Early detection of cancer Flashcards
What are some concerning clinical features of ulcers that indicate the need for urgent referal? (6)
- Rolled edges
- Necrotic centre
- Irregular shape
- Failed to heal
- High risk area
- Risk factors present eg. tobacco, alcohol, paan
What is Toluidine blue staining?
Stain the oral mucosa to help identify high risk malignant change tissue to biopsy
Describe how the site of a Leukoplakia lesion may change to be suggestive of increased risk of malignant transformation
High risk areas
High risk areas include:
- Floor of mouth
- Lateral border of tongue
- Retromolar region
- Buccal sulcus (paan chewers)
- Labial Commissure
Describe how the colour of a Leukoplakia lesion may change to be suggestive of increased risk of malignant transformation
Increased if speckled (red and white)
What are some high cancer risk lesions? (3)
- All red patches (erythroplakias)
- Non-homogenous leukoplakias (speckled or nodular appearance)
- All lesions showing dysplasia on biopsy
What is the difference between homogenous and non-homogenous leukoplakia?
Homogenous leukoplakia consists of uniform white platches
Non-homogenous leukoplakias resemble mixed red and white non-uniform patches (speckled or nodular appearance)
Non-homogenous have a higher risk of cancerous change
Give some examples of Oral Potential Malignant Disorders (OPMD)
- Leukoplakia
- Erythroplakia
- Oral submucous fibrosis
- Oral lichen planus
- Actinic cheilitis
- Palatal lesions of reverse smoking
- Discoid lupus erythematosus
What are the risk factors of oral cancer?
- Tobacco
- Alcohol
- Betel nut
- Sunlight (lip)
- Mucosal disease – OLP, Oral Submucous Fibrosis, Dysplasia
- Viral infections – HPV
- Malnutrition – Plummer–Vinson Syndrome
- Immunosuppression
- Genetic disorders – Fanconi anaemia, dyskeratosis congenita
Describe how the surface of a Leukoplakia lesion may change to be suggestive of increased risk of malignant transformation
Increased risk if raised or nodular
