Oral Cancer

Question 1

What is the definition of oral cancer?

Answer 1

A malignant neoplasm whose primary origin is in the mouth and related structures.

Question 2

What is the epidemiology of oral cancer?

Answer 2

Higher incidence and mortality in Scotland compared to England/Wales

2:1 M:F Incidence

Relationship with socioeconomic inequality

Question 3

Describe the aetiology of oral cancer.

Answer 3

Local agents in the mouth: Smoking, alcohol, paan, khat, general inflammation.

In the oropharynx its as above and HPV.

Diet can be protective factor.

Question 4

What are the general rules for suspicion of head and neck cancer?

Answer 4

Persistent unexplained head and neck lumps for > 3 weeks.

All unexplained red or white patches on the mucosa persisting for >3 weeks.

Persistent hoarseness lasting >3 weeks.

Persistent pain in the throat or pain on swallowing lasting >3 weeks.

Question 5

What are the symptoms of oral cancer?

Answer 5

Pain on eating
Dysphagia
Unilateral earache
Sensory loss
Coughing blood
Unexplained weight loss

Question 6

What are the signs of oral cancer?

Answer 6

Verrucous lesions
Hemi-tongue atrophy
Fracture of mandible
Nasal obstruction

Question 7

What are the main treatment options for oral cancer?

Answer 7

Curative
- Early treatment
- Locoregionally advanced
- Surgery +/- chemo or radiotherapy

Palliative:
- Symptom control - sometimes radiotherapy, rarely surgery
- Prolongation of survival - immunotherapy

Question 8

What are the impacts of radiotherapy on the oral cavity?

Answer 8

Xerostomia

Late toxicity:
- ORN
- Dysphagia
- Flexion deformity
- Trismus
- Hypothyroidism