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Oral cancer Diagnosis and Treatment- A Detailed Guide

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What are the Tests for Oral Cancer Diagnosis?

The following are the oral cancer diagnosis tests:

Physical examination


Patients suspected of having oral cancer undergo a comprehensive examination to find the cause of their symptoms. The medical history, social history, and presence of risk factors are evaluated. The doctors may ask about the development, progression, and severity of symptoms. The doctor may examine the internal mucosa of the oral cavity by touching it with gloved hands to detect the presence of bumps. If the doctor finds anything suspicious about the symptoms, the patients are referred to specialists, such as head and neck cancer specialists. There is no blood test for oral cancer diagnosis.


Scrape biopsy


Scrape biopsy is also known as exfoliative cytology. In this procedure, the doctor scrapes the abnormal area of the oral cavity and collects the cells on a glass slide. The cells are stained for a clear view and examined. If abnormal cells exist, the doctor may advise the patient to undergo a biopsy. The exfoliative cytology test is simple and causes relatively little discomfort. It is one of the important tests recommended for oral cancer diagnosis.


Incisional biopsy


Incisional biopsy involves obtaining a sample of the abnormal tissues through an incision. It is one of the most common methods of performing a biopsy of the oral cavity. The type of procedure (inpatient or outpatient) depends on several factors, such as the location of the tumor and the ease of access to the abnormal cells. The inpatient biopsy (in the operating room) is done under general anesthesia, while the outpatient biopsy can be performed under local anesthesia.


Indirect laryngoscopy and pharyngoscopy


During this examination, the doctor uses a mirror with a thin, long handle to view the base of the tongue, throat, and larynx. The doctor may also shine a light on the mirror to view the throat and a part of the larynx.


Flexible pharyngoscopy and laryngoscopy


Flexible pharyngoscopy and laryngoscopy are performed to view the areas that cannot be assessed with indirect laryngoscopy and pharyngoscopy. The procedure is performed with a pharyngoscope. It is a long tube with a camera at the end to view the deeper areas of the throat. Flexible pharyngoscopy and laryngoscopy also provide a clear view of the areas examined with indirect laryngoscopy and pharyngoscopy.


Endoscopy


Endoscopy is the procedure used to examine the throat for the presence of abnormal tissues. The procedure is done through an endoscope, a thin tube with a camera at the end.


Imaging Test

Imaging tests are an important part of oral cancer diagnosis. The following oral cancer tests are recommended as part of imaging and cancer staging:


CT Scan

A computed tomography scan determines the size and location of the oral tumor. It involves using X-rays to create clear and detailed images of the oral cavity. CT scans also provide information about the spread of cancer to the lymph nodes or distant organs, such as the lungs.

MRI Scan

An MRI provides detailed information about the tumors in the oral cavity. The technique uses radio waves and powerful magnetic fields to develop detailed images. The information related to the tumor provided by MRI includes the extent of tumor spread, lymphadenopathy, and depth of invasion.

PET Scan

PET scan is an advanced imaging technique for staging oral cancers. The technique involves the use of radioactive tracers which comprises a sugar molecular tagged with a radioactive substance. When these tracers are injected, they are rapidly taken up by the cancer cells. Further, this radioactive substances are traced with a specialized device to determine the spread of cancer to other body parts.

Genomic Testing

Genomic analysis of the tumor cells provides detailed information about the tumor biology and the response of cancer cells to various drugs. Genomic testing of oral cancer cells improves staging and optimizes the choice of therapy for patients with oral cancer.


Panendoscopy

Some risk factors, such as chewing tobacco and smoking, overlap with oral, esophageal, and lung cancers. In some cases, there is a chance that more than one cancer is present in a patient. To rule out the presence of abnormal tissues in patients suspected of having oral cancer, the doctor may advise a panendoscopy. During this procedure, the doctor may use a laryngoscope, esophagoscope, or bronchoscope to look into the larynx, esophagus, windpipe, and bronchi. Panendoscopy is done to determine the location and size of the tumor and its invasion of nearby tissues.

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Therapies, Surgeries & Ways of Oral Cancer Treatment

There are several oral cancer treatment options:

Radiation Therapy


It uses high-energy radiation to kill the cancerous cells. Radiation therapy can be delivered through the following techniques:

External Beam Radiotherapy

EBR is used for oral cancer early-stage treatment when patients are not able to undergo surgical interventions. The technique is also advised when patients have cosmetic concerns because of surgery, especially lip cancer. EBR is recommended along with chemotherapy in patients with advanced disease when surgery is not feasible due to poor health status or comorbidities.

Interstitial Brachytherapy

This form of oral cancer treatment is used in patients with early stages of the disease and well-defined tumors. It is also used along with EBR to increase the dose of radiotherapy in areas with high risk. It is a useful option in cases where re-radiation therapy is required.


