HEALTH - ORAL CANCER (MOUTH) SYMPTOMS & TREATMENT
What is Oral Cancer?
Oral cancer is cancer of the mouth. Oral cancer is part of a group of cancers called head and neck cancers. Oral cancer can develop in any part of the oral cavity or oropharynx. Most oral cancers begin in the tongue and in the floor of the mouth. Almost all oral cancers begin in the flat cells (squamous cells) that cover the surfaces of the mouth, tongue, and lips. These cancers are called squamous cell carcinomas.
When oral cancer spreads (metastasizes), it usually travels through the lymphatic system. Cancer cells that enter the lymphatic system are carried along by lymph, a clear, watery fluid. The cancer cells often appear first in nearby lymph nodes in the neck.
Cancer cells can also spread to other parts of the neck, the lungs, and other parts of the body. When this happens, the new tumor has the same kind of abnormal cells as the primary tumor. For example, if oral cancer spreads to the lungs, the cancer cells in the lungs are actually oral cancer cells. The disease is metastatic oral cancer, not lung cancer. It is treated as oral cancer, not lung cancer. Doctors sometimes call the new tumor "distant" or metastatic disease.
Mouth cancer refers to cancer that develops in any of the parts that make up the mouth. Mouth cancer can occur on the lips, gums, tongue, inside lining of the cheeks, and the roof and floor of the mouth. Cancer that occurs on the inside of the mouth is sometimes called oral cancer or oral cavity cancer.
Two of the most common types of head and neck cancer are cancer of the oral cavity (mouth and tongue) and the oropharynx (the middle of the throat from the tonsils to the tip of the voice box). Cancer begins when cells become abnormal and multiply without control or order. These cells form a growth of tissue, called a tumor. A tumor can be benign (noncancerous) or malignant (cancerous). Cancerous cells can invade nearby tissue and sometimes spread to other parts of the body through the bloodstream and the body’s lymphatic system.
The oral cavity includes the lips, buccal mucosa (lining of the lips and cheeks), gingiva (upper and lower gums), front two-thirds of the tongue, floor of the mouth under the tongue, hard palate (roof of the mouth), and the retromolar trigone (small area behind the wisdom teeth).
The oropharynx begins where the oral cavity stops. It includes the soft palate at the back of the mouth, the part of the throat behind the mouth, the tonsils, and the base of the tongue.
The oral cavity and oropharynx, along with other parts of the head and neck, contribute to the ability to chew, swallow, breathe, and talk.
More than 90% of oral and oropharyngeal cancers are squamous cell carcinoma, meaning they begin in the flat, squamous cells in the lining of the mouth and throat.
Oral and oropharyngeal cancers are among the main types of cancer in the head and neck region, a grouping called head and neck cancer. Although oral cancer and oropharyngeal cancer are commonly combined using one phrase, it is important to identify exactly where the cancer began, because there are differences in treatment between the two locations.
Oral cancer accounts for about 8% of all malignant growths. Men get oral cancer twice as often as women do, particularly men older than 40.
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Health: Risk Factors of Oral Cancer (Mouth - Cancer)
Two factors greatly increase the risk of oral cancer:
Tobacco use. Smoking and other tobacco use are associated
with 70 - 80% of oral cancer cases. Smoke and heat from cigarettes,
cigars, and pipes irritate the mucous membranes of the mouth. Use of
chewing tobacco or snuff causes irritation from direct contact with the
mucous membranes.
The use of tobacco, including cigarettes, cigars, pipes, chewing tobacco, and snuff, is the single largest risk factor for mouth cancer. Pipe smoking is particularly linked to cancer in the part of the lips that contact the pipe stem. Chewing tobacco or snuff is associated with a 50% increase in risk of cancers of the cheeks, gum, and inner surface of the lips where the tobacco has the most contact.
Alcohol. Frequent and heavy consumption of alcohol increases the risk of mouth cancer.
