for larger cancers is technically demanding. Reconstructive surgery may be required to give an acceptable cosmetic and functional result. Bone grafts and surgical flaps such as the radial forearm flap are used to help rebuild the structures removed during excision of the cancer. A bone graft is a surgical procedure where bone is taken from a donor site and placed elsewhere within the patient. ...

Survival rates for oral cancer depend on the precise site, and the stage of the cancer at diagnosis. Overall, survival is around 50% at five years when all stages of initial diagnosis are considered. Survival rates for stage 1 cancers are 90%, hence the emphasis on early detection to increase survival outcome for patients.

Following treatment, rehabilitation may be necessary to improve movement, chewing, swallowing, and speech. Speech therapists may be involved at this stage. Physical medicine and rehabilitation (PM&R) or physiatry is a branch of medicine dealing with functional restoration of a person affected by physical disability. ... It has been suggested that Speech-Language Pathology, Speech pathology, Phoniatrics be merged into this article or section. ...

Chemotherapy is useful in oral cancers when used in combination with outher treatment modalities such a radiation therapy. It is seldmom used alone as a monotherapy. When cure is unlikely it can also be used to extend life and can be consider palliative but not curative care. Biological agents, such as Cetuximab have recently been shown to be effective in the treatment of squamous cell head and neck cancers, and are likely to have an increasing role in the future management of this condition when used in conjuction with other treatments. Chemotherapy is the use of chemical substances to treat disease. ...

Treatment of oral cancer will usually be by be a multidisciplinary team, with treatment professionals from the realms of radiation, surgery, chemotherapy, nutrition, dental professionals, and even psychology all possibly involved with diagnosis, treatment, rehabilitation, and patient care.

Complications

• Postoperative disfigurement of the face, head and neck
• Complications of radiation therapy, including dry mouth and difficulty swallowing
• Other metastasis (spread) of the cancer

For the musical composition, see Metastasis (Xenakis composition). ...

External links

• US oral/mouth cancer foundation, with survivor/patient interactive support group, and hundreds of pages of peer reviewed information
• NIH site on oral cancer
• Mouth Cancer Foundation information site and online support group in the UK
• a website with lots of information and photographs on mouth cancer especially in India
• Cancer Help UK
• Liverpool based centre with international reputation in the treatment of oral and oro-pharyngeal cancer