Oral cancer can spread if neglected.

Phyathai Phaholyothin

5 Min

Tu 28/05/2024

AI Translated

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Oral cancer can spread if neglected.

This is why oral cancer occurs

Oral cancer often occurs in people aged 40 and above who smoke, drink alcohol, or those in the northeastern region who still chew betel nut. Chewing betel nut is also a risk factor. Additionally, Dr. Dulyapong mentioned recent research that infection with the carcinogenic virus Human papillomavirus (HPV), the same virus that causes cervical cancer, is another risk factor for oral cancer. Oral HPV infection is associated with oral sex.

 

Symptoms of oral cancer include chronic sores or lumps in the mouth lasting more than 2 weeks, as well as white and red patches in the mouth. He also added that these sores or lumps can occur anywhere, but the most common sites are the tongue, the sides of the tongue, and under the tongue. This differs from canker sores, as cancerous sores in the mouth do not heal and last longer than 2 weeks. The sores may have raised edges, hard borders, and some people may not feel any pain but only notice the lesion. There have been cases where the sore lasted a long time but the patient did not see a doctor until it was finally diagnosed as oral cancer.

 

Why is oral cancer more common in the elderly?

It is normal for elderly people to have oral health problems. Regarding teeth, issues such as tooth wear, tooth fracture, and easy tooth decay are common. Gum problems like periodontitis or gingivitis are also frequent. Other oral issues include dry mouth, altered taste, or burning sensations in the mouth. Similarly, precancerous lesions or oral cancer lesions are often found in the elderly. This is due to the degeneration of oral organs such as teeth, gums, and soft tissues, combined with systemic diseases or multiple medications that affect oral health, causing dry mouth and burning sensations. Moreover, the long-term accumulation of carcinogens from smoking, betel nut chewing, or alcoholic beverages often leads to tissue changes in the mouth, resulting in precancerous lesions or oral cancer in the elderly.

 

Screening… Prevention before it’s too late

For those at risk, doctors recommend oral cancer screening, which can be done by examining the soft tissues. “Some patients with oral sores may not know whether they need to be checked or how to do it. Screening by a specialized dentist who is an expert in soft tissue examination is an option for patients. Even those without symptoms but who are concerned can come for screening. Soft tissue examination is to check for oral cancer or precancerous lesions. If lesions are found, the next step is a biopsy for detailed examination. For those without lesions but with risk factors such as smoking, drinking, betel nut chewing, or oral HPV infection, regular monitoring is necessary to watch for oral cancer development. From my experience, some patients had sores for years but thought it was nothing because they had no symptoms until they saw a doctor and were diagnosed with oral cancer. Therefore, raising awareness is important so patients know that if they have sores or unusual white or red patches in the mouth, they should get checked. A specialized dentist can visually examine the soft tissues to diagnose and plan treatment or decide if a biopsy is needed.”

 

Treatment varies according to the cancer stage

Before oral cancer develops, there are often signs in the mouth that can be detected at the precancerous stage. However, these lesions usually have no symptoms, causing most patients to think nothing is wrong. When they see a doctor, symptoms are often severe. The doctor explained that this is why treatment is difficult for most patients. “Usually, patients who have not been screened tend to be in the late stages, stage 3 or 4, and come to the doctor when symptoms are severe. This is because there were no symptoms before, or they waited until the pain was unbearable. Some may have pain, numbness, abnormal bleeding, or loose teeth, but some may have no symptoms. Treatment at stages 3 or 4 is more difficult, complicated, and survival rates are lower. Therefore, if screening detects cancer early or at the precancerous stage, treatment is less complicated. Especially at the precancerous stage, it may only require removal and continuous monitoring. If cancer is present, treatment depends on the stage. Early-stage cancer that has not spread to lymph nodes or other sites and is small in size has a high success rate. However, in later stages or if the cancer is large and has spread to lymph nodes or other organs, it is considered dangerous because cancer can spread to other parts of the body, especially through lymph nodes.”

 

Reduce complications by clearing the mouth before radiation therapy

Radiation therapy is one of the treatments for many types of cancer in the body, including oral, head, and neck cancers. Before radiation treatment in the oral, head, and neck areas, doctors advise patients to clear their mouths to reduce side effects from radiation in these areas. “Clearing the mouth before radiation therapy is very important, especially for those receiving radiation in the oral, head, and neck areas because it affects the salivary glands, causing dry mouth, which leads to easy tooth decay. Moreover, radiation also affects the bones in cases where radiation is applied to the face or jaw. If teeth need to be extracted after radiation, the bone may not heal or close normally, resulting in osteonecrosis, where the bone gradually becomes exposed. Some patients may require bone removal surgery, may develop infections, or other complications, leading to further treatment. In cases where extensive osteonecrosis occurs in the jaw, complete removal may be necessary. Therefore, doctors usually recommend patients clear their mouths before radiation. Dentists help assess which teeth should be kept and which should be extracted before radiation because if poor teeth are kept and need extraction after radiation, it can lead to serious problems or osteonecrosis.”


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