Eighty-five percent (85%) of oral cancer is linked to tobacco use. Using alcohol and tobacco together increases this risk even more. Recent studies have suggested that people who have used marijuana may be at higher than average risk for mouth cancer. Second-hand smoke may also increase a person’s risk of oral cancer.
Other factors can raise a person’s risk of mouth cancer include:
- Human papillomavirus (HPV). Research indicates that infection with this virus is a risk factor for oral cancer. HPV is passed from person to person during sexual intercourse. There are different types, or strains, of HPV, and some strains are more strongly associated with certain types of mouth cancers.
- Gender. Men are more likely to develop lip cancer than women.
- Prolonged sun exposure. Prolonged sun exposure is linked to cancer in the lip area.
- Fair skin. Fair skin is linked to a higher risk of lip cancer.
- Age. People over 45 are at increased risk for oral cancer, although this type of cancer can develop in people of any age.
- Oral hygiene. People with poor oral hygiene/dental care may have an increased risk of oral cavity cancer. Poor dental health or ongoing irritation from poorly fitting dentures, especially in people who use alcohol and tobacco products, may contribute to the promotion of mouth cancer.
- Poor diet/nutrition. A diet low in fruits and vegetables, a vitamin A deficiency, and chewing betel nuts (a nut containing a mild stimulant that is popular in Asia) increase the risk of oral cancer.
- Weakened immune system. People with a weakened immune system have a higher risk of oral cancer.
- Cancer or radiation treatments. Previous cancer or radiation treatments in the head or neck area.
Often, a dentist is the first person
to find this type of cancer during a routine examination. People with
oral cancer may experience the following symptoms.
Sometimes, people with oral cancer do not show any of
these symptoms. Or, these symptoms may be caused by a medical condition
that is not cancer. If you are concerned about a symptom on this list,
please talk with your doctor or health care provider. People who notice any of these warning signs should consult a doctor
and/or dentist as soon as possible. When detected early, cancers of the
oral cavity and oropharynx have a much better chance of cure. Because many of these symptoms can be caused by other, noncancerous
health conditions as well, it is important for people to receive
regular health and dental screenings, especially those who routinely
drink alcohol or currently use tobacco products or have used them in
the past. In fact, people who use alcohol and tobacco should receive a general
screening examination at least once a year. This is a simple, quick
procedure in which the doctor looks in the nose, mouth, and throat for
abnormalities and feels for lumps in the neck. If anything unusual is
found, the doctor will recommend a more extensive examination using one
or more of the diagnostic procedures mentioned in the diagnosis section. Health: Diagnosis of Oral Cancer (Mouth - Cancer) The following tests may be used to diagnose oral cancer: Physical examination. Dentists and doctors often find lip and
oral cavity cancers during routine check-ups. If a person shows signs
of oral cancer, the doctor will take a complete
medical history, asking about the patient’s symptoms and risk factors.
The doctor will feel for any lumps on the neck, lips, gums, and cheeks.
