Oral cavity cancer

Question 1

What are the risk factors for oral cavity cancer?

Answer 1

• Smoking
• Spirits (alcohol)
• Spices (betel nut chewing)
• STDs (but not HPV! HPV only have risk factor for oropharynx)
• Sharp teeth and ill-fitting/loose dentures (repeated trauma)
• Sunlight exposure

Question 2

What are the subsites of the oral cavity to examine?

Answer 2

• Lips
• Oral/anterior tongue (base of tongue is oropharynx)
• Buccal mucosa
• Retromolar trigone
• Hard palate
• Floor of mouth
• Alveolar ridge

Question 3

What are the subsites of the oral pharynx to examine?

Answer 3

• base of tongue
• tonsils
• soft palate
• posterior pharyngeal wall

Question 4

How to confirm the diagnosis of the oral cavity cancer?

Answer 4

• Biopsy
• Arrange for CT neck
• Perform nasoendoscopy: Always done as routine ENT examination
• Never r/o CA just by clinical examination/symptoms.

Question 5

How to stage oral cavity cancer?

Answer 5

MRI neck, CT thorax and liver

• Local stage: CT/MRI neck are okay; MRI is preferred for better soft tissue definition
• Distal staging: PET-CT scan full body is usually the standard; otherwise CT thorax liver (lung, liver, bone, brain)
• Recall spread: oral cavity 🡪 nodes 🡪 distal sites (lung, liver, then brain, bone)

Question 6

What is the treatment for oral cavity CA?

Answer 6

Surgery is the primary mx modality for oral CA, always for every stage, except metastasis (M1).

Question 7

what are symptoms of oral cavity CA?

Answer 7

• Panful ulcer
• Trismus (pterygoid involvement)
• Referred otalgia
• Blood (bleeding ulcer)
• Sore throat, sometimes dysphagia
• Constitutional symptoms 🡪 inflamm, CA

Question 8

What are the signs of oral cavity CA?

Answer 8

ulcerating mass, irregular base, contact bleeding, heaped-up borders