Oral cavity cancer
Oral cavity cancer – the malignant new growth coming from an epithelium and soft tissues of a mouth. At early stages proceeds asymptomatically, represents a small knot or a sore. In the subsequent cancer of an oral cavity increases in the diameter, pain, at first local, then – irradiating in the head and ears develops. Salivation amplifies. At disintegration there is an unpleasant smell from a mouth. Often secondary infections join. At limfogenny metastasis increase in regionarny lymph nodes is noted. The diagnosis is exposed taking into account data of survey and a biopsy. Treatment – radiotheraphy, expeditious removal, chemotherapy.
Oral cavity cancer
Oral cavity cancer – the malignant tumor which is localized in a zone of language, mucous cheeks, gums, a bottom, the sky or alveolar shoots of jaws. The incidence depends on the region, the disease affects residents of the Asian states more often. In Russia cancer of an oral cavity makes 2-4% of total of oncological diseases, in the USA – 8% (it is probable, caused by a large number of emigrants from the countries of Asia), in India – 52%. Usually it is found in patients 60 years are more senior. It is seldom diagnosed for children. The expressed prevalence of males is noted.
65% of cancer of oral cavity are presented by new growths of language, 13% – mucous cheeks, 11% – a mouth floor, 9% - a hard palate and the mucous top jaw of alveolar shoots, 6,2% - a soft palate, 6% - the mucous lower jaw of alveolar shoots, 1,5% – a uvula, 1,3% - palatal handles. Epitelialny tumors come to light more often than sarcomas. Oral cavity cancer quite often develops against the background of the precancer processes which are usually arising at the age of 40-45 years. Treatment is performed by experts in the sphere of oncology and maxillofacial surgery, sometimes – with the assistance of otolaryngologists.
Oral cavity cancer reasons
The reasons of tumors of a mouth are definitely not established, however, experts managed to define a number of the factors promoting development of this pathology. The leading role in developing of cancer of oral cavity is played by addictions, especially – a combination of smoking and abuse of alcohol. At residents of the countries of Asia chewing of a betel and the use of NASA are of great importance. As the factor, the second for the importance, provoking oral cavity cancer, oncologists consider the repeating mechanical injuries: use of low-quality dentures, wounds arising at contact with a keen edge of a seal or a splinter of tooth.
Less often in the anamnesis of patients with cancer of an oral cavity single mechanical damages come to light: maxillofacial injuries or wound dental tools during removal or dental care. Oncologists and stomatologists point to importance of hygiene of an oral cavity, removal of a scale, treatment of caries and a periodontal disease and to inadmissibility of installation of the dentures made of different materials (it causes galvanic currents and promotes development of diseases of a mouth).
The last researches of the American oncologists indicate existence of communication between new growths of a mouth and nasopharynx and a virus of papilloma of the person, sexually transmitted, at kisses or (more rare) at household contacts. The virus not always provokes tumors, but increases risk of their emergence. At some patients with cancer of an oral cavity communication with professional vrednost is traced: work in strongly polluted rooms, contact with cancerogenic substances, long stay in conditions of the high humidity increased or the lowered temperature. Besides, development of cancer of oral cavity is promoted by the use of spicy or too hot food and deficiency of vitamin A at which processes of an orogoveniye of an epithelium are broken. New growths often appear against the background of chronic inflammatory and precancer defeats.
Classification of cancer of oral cavity
Taking into account features of a histologic structure allocate the following types of planocellular cancer:
- in situ oral cavity cancer. It is found seldom.
- Orogovevayushchy planocellular cancer. Existence of large sites of the horny epithelium ("cancer pearls") comes to light. Rapid aggressive local growth is characteristic. It is diagnosed in 95% of cases.
- Neorogovevayushchy planocellular cancer of an oral cavity with growth of an atypical epithelium without congestions of the horny cages.
- The low-differentiated cancer which cells remind sarkomatozny. Proceeds most zlokachestvenno.
Taking into account features of growth of a tumor distinguish three forms of cancer of oral cavity: ulcer, knotty and papillary. The ulcer form – the most widespread, is shown by education slowly or quickly growing ulcers. Knotty cancer of an oral cavity on appearance represents the dense knot covered with whitish spots. At papillary new growths in a mouth there are quickly growing dense outgrowths.
For definition of tactics of treatment of a disease use four-phasic classification of cancer of oral cavity:
- 1 stage – diameter of a tumor does not exceed 1 cm, the new growth does not extend out of limits of mucous and submucous layers. Lymph nodes are not changed.
- 2A the stage - comes to light the new growth with a diameter less than 2 cm sprouting fabrics on depth no more than 1 cm Regionarny lymph nodes of an intaktna.
- 2B the stage – is observed a picture of cancer of oral cavity 2A stages and damage of one regionarny lymph node.
- 3A a stage – diameter of a tumor does not exceed 3 cm Regionarny lymph nodes are not involved.