Since patients with oral cancer have a higher risk of
other cancers elsewhere in the head and neck region, the area behind
the nose, the larynx (voice box), and the lymph nodes of the neck are
also examined. Endoscopy. This test allows the doctor to see inside the
mouth and throat. Typically, an endoscope (a thin, flexible tube with
an attached light and view lens) is inserted through the nose to
examine the head and neck areas. Sometimes, a rigid endoscope (a hollow
tube with a light and view lens) is placed into the back of the mouth
to see the back of the throat in more detail. The examination has
different names depending on the area of the body that is examined,
such as laryngoscopy (larynx), pharyngoscopy (pharynx), or a
nasopharyngoscopy (nasopharynx). To make the patient more comfortable,
these examinations are performed using an anesthetic spray to numb the
area. If tissue looks suspicious, the doctor will take a biopsy. Tests
are often done in the doctor’s office, although sometimes an endoscopy
must be performed in the operating room using a general anesthesia. Biopsy. A biopsy is the removal of a small amount of tissue
for examination under a microscope. Other tests can suggest that cancer
is present, but only a biopsy can make a definite diagnosis. The sample
removed from the biopsy is analyzed by a pathologist (a doctor who
specializes in interpreting laboratory tests and evaluating cells,
tissues, and organs to diagnose disease). The type of biopsy performed
will depend on the location of the cancer. In a fine needle aspiration
biopsy, cells are withdrawn using a thin needle inserted directly into
the tumor. The cells are examined under a microscope for cancer cells
(called cytologic examination). Oral brush biopsy. During routine dental examinations, some
dentists are using a newer, simple technique to detect oral cancer in
which a dentist uses a small brush to gather cell samples of a
suspicious area. The specimen is then sent to a laboratory for
analysis. This oral brush biopsy procedure is easy and can be done
right in the dentist’s chair with very little or no pain. If cancer is
found using this method, it is recommended that a traditional biopsy
(see above) be done to confirm results. X-ray. An x-ray is a picture of the inside of the body. For
instance, a chest x-ray can help doctors determine if the cancer that
has spread to the lungs. A dentist may take extensive x-rays of the
mouth, including a panorex (panoramic view). Barium swallow. Two types of these tests are generally used
to look at the oropharynx and swallowing. The first is a traditional
barium swallow, during which the patient is asked to swallow liquid
barium so the doctor can look for any changes in the structure of the
oral cavity and throat and to see whether the liquid passes easily to
the stomach. X-ray is then used. A modified barium swallow, or
videofluoroscopy, is used to assess swallowing; the patient is asked to
swallow liquid barium, pudding, and a cracker coated with barium. Panorex. This is a rotating, or panoramic, x-ray of the upper
and lower jawbones to detect bone destruction from cancer, or to
evaluate teeth before radiation therapy or chemotherapy. Computed tomography (CT or CAT) scan. A CT scan creates a
three-dimensional picture of the inside of the body with an x-ray
machine. A computer then combines these images into a detailed,
cross-sectional view that shows any abnormalities or tumors. Sometimes,
a contrast medium (a special dye) is injected into a patient’s vein to
provide better detail. A CT scan can help a doctor decide whether the
cancer can be surgically removed and determine whether the cancer has
spread to lymph nodes in the neck or lower jawbone. Magnetic resonance imaging (MRI). An MRI uses magnetic
fields, not x-rays, to produce detailed images of the body, especially
images of soft tissue, such as the tonsils and base of the tongue. A
contrast medium may be injected into a patient’s vein to create a
clearer picture. Ultrasound. An ultrasound uses sound waves to create a
picture of the internal organs. This test can detect the spread of
cancer to the lymph nodes in the neck (called the cervical lymph nodes). Positron emission tomography (PET) scan. A PET scan
is a way to create pictures of organs and tissues inside the body. A
small amount of a radioactive substance is injected into a patient’s
body and absorbed by the organs or tissues being studied. PET scans are
often used to complement information gathered from CT scan, MRI, and
physical examination. PET scanning is especially useful to detect
cancer that has spread to other organs or hidden primary tumors.
Health: Symptoms of Oral Cancer (Mouth - Cancer)
Health: Mouth Cancer Stages (Oral - Cancer)
Once mouth cancer is diagnosed, your doctor works to determine the
extent, or stage, of your cancer. Mouth cancer staging tests may
include:
- Using a scope to inspect your throat. During a procedure called endoscopy, your doctor may pass a lighted scope down your throat to look for signs that cancer has spread beyond your mouth.
- Imaging tests. A variety of imaging tests may help determine whether cancer has spread beyond your mouth. Imaging tests may include X-rays, computerized tomography (CT) scans, magnetic resonance imaging (MRI) and positron emission tomography (PET) scans, among others. Not everyone needs each test. Your doctor determines which tests are appropriate based on your condition.
