Prevention Of Oral Cancer Flashcards
1
Q
What are host factors of oral cancer
A
- Age: It is predominantly seen in older age group (5th and 6th decade of life). Persons as young as 21 years have also being reported to have oral cancer.
- Gender : It is more common in males as compared to females.
- Site: cancer of tongue and buccal mucosa constitutes the bulk of oral cancers. The lateral border, under surface of tongue.
- Occupation: Textile workers show an increase risk of cancer in oral cavity. Male leather workers show an increase risk of cancer of buccal cavity, larynx and pharynx.
- Ethnic variation: Ethnicity strongly influences prevalence as a result of social and cultural practices,
- Familial and genetic predisposition
- Demographic shift: Urbanization, industrialization, changes in lifestyle, population growth and increase in the age expectancy have contributed for epidemiological transition in the country.
2
Q
What are agent factors of oral cancer?
A
- Tobacco: The role of tobacco in the etiology of oral cancer have been shown in numerous studies. that 90% of oral cancer is directly attributable to chewing and tobacco smoking. 70% smoke bidi, 10% smoke cigarette.
- Alcohol:
a. A synergistic effect of tobacco and alcohol has been observed.
b. They account for 75% of all oral and pharyngeal cancers.
c. Alcohol may promote carcinogenesis by various mechanisms which may include dehydrating effects, of alcohol on the mucosa, increasing the mucosal permeability to the carcinogen in tobacco, and causing nutritional deficiency. Also liver damage may weaken the immunological status - Nutrition: Several components of diet are seen as tumor promoters or anti promoters. They may enhance or impede the delivery of carcinogen or alter the susceptibility of the target tissue to the carcinogen, a. e.g. Plummer-Vinson syndrome, deficiency of copper, zinc and manganese is reported to deplete levels of antioxidant nutrients in tissues and increase production of tumor enhancing free radicals.
- Beta carotene (concentrated in deep green, yellow or orange vegetables like carrots, spinach, lettuce) vitamin C and vitamin E are found to impede the carcinogenic action.
3
Q
What are other agents of oral cancer?
A
- Biological:
a. Viral—Human papilloma virus, herpes simplex virus (HSV-1), EpsteinBarr virus
b. Immunological disorders
c. Fungal infection: Candida infections - Mechanical:
a. Irritation from jagged teeth or denture
b. Poor oral hygiene - Chemical: Arsenic, dyes, nickel, aromatic amines, chromium
4
Q
What are environmental factors?
A
- Effects of solar radiation: Occupation like farming, fishing, forestry and postal delivery are at risk due to long term exposure to UV radiation, e.g. lip cancer, Solar keratosis leading to Squamous cell carcinoma.
- Effects of atmospheric pollution: Air pollution caused by release of a number of gases from factories, automobiles can act as a risk factor in the initiation of the cancer
5
Q
There are three main public health approaches:
A
- Regulatory or legal approach
- Service approach
- Educational approach
6
Q
What’s the service approach?
A
- This embodies screening of people for diagnosing cancer in its early stage.
- The oral cavity is easily accessible and its examination poses relatively little discomfort to the patient.
- It provides opportunity to identify and counsel patients about habits that increase the risk of oral cancer.
7
Q
What’s Primary Prevention of Oral Cancer?
A
- Encourage people never to adopt any tobacco related habit.
- Encourage people who already use tobacco to stop.
- Encourage people who already use tobacco and cannot stop to at least decrease their use or to modify behavior in other ways to decrease the risk of cancer.
8
Q
e educational program should be targeted at various levels:?
A
- General public.
- decision makers.
- leading public figures.
- medical and para-medical personnel.
- schoolchildren and high risk individuals.
9
Q
What’s primary prevention in clinic?
A
- The dentist can be in an ideal situation to advise the patient.
- Educative magazines can be kept in the waiting room, one to one patient education can be done in the clinic.
10
Q
What’s Chemoprevention
A
Chemoprevention: It is a method of cancer control in which the occurrence of this disease is prevented by the administration of one or several chemical compounds, e.g.
- Compounds those are effective against a complete carcinogen.
- Compounds those are effective against a tumor promoter.
- Compounds that inhibit neoplasia when administered shortly before exposure to a carcinogenic compound.
11
Q
What’s Secondary Prevention-in oral cancer?
A
- Secondary Prevention At present in the developing countries, more than 50% of cancers are detected only after they have reached an advanced stage.
- Treatment required will be both extensive and expensive and the survival rate are low. Hence, early detection can be very helpful.
- Early detection: The natural history and anatomical site of oral cancer, provide excellent opportunity for early detection. Efforts at early detection can take many forms:
- Educate and encourage individuals to examine their own mouths for early signs of cancer.
- Screening the patients, who visit for other reasons.
- Organization and government can sponsor large scale efforts to seek out and examine groups of the population at risk.
12
Q
What’s Tertiary Prevention
A
Treatment modalities:
- The main treatment modalities are surgery, radiotherapy and chemotherapy.
- Prognosis will depend on the stage of the cancer.
- Additionally, supportive measures have an important impact on the effectiveness of the therapy. Good nutrition, attention to oral hygiene and dental care is especially important to prevent the adverse effects of the treatment.
13
Q
What’s rehabilitation in oral cancer?
A
The objective of rehabilitation is :
- to restore the patient to as normal a state of health.
- Reconstructive procedures may include correction of cosmetic defects, speech, swallowing and respiration.
- The extent of rehabilitation that will be needed is directly proportional to the extent of surgical excision