Chemotherapy


Oral cancer chemotherapy is a method of treating oral cancer that involves delivering oral cancer medications to kill cancer cells. The delivery of the oral cancer medicines may be done orally or by injection. It is combined with radiation therapy in patients with advanced and unresectable diseases. Chemotherapy may also be combined with surgery and delivered before (neoadjuvant therapy) and after the surgery (adjuvant therapy).

Targeted drug therapy


Although combinatorial strategies involving surgery, chemotherapy, and radiation therapy effectively manage oral cancer, treatment-related toxicity due to non-specific cell death causes major problems. Molecularly targeted therapies are an effective way to manage advanced-stage oral cancers with relatively fewer side effects. This form of oral cancer treatment targets specific molecules and cellular pathways that are responsible for the growth of cancer cells. Several receptors are related to oral squamous cell carcinoma through targeted therapy. These include the urokinase-type plasminogen activator receptor, the folate receptor, and Integrin αvβ6.

Immunotherapy


Immunotherapy is the therapy administered to treat various types of cancer, including oral cancer. Certain mechanisms within the cancer cells allow them to hide from the immune system. Immunotherapy inhibits those processes and allows the immune cells to identify, target, and kill cancer cells. Immunotherapy also strengthens the functioning of the immune system. A study reported that administering immunotherapy before surgery improves long-term outcomes in patients with oral cancer.

Oral cancer surgery


Oral cancer surgery is often the first line of oral cancer treatment. Following are the types of oral cancer surgery:

Glossectomy

A glossectomy is performed to manage tongue cancer. It involves the partial or complete removal of the tongue. A glossectomy may also be done to remove the premalignant lesions on the tongue.

Mandibulectomy

This procedure is also known as mandibular resection. The procedure removes the tumor or diseased part of the lower jawbone. Mandibulectomy is usually performed in patients with advanced stages of oral cancer.

Maxillectomy

Maxillectomy removes all or part of the maxillary bone (upper jawbone). It is done to remove both malignant and benign tumors. The process may also involve the removal of the roof of the oral cavity and some teeth.

Neck dissection

Neck dissection is a procedure that removes the lymph nodes affected by cancer. The different types of neck dissection surgeries include selective or partial neck dissection, modified radical neck dissection, and radical neck dissection.

Reconstruction

Reconstruction surgery is when the surgeon restores the structure, function, and overall appearance of the sites affected during oral cancer surgery. Reconstructive surgery often plays a pivotal role in improving the quality of life for oral cancer patients.

Can Oral Cancer Be Cured Without Surgery?


Surgical resection is the primary line of oral cancer treatment. However, mouth cancer treatment without surgery is possible through radiation therapy and chemotherapy in the early stages of cancer for patients who are concerned about their appearance or in the advanced stages when cancer surgery is not possible. These treatments help in the effective management of oral cancer.

Why Choose HCG for the Diagnosis and Treatment of Oral Cancer?


HCG is an advanced center for the diagnosis and treatment of oral cancer. The center has all the diagnostic facilities, including CT, PET, and MRI scans. The oral cancer treatment facilities available at HCG are specifically designed with the comfort and well-being of cancer patients in mind. With the advanced technology and clinical expertise available at HCG, we aim to deliver superior-quality diagnostic and treatment support to our patients.

Conclusion


Oral cancer diagnosis is done through physical examination and medical history, imaging techniques such as PET scan, CT scan, MRI, biopsy, endoscopy, pharyngoscopy, laryngoscopy, and genomic testing. Standard oral cancer treatments include surgery, chemotherapy, radiation therapy, and targeted therapy

Frequently Asked Questions

Does mouth cancer always return?

Early-stage oral cancers have a lower likelihood of recurrence after treatment completion than advanced-stage cancers.

Removal of oral cancer depends on several factors, the most important being the stage of disease diagnosis. If diagnosed at early stages, oral cancers are easy to remove.

It is not easy to diagnose oral cancers at early stages, as most symptoms of cancer, such as ulcers, bleeding, and pain, overlap with other common conditions.

The rate of success of oral cancer depends on several factors, such as stage of disease diagnosis, type of oral cancer, response to treatment, and overall health status. It is important to note that oral cancer can be cured if it is caught in its precancerous state. That said, it is important to keep up with follow-up appointments after the treatment in order to reduce the risk of recurrences.

The side effects of oral cancer treatment depend on the type of treatment. For instance, chemotherapy results in hair loss, nausea, and vomiting, while radiation therapy causes tooth decay and dry mouth.

The length of the oral cancer treatment is determined by the type of cancer, stage of cancer, health of the patient, and treatment response.

Early oral cancer diagnosis is important for effective management, improved survival, and enhanced overall quality of life.