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Natural Alternative Treatment: NATURAL CANCER TREATMENT
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Health: Conventional Treatment for Oral Cancer (Mouth - Cancer)
The treatment of oral cancer depends on the size and location of the tumor, whether the cancer has spread, and the person’s overall health.Oral cancer can often be cured, especially if it is found early.
Although curing the cancer is the primary goal of treatment, preserving the function of the nearby nerves, organs, and tissues is also very important. When doctors plan treatment, they consider how treatment might affect a person’s quality of life, how a person feels, looks, talks, eats, and breathes.
In many cases, a team of doctors will work with the patient to
determine the best treatment plan. Head and neck cancer specialists
often form a multidisciplinary team to care for each patient, and an
evaluation should be done before any treatment begins. The team may
include medical oncologists, radiation oncologists, surgeons,
otolaryngologists (ear, nose, and throat doctors), maxillofacial
prosthodontists (specialists who perform restorative surgery to the
head and neck area), dentists, physical therapists, speech
pathologists, mental health professionals, nurses, dietitians, and
social workers.
It is crucial that a comprehensive treatment plan is established before treatment begins, and people may need to be seen by multiple specialists before such a plan can be created.
There are three main treatment options for oral and oropharyngeal cancer: surgery, radiation therapy, and chemotherapy. Each is described below in more detail. One of these therapies, or a combination of them, may be used to treat the cancer.
Surgery
It is important that a person seek the opinion of different members of the multidisciplinary team prior to deciding on a specific treatment. Even though surgery is the fastest way to eliminate cancerous tissues, other treatment methods do exist and may be equally effective in treating the cancer. People are encouraged to ask about other treatment options.
During surgery, a surgeon performs an operation to remove the cancerous tumor and some of the healthy tissue around it (called a margin). The goal of surgery is to remove all of the tumor and leave negative margins (which means there is no trace of cancer in the healthy tissue). Sometimes surgery is followed by radiation therapy and/or chemotherapy. Depending on the location, stage, and pathology of the cancer, some people may need more than one operation to remove the cancer and to help restore the appearance and function of the tissues affected.
Any surgical procedure should be done with the assistance of frozen
section determination of the margins at the time of surgery. This will
require removal of additional tissues to obtain a margin free of
cancer. The use of micrographic surgery, which is very frequent in the
treatment of skin cancer, can occasionally be utilized for oral cavity
tumors, and it is one way to minimize the amount of normal tissue
removed.
This technique is often used with cancer of the lip. This technique involves removing the visible tumor, in addition to small fragments of the edge around where the tumor existed. Each small fragment is examined under a microscope until all cancer is removed.
The most common surgical procedures for oral and oropharyngeal cancer include:
Primary tumor surgery. The tumor and an area of surrounding tissue are removed to decrease chances that any of the cancer will be left behind. The tumor can be removed through the mouth or through an incision in the neck. A mandibulotomy, in which the jawbone is split to access the tumor, may also be required.
Glossectomy. The partial or total removal of the tongue.
Mandibulectomy (Full or partial removal of the jaw). If the tumor has entered a jawbone but not spread into the bone, then a piece of the jawbone is removed. If there is evidence of destruction of the jawbone on an x-ray, then the entire bone may need to be removed.
Maxillectomy. A surgery that removes part or all of the hard palate, which is the bony roof of the mouth. Prostheses (artificial devices), or more recently, the use of flaps of soft tissue with and without bone can be placed to fill gaps from this operation.
Neck dissection. Cancer of the oral cavity and oropharynx often spreads to lymph nodes in the neck, and it may be necessary to remove some or all of these lymph nodes in a surgical procedure called a neck dissection.
Laryngectomy. A laryngectomy, complete or partial removal of
the larynx or voicebox, is rarely necessary for treatment of oral or
oropharyngeal cancer. The larynx is critical to swallowing because it
protects the airway from food and liquid entering the trachea or
windpipe and reaching the lungs, which can cause pneumonia.
