December 8, 2021

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Prevention and treatment of oral cancer

Prevention and treatment of oral cancer

Prevention and treatment of oral cancer. Oral cancer is a general term for malignant tumors that occur in the oral cavity, most of which belong to squamous cell carcinoma, the so-called mucosal mutation. In clinical practice, oral cancer includes gum cancer, tongue cancer, soft and hard palate cancer, jaw bone cancer, mouth floor cancer, oropharyngeal cancer, salivary gland cancer, lip cancer, and maxillary sinus cancer, as well as cancers that occur in the skin and mucosa of the face. . Oral cancer is one of the more common malignant tumors of the head and neck.

Prevention and treatment of oral cancer

 

Causes of Oral Cancer

1. Long-term addiction to tobacco and alcohol

Most oral cancer patients have a long-term history of smoking and drinking. Oral cancer is rare in those who do not smoke or drink.

2. Poor oral hygiene

Poor oral hygiene habits create conditions for the growth and reproduction of bacteria or molds in the oral cavity, which is conducive to the formation of nitrosamines and their precursors. In addition to stomatitis, some cells are in a proliferative state and are more sensitive to carcinogens. Such various reasons may promote the occurrence of oral cancer.

3. Long-term stimulation of foreign bodies

Tooth roots, sharp tooth tips, and inappropriate dentures have long-term irritation to the oral mucosa, causing chronic ulcers and even cancer.

4. Malnutrition

Vitamin A deficiency can cause oral mucosal epithelial thickening and hyperkeratosis, which is related to the occurrence of oral cancer. Demographic studies have shown a high incidence of oral cancer in countries with low vitamin A intake. Some think it is related to insufficient intake of trace elements, such as low zinc content in food. Zinc is an indispensable element for the growth of animal tissues. Zinc deficiency may cause mucosal epithelial damage, creating favorable conditions for the occurrence of oral cancer. In addition, insufficient intake of total protein and animal protein may be related to oral cancer.

5. Mucosal leukoplakia and erythema

Oral mucosal leukoplakia and hyperplastic erythema are often precancerous lesions.

6. Related lesions

(1) The relationship between oral cancer and precancerous lesions

Many people have the experience of white ulcers or blisters on the inner side of the buccal mucosa. It often occurs when there is stress, poor sleep, or changes in eating habits (such as insufficient fruit). It will usually heal within two weeks; if it does not heal for more than two weeks, Must be checked to rule out the possibility of epithelial cell carcinoma.

(2) The color of the oral mucosa changes

The normal epithelium is pink, white or red polarized colors are abnormal. If the red is white with white, it is a more serious condition, and if the tip of the tongue appears dark red with white dots, it is highly suspected that cancer will occur.

(3) Ulcers

Oral mucosal ulcers that have not healed for more than two weeks.

 

Clinical manifestations

  • 1. There are lumps and nodules;
  • 2. There are white, smooth scaly patches;
  • 3. Those who have symptoms such as red plaques, ulcers, inflammatory areas, etc. and cannot be cured for a long time; #Harbin Ci’an Hospital#
  • 4. Repeated bleeding in the mouth without obvious cause;
  • 5. Numbness, burning or dryness in the mouth for no obvious reason;
  • 6. Difficulty or abnormality in speaking or swallowing.

 

An examination

1. Radionuclide inspection

In addition to providing information on tongue thyroid and oral cancer bone metastasis, it is rarely used in the diagnosis of oral cancer itself. Ultrasound is also rarely used in oral cancer. Plain X-ray and tomography can provide more valuable information when oral cancer invades the upper jaw, mandible and paranasal sinuses of the nasal cavity, but it can provide more valuable information on the location of oral cancer and the scope of tumor invasion, especially the soft tissue around the primary tumor. The situation has not yet met the needs of clinicians for diagnosis and treatment planning. CT makes up for the above requirements to a considerable extent, but CT should not be used as a routine examination method, and should be selectively applied on the basis of obtaining a detailed medical history, physical examination and other examination materials.

2. Cytology and biopsy

Exfoliation cytology examination is suitable for superficial asymptomatic precancerous lesions or early squamous cell carcinoma with unclear lesion range, and is suitable for screening examination. Then the positive and suspicious cases are further confirmed by biopsy.

