If you smoke more than a pack of cigarettes a day, your chances of developing oral cancer are about 10 times higher than the average person. If you combine smoking with drinking, the incidence rate becomes even higher. It is crucial to check whether your everyday habits are leading to oral cancer.
Oral cancer is a malignant tumor that can occur anywhere in the mouth, from the oral cavity to the gums, cheek lining, tongue, floor of the mouth, back of the molars, jawbone, lips, oropharynx (back of the tongue), and the areas connecting to the throat. Most commonly, it occurs on the tongue and in the gums, including the upper and lower jaws and cheek lining. According to the National Cancer Registration Statistics last year, as of 2020, there were 4,064 cases of oral cancer, accounting for 1.6% of all cancer occurrences.
Oral cancer is characterized by a lesion that continues to grow and does not disappear in a specific area. Environmental factors play a more significant role than genetic factors. Smoking, chewing tobacco, drinking, dietary habits, and nutritional deficiencies all have an impact. If you drink and smoke together, the incidence rate is about 15 times higher. Poor oral hygiene or continuous irritation from dentures is also a major cause, along with the human papillomavirus (HPV), syphilis, and leukoplakia of the oral mucosa. Particularly, the incidence rate of oral cancer in women has been increasing, with a male to female ratio of 2.7:1. This is believed to be due to the increase in smoking and drinking among women.
Professor Jeong Eun-Jae of the Department of Otolaryngology at Seoul National University Hospital advised, “Knowing the suspicious symptoms can be helpful as early detection and treatment of oral cancer are most important.” He further added, “If leukoplakia or red spots in the mouth, or inflammatory ulcers like stomatitis persist for more than three weeks, or if the range of lesions is wide or there is persistent bleeding and pain, a biopsy or other detailed examination should be conducted.”
As oral cancer progresses, it often metastasizes to the lymph nodes under the jaw, so a lump in the neck can be felt. Therefore, if you feel a lump in your neck or experience discomfort or pain when swallowing food, you should seek a specialist’s examination. Oral cancer can be overlooked in its early stages as it can mimic stomatitis or periodontal disease. As it is a dangerous cancer that easily metastasizes to lymph nodes in the neck, regular check-ups are necessary.
If oral cancer is visible to the naked eye, it can be confirmed without an otolaryngological endoscopic examination. If the lesion progresses to the tonsils or the root of the tongue, the lesion is confirmed by comprehensively judging the results of the otolaryngological endoscopy and imaging examination.
To diagnose oral cancer, a biopsy is performed by removing a small piece from the suspected area in the mouth under local anesthesia and diagnosing it under a microscope. Any oral lesion that does not heal for more than three weeks, especially large lesions accompanied by pain and bleeding, must be confirmed through a biopsy. In addition, to confirm the exact invasive range of the lesion and the presence of systemic metastasis to lymph nodes or lungs, computerized tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) are used.
Particularly in patients diagnosed with oral cancer due to smoking, there is a possibility of metastasis or multiple cancers in other organs, including the esophagus and lungs, so additional endoscopy or imaging examinations are necessary.
The treatment of oral cancer varies depending on the stage of the disease, age, overall health, and the range of defects, but surgical treatment is primarily considered. Generally, the cure rate for early oral cancer is about 80%. However, in advanced stages, it is known to drop to 30%.
Early oral cancer can easily progress within the mouth, and in many cases, additional reconstructive surgery is not necessary if the defect area is not large. However, there are many factors to consider in the case of advanced oral cancer. Typically, treatment is not limited to surgery alone, but is followed by radiation therapy or chemotherapy. As oral cancer progresses, it can invade other parts of the mouth or structures around the mouth, resulting in a wider area being removed during surgery.
Since the structures in the mouth play a crucial role in eating and speaking, it is important to minimize secondary functional loss due to surgery. Moreover, if facial bones such as the jawbone need to be removed, appropriate reconstruction is essential as it directly affects the shape of the face. Reconstruction after oral cancer surgery involves transplanting necessary skin, muscle, and bone tissues from various parts of the body such as the arms, legs, back, and abdomen to the required areas in the mouth. Recently, digital programs and 3D printing technology have been used to reproduce removed jawbones, facial bones, and teeth, improving the quality of life after surgery.
Professor Jeong emphasized, “Research results that lifestyle habits are closely related to oral cancer suggest that it is somewhat possible to prevent oral cancer through personal lifestyle improvements.” For the prevention of oral cancer, quitting smoking, controlling alcohol consumption, and blocking radiation or ultraviolet rays are necessary. Many studies have also revealed that the intake of fruits and green-yellow vegetables, and vitamins A, C, and E can prevent the occurrence of oral cancer. Hot or hard food can stimulate the mouth, and continuous damage from ill-fitting dentures or worn-out oral prosthetics, and wounds occurring in the oral mucosa can potentially turn into oral cancer, necessitating regular check-ups and improvements.
Professor Jeong advised, “As with most cancers, the treatment methods and results of early cancer and advanced cancer show a big difference.” He added, “Early cancer is easy to treat, has a high cure rate, and does not leave sequelae, but advanced cancer is complex to treat, has a low cure rate, and is often accompanied by various functional declines, increasing the risk of a lower quality of life.” He concluded, “Therefore, it is important to pay attention to oral hygiene, avoid smoking, excessive drinking, and chronic stimulation in the mouth, and see a specialist quickly if a suspicious lesion occurs. Even in the case of advanced cancer, medical staff are doing their best through rapidly advancing medical technology to maintain the quality of life while achieving a cure, so don’t be disappointed and let’s overcome this together.”
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