When there is a large tumor of the tongue or oropharynx, the doctor may also need to remove the larynx so that the individual is able to swallow safely. If the larynx is removed, the windpipe is reattached to the skin of the neck where a hole is made, called a stoma, through which the patient breathes. Rehabilitation is required to learn a new way of speaking.
Tracheostomy. If cancer is blocking the throat or is too large to completely remove, a hole called a tracheostomy is made in the neck and a tracheostomy tube is placed through which the person breathes. A tracheostomy can be temporary or permanent.
Gastrostomy tube. If cancer is inhibiting the ability to swallow, a feeding device called a gastrostomy tube is placed through the skin and muscle of the abdomen directly into the stomach. If the swallowing problem is temporary, a nasogastric (NG) tube (inserted through the nose, down the esophagus, and into the stomach) may be used instead of a tube into the stomach. Tubes placed into the stomach may also be temporary methods for maintaining nutrition until the person can safely and adequately swallow by mouth.
Reconstruction. If treatment requires removing large areas of
tissue, reconstructive surgery may be necessary so the patient can
swallow and speak again. Healthy bone or tissue may be taken from other
parts of the body to fill gaps left by the tumor or to replace part of
the lip, tongue, palate, or jaw. A prosthodontist (a dental specialist
with expertise and certification in the restoration and replacement of
broken teeth with crowns, bridges, or removable prosthetics [dentures])
may be able to make an artificial dental or facial part to facilitate
swallowing and speech.
A speech pathologist can teach the patient to communicate using new techniques or special equipment. A speech pathologist will also help restore the ability to swallow in patients who have difficulty eating by mouth after surgery or after radiation therapy.
In general, surgery for oral cancer often causes swelling, making it difficult to breathe. It may cause permanent loss of voice or impaired speech; difficulty in chewing, swallowing, or talking; numbness of the ear; weakness in raising arms above the head; lack of movement in the lower lip; and facial disfigurement. Surgery can decrease functioning of the thyroid gland, especially after a total laryngectomy and/or radiation therapy to the area.
Radiation therapy is the use of high-energy x-rays or other
particles to kill cancer cells. The most common type of radiation
treatment is external-beam radiation therapy, which is radiation given
from a machine outside the body. External-beam radiation therapy is
conducted with a radiation beam aimed at the tumor and is generally
done as an outpatient procedure.
When radiation treatment is given using implants, it is called internal radiation therapy or brachytherapy. Internal radiation therapy involves tiny pellets or rods containing radioactive materials that are surgically implanted in or near the cancer site. The implant is left in place for several days while the person stays in the hospital.
A new method of external radiation therapy, known as intensity modulated radiation therapy (IMRT), allows for more effective doses of radiation therapy to be delivered while reducing the damage to healthy cells, thus causing fewer side effects. Proton-beam or charged-particle radiation therapy directs high-energy particles to the tumor, which also reduces the possibility of damage to nearby tissue.
Radiation therapy can be the main treatment for oral cavity cancer, or used after surgery to destroy small areas of cancer that could not be removed surgically.
Before beginning radiation treatment for any head and neck cancer, people should receive a thorough examination from an oncologic dentist (a dentist with experience in treating people with head and neck cancer). Since radiation therapy can cause tooth decay, damaged teeth may need to be removed. Often, tooth decay can be prevented by proper treatment from a dentist before beginning treatment.
It is also important that people receive counseling and evaluation
from an oncologic speech pathologist (a speech pathologist with
experience in treating people with head and neck cancer). Since
radiation therapy can cause damage to healthy tissue, people often have
difficulty speaking and/or swallowing after radiation therapy. These
problems may occur long after radiation is completed.
Speech pathologists can teach exercises and techniques to prevent long-term speech and swallowing problems. Hearing may also be affected in patients who receive radiation therapy to the head region. Sometimes, patients may need to be evaluated by an audiologist (hearing specialist) to determine hearing abilities and/or loss.