The diagnosis of oral squamous cell carcinoma generally adopts forceps or biopsy, because the surface mucosa has been ruptured or abnormal, and the location is superficial. Necrosis and keratinized tissues should be avoided, and tissues should be taken at the junction of tumor and surrounding normal tissues, so that the materials obtained have both tumor tissues and normal tissues. The forceps should be sharp to prevent the tissue from being compressed and deformed and affecting the pathological diagnosis. If the tissue is deformed under pressure, another material should be taken. For submucosal masses with intact mucosa, fine needle aspiration cytology can be used.

 

Diagnosis

Diagnosis requires the determination of location, qualitative and scope: ①The anatomical division of the primary tumor and its tissue origin; ②Whether the primary tumor is a tumor. If it is a tumor, whether it is benign or malignant, ③ the lesion is limited to the original anatomical site, has spread to nearby anatomical sites, is limited to the oral cavity, has metastasized to regional lymph nodes, whether there has been distant metastasis.

 

Differential diagnosis

1. Traumatic ulcer

This ulcer often occurs on the side of the tongue, and there are always canines, tooth roots or irregular dental restorations at the corresponding part of the ulcer, indicating that the ulcer is caused by the above-mentioned irritants. The ulcer is soft, with a soft base and no induration. The ulcer will heal itself after 1 to 2 weeks after the elimination of the above irritants.

2. Tuberculous ulcer

Almost all are secondary, most of which are the result of direct spread of open tuberculosis. It often occurs in the soft palate, buccal mucosa and the back of the tongue. The ulcer is shallower than the cancerous ulcer, and the base of the ulcer is soft without infiltrating induration. The anti-tuberculosis treatment is effective. Imaging examination and tissue biopsy can accurately identify and diagnose.

 

Treatment

Treatment methods are divided into: surgical resection, radiation therapy, chemotherapy, and traditional Chinese medicine treatment.

If there is no cervical lymphatic metastasis in early oral cancer, surgery or radiation therapy alone has good results.

Oral cancer in the middle and late stages is more suitable for surgery combined with postoperative and radiation therapy.

 

Prevention

  • 1. Avoid unnecessary long-term light to prevent lip cancer.
  • 2. Avoid smoking and drinking.
  • 3. Patients with false teeth: If there is pain or inflammation in the tissue under the denture, seek medical attention in time. Strive to achieve early detection, early diagnosis and early treatment of cancer, and adhere to regular inspections.
  • 4. Balanced diet, collocation of thickness, reasonable nutrition. Do not drink or eat hot water and food to avoid irritating oral tissues.
  • 5. Pull out the residual root and crown of the tooth (tooth that cannot be repaired). Wear good dentures without irritating tissues.
  • 6. Develop good oral hygiene habits.  Brush your teeth often. Pay attention to the balance of nutrition, treat the residual roots and crowns in time to remove bad irritation.
  • 7. Actively participate in the anti-cancer publicity of oral cancer. Learn about the prevention of oral cancer and recognize the dangers of oral cancer.

 

Four symptoms to be alert to oral cancer

If the oral cavity turns white, brown or black, it means that the mucosal epidermal cells have changed. In particular, the oral mucosa becomes rough, thickened or indurated, and oral mucosa leukoplakia and erythema appear, and it is likely that cancer has occurred.

1. Unhealed ulcers

The course of oral ulcers generally does not exceed two weeks. If symptoms such as burning sensation and pain do not get better after two weeks, beware of the possibility of oral cancer. Because oral cancer often manifests in the form of ulcers, the surrounding edges are raised, the center is uneven, and there is necrotic tissue coverage, and the pain is obvious.

2. Pain is obvious

In the early stage, there is generally no pain or only local abnormal friction. The pain is obvious after the ulceration. As the tumor further invades the nerves, it can cause ear and throat pain.

3. Swollen lymph nodes

Oral cancer usually metastasizes to nearby cervical lymph nodes. Sometimes the primary lesion is small and the symptoms are not obvious, but metastatic cancer cells are found in the cervical lymph nodes. Therefore, if the lymph nodes in the neck suddenly swell, check the oral cavity.

4. Dysfunction

The tumor may invade the opening and closing muscles and mandibular joints, resulting in restricted opening and closing movement.

It should be emphasized that although the above symptoms are common symptoms of oral cancer, it is not completely used to determine whether you have cancer. Because the above symptoms can also occur with oral inflammation, it is best to go to the hospital for timely treatment for early diagnosis and symptomatic treatment.

(source:internet,reference only)


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