Cancer lip and oral cavity:
Oncology / / August 12, 2017
lip and oral cavity cancer - a disease in which malignant (cancer) cells form in the lips or in the mouth.Malignant tumors of the lips, mouth and throat have a common origin, a similar structure and the same reasons for the development.
oral cavity include:
- two front third of the tongue;
- buccal mucosa (the inner surface of the shell of the lips and / or cheeks);
- the bottom of the mouth under the tongue;
- hard palate (the front part of the bone of the upper jaw);
- retromolar triangle (the small area behind the wisdom teeth).
Most cases of mouth cancer and mouth start in squamous cells - thin, flat cells that line the lips and oral cavity.They are called "squamous cell carcinoma".
With the development of cancer, cancer cells can spread to deeper tissues.Squamous cell carcinoma usually develops in areas of leukoplakia (white patches - cells that can not be erased).
lip and oral cavity cancer is a type of head and neck cancer.
Risk factors for lip and oral c
All that increases the risk of infection is referred to as the "risk factor".Having a risk factor does not mean that a person has cancer arises, and the absence of risk factors does not mean that a person will not develop cancer.Any person should talk to your doctor if you think that might be at risk of
cancer risk factors lip and oral cavity include:
- the use of tobacco products, smoking;
- excessive use of alcohol;
- exposure to aggressive natural sunlight or artificial sunlight (such as from tanning beds) for a long time;
- the male sex;
- infection with human papilloma virus (HPV);
- possible signs of lip and oral cavity diseases, including pain on the lips or in the mouth.
Symptoms of mouth cancer and oral
These and other symptoms may be caused by cancer of the lips and oral cavity:
- sore on the lip or in the mouth that does not heal;
- single seal on the lips, on the gums or in the mouth;
- white or red patches on the gums, tongue, tonsils and oral mucosa;
- bleeding, pain or numbness of the lips or the whole mouth;
- change of voice;
- the mobility of the teeth or dentures that are not clearly fit in the jaw;
- trouble chewing, swallowing or moving the tongue or jaw;
- swelling of the jaw;
- sore throat or feeling that the throat is something worth (lump).
This cancer of the lips and oral cavity of the mouth may not have any symptoms and is sometimes found only during regular dental examinations.
diagnosis of cancer of the lips and mouth
tests by which check the mouth and throat are used to detect (find) and diagnose the stage lip and oral cavity cancer.
following tests and procedures may be used:
- Diagnostic examination of the lips and oral cavity to check the abnormal areas of the lips and mouth.The doctor will examine the inside of the mouth in a sterile gloved finger and examine the oral cavity with a small long-handled mirror and lights.This will include a check of the inside of the cheeks and lips, gums, floor of the mouth and upper, lower and side portions of the language.On the neck will be felt swollen lymph nodes.Also, the patient's medical history will be investigated, his habits, past illnesses and medical and dental treatment;
- Endoscopy - body treatment inspection organs and tissues inside to check for abnormal areas.An endoscope is a thin, tubular instrument with a light and a lens for viewing.It may also have a tool to remove tissue samples or lymph nodes are checked under a microscope for signs of disease.The endoscope is inserted through an incision in the skin or body opening - such as for example the mouth;
- Biopsy, removal of cells or tissue to a pathologist can examine them under a microscope.If leukoplakia is found, cells are also checked under the microscope for signs of cancer;
- Exfoliative cytology.This microscopic examination of the material obtained by gynecological examination for normality;method of diagnosing abnormalities of cells, including cancer, which cells are scraped or cut off from the body surface;cell collection procedure, in this case - of the lips or oral cavity.Use a piece of cotton, a brush, or a small wooden stick to gently scrape cells from the lips, tongue, mouth, or throat;
- Magnetic resonance imaging (MRI). procedure that uses magnetic radio waves and a computer to make a series of detailed pictures of the body (of a nuclear magnetic resonance imaging - MRI);
- Computed tomography (CT). procedure that uses a computer connected to the x-ray machine, make a series of detailed pictures of areas inside the body, taken from different angles.The dye can be introduced into a vein or swallowed by the patient to the organs or tissues are more clearly visible.This procedure is also called "computerized axial tomography";
- X-ray of the esophagus and stomach with barium. patient drinks a liquid containing barium (a silver-white metallic compound that, being an artificial contrast agent allows you to explore the esophagus and stomach;
- Positron emission tomography (PET) procedure to find malignant tumor cells in the body small..glucose radionuclides (sugar) is introduced into the vein. The PET scanner rotates around the body and makes the picture locations in the body where glucose is used. Malignant tumor cells appear in the image is brighter because they are more active and receiving ( "eat") more glucosethan normal cells;
- bone scan or scintigraphy skeleton (method of radionuclide diagnostics, based on the introduction into the patient tropic to the bone radiopharmaceutical and registration of its distribution and accumulation in the skeleton using isotope gamma radiation, which is part ofpreparation;verification procedure rapidly dividing cells - such as cancer in the bones.A very small amount of radioactive material is injected into a vein and carried through the blood.The radioactive material is stored in bones and is detected by the scanner.