Radiation therapy to the head and neck may cause the following side effects: redness or skin irritation to the treated area; dry mouth or thickened saliva, from damage to salivary glands (this can be temporary or permanent); bone pain; nausea; fatigue; mouth sores and/or sore throat; dental problems (usually preventable, see above); painful or difficulty swallowing; difficulty opening the mouth; difficulty speaking; loss of appetite, due to a change in sense of taste; hearing loss, due to buildup of fluid in the middle ear or nerve damage; and buildup of earwax, which dries out because of the radiation therapy’s effect on the ear canal.
Radiation therapy may also cause a condition called hypothyroidism, in which the thyroid gland (located in the neck) slows down, and this causes the patient to feel tired and sluggish. Every patient who receives radiation therapy to the neck area should have his or her thyroid checked regularly.
Chemotherapy is the use of drugs to kill cancer cells. Systemic chemotherapy is delivered through the bloodstream, targeting cancer cells throughout the body.
The use of chemotherapy in combination with radiation therapy (called concomitant radiochemotherapy) is commonly recommended. The combination of these two treatments can sometimes control tumor growth, and frequently it will cause a significant increase in the effectiveness compared to either treatment given alone. However, the side effects can be greater when combining these treatments.
Chemotherapy may be used as a neoadjuvant therapy (the initial treatment before surgery, radiation therapy, or both) or an adjuvant therapy (the initial treatment after surgery, radiation therapy, or both).
Chemotherapy for oral cavity cancer is most often given as part of a clinical trial (a research study). Many combined treatments (chemotherapy and radiation therapy) are performed as part of a clinical trial.
Each drug or combination of drugs can cause specific side effects. While some can be permanent, most are temporary and these can typically be well-controlled. In general, chemotherapy may cause the following side effects: fatigue; nausea; vomiting; hair loss; dry mouth; hearing loss; loss of appetite, often due to a change in sense of taste; difficulty eating food; weakened immune system; diarrhea and/or constipation; and open sores in the mouth (this condition coupled with a low immunity can lead to infections).
The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications you've been prescribed, their purpose, and their potential side effects or interactions with other medications.
Immunotherapy
Immunotherapy (also called biologic therapy) is designed to boost the body’s natural defenses to fight cancer. It uses materials either made by the body or in a laboratory to bolster, target, or restore immune system function.
Targeted therapy
Targeted therapy is a treatment that targets faulty genes or proteins that contribute to cancer growth and development. Unlike chemotherapy that kills both healthy and cancerous cells, these drugs selectively kill cancer cells, which helps to reduce side effects. Currently, antibodies directed against a cellular receptor called the epidermal growth factor receptor (EGFR) are being used in combination with radiation therapy for head and neck cancers.
Health: Side Effects of Treatment of Oral Cancer (Mouth - Cancer)
Because treatment often damages healthy cells and tissues, unwanted side effects are common. These side effects depend mainly on the location of the tumor and the type and extent of the treatment. Side effects may not be the same for each person, and they may even change from one treatment session to the next. Before treatment starts, your health care team will explain possible side effects and suggest ways to help you manage them.
Surgery
It takes time to heal after
surgery, and the time needed to recover is different for each person. You may be
uncomfortable for the first few days after surgery. However, medicine can
usually control the pain. Before surgery, you should discuss the plan for pain
relief with your doctor or nurse. After
surgery, your doctor can adjust the plan if you need more pain relief.
It is common to feel tired or weak for a while. Also, surgery may cause tissues in your face to swell. This swelling usually goes away within a few weeks. However, removing lymph nodes can result in swelling that lasts a long time.
Surgery to remove a small tumor in the mouth may not
cause any lasting problems. For a larger tumor, however, the surgeon may remove
part of the palate, tongue, or jaw. This surgery may change your ability to
chew, swallow, or talk. Also, your face may look different after surgery.
