Oral cancer, characterized by abnormal cell growth in the mouth, is predominantly observed in adults. However, its rare occurrence in children makes awareness a significant concern for parents and caregivers.
What is Oral Cancer in Children
Oral cancer in children refers to malignant growths originating in various parts of the mouth, including the lips, tongue, gums, floor of the mouth, inner cheek lining, and the hard or soft palate. This type of cancer is uncommon in children; over 90% of oral tumors in this age group are benign. When malignant oral cancers do occur, they often present as different types than those typically seen in adults.
The types of oral cancer more commonly found in children include sarcomas, such as rhabdomyosarcoma, and lymphomas. Squamous cell carcinoma, the most prevalent form of oral cancer in adults, is very rare in the pediatric population.
Recognizing Signs and Symptoms
Parents should look for several signs that might indicate oral cancer in their children, though these can also point to many less serious conditions. A persistent sore in the mouth or on the lips that does not heal within a few weeks is a notable symptom. Additionally, the presence of a lump, abnormal thickening, or unusual white or red patches on the gums, tongue, or lining of the mouth warrants attention.
Other symptoms can include unexplained bleeding or pain in the mouth. Difficulty chewing or swallowing, a persistent sore throat, changes in the child’s voice, or swelling in the neck or jaw area may also be present. While these symptoms can be caused by various benign conditions, their persistence or progression necessitates a medical evaluation to determine the underlying cause.
Potential Causes and Risk Factors
Unlike oral cancers in adults, which are often linked to lifestyle factors such as tobacco and alcohol use, these are generally not primary causes in children. Instead, specific genetic predispositions play a role. Certain inherited syndromes, including Fanconi anemia, dyskeratosis congenita, connexin gene mutations, epidermolysis bullosa, and xeroderma pigmentosum, are associated with an increased risk.
A weakened immune system or a history of prior radiation exposure for other medical conditions can also contribute to the risk. Human papillomavirus (HPV) infection is a known risk factor in some cases, although it is less common as a cause of oral cancers in children than in adults. In many pediatric oral cancer cases, the specific cause remains undetermined.
Diagnostic Methods and Treatment Options
The diagnostic process for suspected oral cancer in children typically begins with a thorough physical examination of the mouth, jaw, and neck by a doctor or dentist. If a concern arises, imaging tests such as X-rays, MRI scans, or CT scans may be performed to visualize any abnormal areas in detail. A biopsy, which involves taking a small tissue sample for microscopic examination, is the definitive method for confirming a diagnosis of cancer.
Treatment plans are highly individualized, depending on the cancer’s type, stage, and location. Surgery to remove the tumor is a common primary treatment, and nearby lymph nodes may also be removed if there is a concern about cancer spread. Other treatment modalities can include chemotherapy, which uses drugs to target and destroy cancer cells, and radiation therapy, which employs high-energy rays for the same purpose. A multidisciplinary team involving oncologists, surgeons, and dentists typically collaborates to manage pediatric cases.
Prognosis and Ongoing Care
The prognosis for children diagnosed with oral cancer varies significantly based on factors such as the specific type of cancer, its stage at diagnosis, and how well the child responds to treatment. Early detection is associated with improved outcomes. Even when malignant, childhood oral cavity cancer may have better survival outcomes compared to adults.
Long-term follow-up care is necessary to monitor for any recurrence of the cancer and to manage potential side effects from treatment. This ongoing care often includes various supportive services, such as speech therapy for speech difficulties, nutritional support to maintain overall health, and psychological support for the emotional well-being of the child and their family.