- 3B a stage – numerous metastasises in regionarny lymph nodes come to light.
- 4A a stage – cancer of an oral cavity extends to bones and soft facial tissues. Regionarny metastasises are absent.
- 4B the stage – is found a tumor of any size, there are remote metastasises or the motionless affected lymph nodes.
Oral cavity cancer symptoms
At early stages the disease proceeds asymptomatically or is shown by poor clinical symptomatology. Patients can notice unusual feelings in an oral cavity. At external survey the sore, a crack or the site of consolidation come to light. A quarter of patients with cancer of an oral cavity shows complaints to local pains, explaining emergence of a pain syndrome with various inflammatory diseases of a nasopharynx, teeth and gums. When progressing oncological process symptoms become brighter. Pains amplify, irradiate in a forehead, an ear, malar or temporal areas.
Strengthening of a salivation caused by irritation mucous products of disintegration of cancer of oral cavity is noted. Because of disintegration and infection of a new growth the putrefactive smell from a mouth appears. Over time the tumor affects the next anatomical structures, causing deformations of the person. Increase in one or several regionarny lymph nodes is found. In the beginning lymph nodes are mobile, then are soldered to surrounding fabrics, sometimes – to the disintegration phenomena. Hematogenic metastasises come to light at 1,5% of patients, usually affect a brain, lungs, a liver and bones.
Separate types of cancer of oral cavity
Language cancer usually arises on its side surface, settles down in a root zone, on the lower surface, a back or a tip less often. Already at the initial stages cancer of an oral cavity causes disorders of chewing, swallowing and the speech that facilitates timely diagnostics. In the subsequent there are pains on the course of a trigeminal nerve. At defeat of a root breath difficulties are possible. Early formation of the secondary centers in regionarny lymph nodes is characteristic.
Mouth bottom cancer at early stages proceeds asymptomatically. Patients address the stomatologist after identification of the opukholevidny education felt as a painless outgrowth. Oral cavity cancer early sprouts nearby fabrics. When progressing regionarny lymph nodes are surprised, there are pains and the strengthened salivation. Bleedings are possible.
Cancer of a mucous cheek is usually localized at the level of the line of a mouth. At early stages patients with cancer of an oral cavity can not address the expert, taking a tumor for an aftozny ulcer. In the subsequent the ulcer increases in the diameter, patients note pains when chewing, swallowing and the speech. At germination of chewing muscles restrictions in attempt to open a mouth are observed.
Sky cancer usually is followed by early emergence of a pain syndrome. In the field of the sky the ulcer or growing, quickly knot comes to light. Sometimes in the beginning cancer of an oral cavity flows asymptomatically, and pains arise at distribution of process on nearby fabrics and accession of an infection.
Cancer mucous alveolar shoots early provokes a toothache, shaking and loss of teeth. Is followed by frequent bleedings.
Diagnostics and cancer therapy of an oral cavity
The diagnosis is exposed taking into account the yielded external survey and results of a biopsy. Ultrasonography, KT and MRT at cancer of an oral cavity are not informative. At suspicion appoint a X-ray analysis of a facial skeleton to defeat of bone structures. For identification of the remote secondary centers carry out ultrasonography of an abdominal cavity and a X-ray analysis of a thorax. The differential diagnosis of cancer of oral cavity is carried out with the precancer processes specific (tuberculosis, syphilis) and nonspecific inflammatory defeats.
Cancer therapy of an oral cavity – radiotheraphy, chemotherapy and surgical interventions. Use of the combined therapy or the isolated techniques is possible. At oral cavity cancer 1-2 stages good effect are provided by brachytherapy. Most of experts give preference to this method as it excludes formation of functional and cosmetic defects and is rather easily transferred by patients. At the same time, the technique does not allow to achieve long remission at distalno the located new growths and tumors 3-4 stages.
The volume of operation at cancer of an oral cavity is defined by prevalence of a new growth. The knot is excised together with not changed fabrics. In the course of radical removal of cancer of oral cavity excision of muscles or a resection of a bone can be required. At emergence of rough cosmetic defects perform plastic surgeries. At breath difficulty perhaps temporary imposing of a tracheostoma until elimination of an obstacle to the movement of air. The chemotherapy at cancer of an oral cavity is less effective. The technique gives the chance to reduce tumor volume by 50 and more percent, but does not provide full treatment therefore it is usually applied in combination with operations and radiotheraphy.
Forecast of cancer of oral cavity
The forecast at cancer of an oral cavity is defined by an arrangement and a stage of process, extent of defeat of these or those anatomical structures, age and a condition of the patient. Tumors of back departments of a mouth proceed more zlokachestvenno. The five-year bezretsidivny period at language new growths 1-2 stages after a course of the isolated radiotheraphy makes 70-85%. At tumors of a mouth floor this indicator equals 46-66%, at cheek cancer – 61-81%. At oral cavity cancer 3 stages lack of a recurrence for 5 years is observed at 15-25% of patients.