Reconstructive or plastic surgery may be done to rebuild the bones or tissues of the mouth.
Radiation therapy
Almost all patients who have
radiation therapy to the head and neck area develop oral side effects. That is
why it is important to get the mouth in good health condition before cancer treatment begins. Seeing a dentist two weeks before
cancer treatment begins gives the mouth time to heal after dental work.
The side effects of radiation therapy depend mainly on the amount of radiation given. Some side effects in the mouth go away after radiation treatment ends, while others last a long time. A few side effects (such as dry mouth) may never go away.
Radiation therapy may cause some or all of these side effects:
- Dry mouth: Dry mouth can make it hard for you to eat, talk, and swallow. It can also lead to tooth decay. You may find it helpful to drink lots of water, suck ice chips or sugar-free hard candy, and use a saliva substitute to moisten your mouth.
- Tooth decay: Radiation
can cause major tooth decay health problems. Good mouth care can help you keep your
teeth and gums healthy and can help you feel better.
- Doctors usually suggest that people gently brush their teeth, gums, and tongue with an extra-soft toothbrush and fluoride toothpaste after every meal and before bed. If brushing hurts, you can soften the bristles in warm water.
- Your dentist may suggest that you use fluoride gel before, during, and after radiation treatment.
- It also helps to rinse your mouth several times a day with a solution made from 1/4 teaspoon baking soda and 1/8 teaspoon salt in one cup of warm water. After you rinse with this solution, follow with a plain water rinse.
- Sore throat or mouth: Radiation therapy can cause painful ulcers and inflammation. Your doctor can suggest medicines to help control the pain. Your doctor also may suggest special rinses to numb the throat and mouth to help relieve the soreness. If your pain continues, you can ask your doctor about stronger medicines.
- Sore or bleeding gum: It is important to brush and floss teeth gently. You may want to avoid areas that are sore or bleeding. To protect your gum from damage, it is a good idea to avoid the use of toothpicks.
- Infection: Dry mouth and damage to the lining of the mouth from radiation therapy can cause infection to develop. It helps to check your mouth every day for sores or other changes and to tell your doctor or health care provider about any mouth health problems.
- Delayed healing after dental care: Radiation treatment may make it hard for tissues in the mouth to heal. It helps to have a thorough dental exam and complete all needed dental treatment well before radiation therapy begins.
- Jaw stiffness: Radiation can affect the chewing muscles and make it difficult for you to open your mouth. You can prevent or reduce jaw stiffness by exercising your jaw muscles. Health care providers often suggest opening and closing the mouth as far as possible (without causing pain) 20 times in a row, 3 times a day.
- Denture problems: Radiation therapy can change the tissues in your mouth so that dentures do not fit anymore. Because of soreness and dry mouth, some people may not be able to wear dentures for as long as one year after radiation therapy. After the tissues heal completely and your mouth is no longer sore, your dentist may need to refit or replace your dentures.
- Changes in the sense of taste and smell: During radiation therapy, food may taste or smell different.
- Changes in voice quality: Your voice may be weak at the end of the day. It may also be affected by changes in the weather. Radiation directed at the neck may cause your larynx to swell, causing voice changes and the feeling of a lump in your throat. Your doctor may suggest medicine to reduce this swelling.
- Changes in the thyroid: Radiation treatment can affect your thyroid (an organ in your neck beneath the voice box). If your thyroid does not make enough thyroid hormone, you may feel tired, gain weight, feel cold, and have dry skin and hair. Your doctor can check the level of thyroid hormone with a blood test. If the level is low, you may need to take thyroid hormone pills.
- Skin changes in the treated area: The skin in the treated area may become red or dry. Good skin care is important at this time. It is helpful to expose this area to the air while protecting it from the sun. Also, avoid wearing clothes that rub the treated area, and do not shave the treated area. You should not use lotions or creams in the treated area without your doctor's advice.