Stage lip and oral cavity cancer
Once cancer of the lips and oral cavity diagnosed, tests are conducted to find out if cancer cells have spread further to other parts of the body.
Information collected in the intermediate process determines the stage (stages) of the disease.It is important to know them to identify the correct treatment plan.The results of tests used to diagnose lip and oral cavity cancer, are also used for setting stages.
There are three ways that cancer spreads in the body:
- through the fabric.Cancer cells invade the surrounding normal tissue;
- via the lymphatic system.Cancer cells invade the lymphatic system and pass through the lymph vessels - in other places in the body;
- through the blood.Cancer cells invade the capillaries and veins and blood - in other places in the body.
When cancer cells break away from the primary, original, tumor and travel through the lymph nodes or blood to other places of the body, the other can form secondary tumors.This process is referred to as "metastasis."Secondary (metastatic) tumors are always the same type of cancer as the primary tumor.For example, if breast cancer spreads to the bones, the cancer cells in the bones - it actually breast cancer cells.And Disease - metastatic breast cancer, not bone cancer.
following stage (stages) are used to determine the lip and oral cavity cancer:
- Stage 0 (carcinoma in situ). abnormal cells are found only in the mucosa of the lips and mouth.These abnormal cells may subsequently become cancerous and spread to adjacent healthy tissue.
- I stage. cancer is formed, and the tumor - 2 cm or less.Cancer has not spread to the lymph nodes.
- II stage. tumor is larger than 2 cm but not more than 4 centimeters, and cancer has not spread to the lymph nodes.
- III stage. tumor can be any size and can be spread to one lymph node on the same side of the neck, and that the tumor, 3 cm or less, or slightly greater than 4 centimeters.
- Stage IV. IV stage is divided into stages (stage) IVA, IVB and IVC:
- IVA - the tumor has spread to the lips or oral tissues, as well as - in the surrounding tissue and / or bone (jaw, tongue, floor of mouth, the maxillary sinusor the skin on the chin or nose);and cancer can spread to one lymph node 3 cm or less, on the same side of the neck as the tumor, or spread on the lip or oral tissue into surrounding tissues and / or bone (jaw, tongue, floor of mouth, maxillary sinusskin or on the chin or nose), and one of the lymph nodes is not more than 6 cm on the same side of the neck, the tumor;or in the lymph nodes of the neck on the opposite side, or on both sides of the neck - not more than 6 centimeters.
- IVB - the tumor can be any size and has spread to one or more lymph nodes that are larger than 6 centimeters, or spread further - in the muscles and bones in the oral cavity or in the base of the skull and / or the carotid artery.Also cancer can spread to one or more lymph nodes anywhere in the neck.
- IVC - the tumor has spread beyond the lip and oral cavity in the distant parts of the body such as the lungs or other vital organs.The tumor may be any size and can spread to the lymph nodes.
Recurrence of cancer of the lips and oral cavity - repetition (return) of the disease after treatment.Cancer can return to the lips or mouth or other body parts.
Some of the tests that are done for the diagnosis of cancer or to determine its stage, can be made again to be seen how well the treatment is helping.The decision whether to continue, change, or discontinue treatment may be based on the results of these tests.This is sometimes referred to as "re-diagnosis" (stage).Some of the tests will continue to be made periodically after treatment.The results of these studies may show whether the patient's condition has changed and whether the cancer is repeated.These tests are sometimes called "follow-or screening test."
