oral cancer Flashcards
How many people in teh uK have Oral cancer
5-10 per 100,000
Is oral cancer more common in men or women
Men (2:1)
What Is the peak age for oral cancer
55-65 But anyone can get it
What are some of the risk factors for oral cancer
- Smoking
- Alcohol
- Beetle nut and Araca nut
- Chewing tobacco
- Human papilloma virus (HPV)
- Immunosuppression
- Fanconi anaemia
What is Fanconi anaemia
A disease that impairs the ability of DNA to repair itself
Talk through how normal mucosa reacts when it gets damaged
- Normal mucosa
- Dysplasia (cellular abnormalities in the mucosa)
- Carcinoma in situ when damage occurs all the way through the mucosa
- Invasive carcinoma characterised by destruction of the basal membrane
Talk through how oral cancer progresses clinically
- Primary site seen on the lateral aspect of the tongue
- Regional metastases of lymph nodes
- Distant metastases
Name a common primary site for oral cancer
Lateral aspect of the tongue
What is a symptom
Something the patient experiences
What is a sign
Something a clinician might see
Gives some symptoms of oral cancer
- Pain/ discomfort
- May be painless
- May be present for a long time
Give some signs of oral cancer
- White patch in the mouth (leukoplakia)
- Red patch (erythplacia)
- Speckled patch (speckled leukoplakia)
- Ulcer especially lasting more than 3 weeks
- Lumps
- Unexplained loose teeth- poorly defined radiolucency
- Unexplained bleeding
Name a high risk site for a white patch in the mouth
Floor of the mouth
Why is early diagnosis of oral cancer important
Increases chances of survival and improved quality of life
What causes a white patch
Thickened epithelium and moisture
What can cause white patches in the mouth
- Frictional keratosis
- Lichen planus
- Chronic hyperpalstic candidiasis
- Idiopathic (eg geographic tongue)
- Smokers keratosis
- Acute pseudomembranous candidiasis
- Oral leukoplakia
8.
Where can you get white patches in the mouth
- Tongue
- Floor of mouth
- Buccal mucosa
How can we make a diagnosis of what a white patch is
Through a biopsy
How is cancer staged
- Tumour node metastasis (TNM)
- Group stage 1-4
How is cancer staged
- Tumour node metastasis (TNM)
- Group stage 1-4
How is oral cancer treated
- Surgery of primary site
- Surgery of regional lymph nodes
- Reconstruction surgery
- Radiotherapy
- Chemotherapy
- Rehabilitation
- Follow up
What are some risks of radiotherapy
- Skin reactions
- Mucositis
- Oropharyngeal thrush
- Xerostomia
- Osteoradionecrosis
Give examples of chemotherapy agents we may give alongside radiotherapy
- Cisplatin
- 5- Fluouracil
- Cetuximab
What does chemotherapy affect
Cell division or blood supply to tumour
It also exaggerates the side effects of radiotherapy
What are some of the side effects of chemotherapy
- Bleeding
- Bruining
- Infection
- Deafness
What are some of the effects of oral cancer treatment
- Loss of teeth
- Changes in soft tissues
- Changes in hard tissues
- Dry mouth
- Caries risk
- Osteoradionecrosis
What is the role of a dentist or hygienist in the long term care of a oral cancer patient
- Managing teeth loss
- Providing dentures
- Managing changes in hard and soft tissues
- Managing caries risk
- Managing risk of osteoradionecoris
- Monitoring cancer recurrence
When are do followups occur for cancer patients post treatment
every month for the first yr
every 2 months for the second year
Every 3 months for the 3rd yr
every 4-6 months in the 4th yr
discharged if no changes in the 5th yr