- Fatigue: You may become very tired, especially in the later weeks of radiation therapy. Resting is important, but doctors usually advise their patients to stay as active as they can.
Although the side effects of radiation therapy can be distressing, your doctor can usually treat or control them. It helps to report any health problems that you are having so that your doctor can work with you to relieve them.
Chemotherapy
Chemotherapy and radiation therapy can cause some of the
same side effects, including painful mouth and gum, dry mouth, infection, and
changes in taste. Some anticancer drugs can also cause bleeding in the mouth and
a deep pain that feels like a toothache. The health problems you have depend on the type and amount of
anticancer drugs you receive, and how your body reacts to them. You may have
these health problems only during treatment or for a short time after treatment ends.
Generally, anticancer drugs affect cells that divide rapidly. In addition to cancer cells, these rapidly dividing cells include the following:
- Blood cells: These cells fight infection, help your blood to clot, and carry oxygen to all parts of the body. When drugs affect your blood cells, you are more likely to get infections, bruise or bleed easily, and feel very weak and tired.
- Cells in hair roots: Chemotherapy can lead to hair loss. The hair grows back, but sometimes the new hair is somewhat different in color and texture.
- Cells that line the digestive tract: Chemotherapy can cause poor appetite, nausea and vomiting, diarrhea, or mouth and lip sores. Many of these side effects can be controlled with drugs.
Health: Lifestyle Changes After Mouth Cancer Treatment
Quit using tobacco
Mouth cancers are closely linked to tobacco use, including cigarettes,
cigars, pipes, chewing tobacco and snuff, among others. Not everyone
who is diagnosed with mouth cancer uses tobacco. But if you do, now is
the time to stop because:
- Tobacco use makes treatment less effective.
- Tobacco use makes it harder for your body to heal after surgery.
- Tobacco use increases your risk of getting another cancer in the future.
Quitting smoking or chewing can be very difficult. And it's that much harder when you're trying to cope with a stressful situation, such as a cancer diagnosis. Your doctor can discuss all of your options, including medications, nicotine replacement products and counseling.
Quit drinking alcohol
Alcohol, particularly when combined with tobacco use, greatly increases
the risk of mouth cancer. If you drink alcohol, stop now. This may help
reduce your risk of a second cancer. Stopping drinking may also help
you better tolerate your mouth cancer treatments.
Health: Prevention of Oral Cancer (Mouth - Cancer)
There's no proven way to prevent mouth cancer. However, you can reduce your risk of mouth cancer if you:
- Stop using tobacco or don't start. If you use tobacco, stop. If you don't use tobacco, don't start. Using tobacco, whether smoked or chewed, exposes the cells in your mouth to dangerous cancer-causing chemicals.
- Drink alcohol only in moderation, if at all. Chronic excessive alcohol use can irritate the cells in your mouth, making them vulnerable to mouth cancer. If you choose to drink alcohol, limit yourself to one drink a day if you're a woman or older than age 65. Men should drink no more than two drinks a day.
- Eat a variety of fruits and vegetables. Choose a diet rich in fruits and vegetables. The vitamins and antioxidants found in fruits and vegetables may help reduce your risk of mouth cancer.
- Avoid excessive sun exposure to your lips. Protect the skin on your lips from the sun by staying in the shade when possible. Wear a broad-brimmed hat that effectively shades your entire face, including your mouth. Apply a sunscreen lip product as part of your routine sun protection regimen.
- See your dentist regularly. As part of a routine dental exam, ask your dentist to inspect your entire mouth for abnormal areas that may indicate mouth cancer or precancerous changes.
You should have the soft tissue of the mouth examined once a year. Many mouth cancers are discovered by routine dental examination.
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Sources: NIH News In Health/National Institutes of Health/National Library of Medicine/Dept of Health and Human Services_______________________________________________________________________________________________________
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