Treatment lip and oral cavity cancer
There are different types of treatment for patients with lip and oral cavity cancer.Some treatments are standard, and some are being tested in clinical trials.Clinical trials are conducted to improve existing treatments or obtain information on new treatments for patients with cancer.When clinical trials show that a new treatment is better than the default (conservative, habitual) treatment, the new method may become the standard treatment.Many patients can discuss with your physician participation in clinical trials.In some tests to patients who have not yet received treatment.
Treatment oversees the medical oncologist.Because the lips and oral cavity are necessary for breathing, eating and speech, patients may need special assistance: adaptation to adverse effects and treatment.The oncologist may refer the patient to other health professionals who have specialized training in the treatment of patients with head and neck cancer.They are specialists:
- Head and Neck Surgery;
- radiation oncologist;
- Speech therapist;
- a specialist in rehabilitation;
- plastic surgeon.
Surgery lip and oral cavity cancer
surgery (removal of the existing cancer) is a common treatment for all stages of lip and oral cavity cancer.Surgery may include the following:
- wide local excision - removal of the cancer and some healthy tissue around it.If the cancer has spread to bone, surgery may include removal of the involved bone tissue;
- Neck dissection: Removal of lymph nodes and other tissues in the neck.This is done when the cancer has spread beyond the lips and oral cavity;
- plastic surgeries that restore and improve the appearance of body parts.Dental implants, skin grafting or other types of plastic surgery may be needed to recover parts of the body - the mouth, throat or neck after removal of large tumors.
Even if the doctor removes all the cancer that can be seen during surgery, some patients after surgery may be given chemotherapy or radiation therapy to kill any remaining cancer cells.Treatment given after surgery to reduce the risk that the cancer will come back, is called "adjuvant therapy".
Radiation therapy for cancer lips and mouth
Radiation (radiation) therapy is a cancer treatment that uses high energy x-rays or other types of radiation to kill cancer cells.
There are two types of radiation therapy:
- External radiation therapy - uses a machine outside the body to send radiation toward the cancer.
- Internal radiation therapy - uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly on the cancer cells or near them.The method of radiation therapy depends on the type and stage of cancer being treated.
For patients who smoke, radiation therapy works better when smoking is stopped before beginning treatment.Furthermore, it is important to check for patients teeth prior radiotherapy to the existing problems can be treated.All new treatments in clinical trials.
Chemotherapy with cancer of the lips and mouth
Chemotherapy - cancer treatment that uses drugs to kill cancer cells or stop their growth and prevent them from dividing.
When chemotherapy drugs are taken orally or injected them in a vein or muscle.Drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy).Chemotherapy drugs are injected directly into the cerebrospinal fluid, body cavity or body - for example, in the stomach, by acting directly on the cancer cells in those areas (regional chemotherapy).A method of chemotherapy depends on the type and stage of the malignant process.
hyperfractionated radiotherapy.It radiation therapy, in which the total dose of radiation is divided into small doses.Procedures carried out more than once a day.
Hyperthermic therapy. Hyperthermic therapy (hyperthermia) - treatment in which body tissue is heated above normal Temperature-to damage or kill cancer cells or to make them more sensitive to radiation and certain anticancer drugs.
treatment options for cancer of the lips and oral cavity in stages
1 stage lip and oral cavity cancer
Treatment depends on where it is in the lip and oral cavity cancer is.
- Guba. If the cancer is in the lip, treatment may include:
- surgery (wide local excision);
- internal radiation therapy with external beam radiation therapy with or without.
- The front part of the tongue. If the cancer is in the front of the tongue, treatment may include:
- surgery (wide local excision);
- internal radiation therapy with external beam radiation therapy with or without;
- radiation therapy to lymph nodes in the neck.
- The mucous membrane of the mouth. If the cancer is in the buccal mucosa (mucous membrane of the internal surface of the cheeks), treatment may include the following:
- surgery (wide local excision) for tumors smaller than 1 cm, with internal and / or external radiation therapy with or without;