Oral squamous cell carcinoma is a type of cancer that begins in the mouth. It is the most common form of oral cancer.
Understanding Oral Squamous Cell Carcinoma
Oral squamous cell carcinoma (OSCC) originates in the flat, thin cells known as squamous cells, which line the inside of the mouth and throat. OSCC accounts for over 90% of all oral malignancies.
This cancer can develop in various locations throughout the oral cavity. Common sites include the tongue and the floor of the mouth. Other locations where OSCC may arise include the gums, the inner lining of the cheeks, the lips, and the palate.
Recognizing the Signs
Recognizing the early signs of oral squamous cell carcinoma is important. A persistent sore or lesion in the mouth or on the lip that does not heal within two weeks is a common symptom. These lesions may appear as ulcers, often feeling firm to the touch.
Red or white patches within the mouth are also warning signs. Any new lump or thickening in the lips, mouth, or cheek, or a mass in the back of the throat or neck, should be evaluated. Other symptoms include difficulty chewing or swallowing, persistent sore throat, hoarseness or changes in voice, and unexplained bleeding from the mouth. Numbness in the tongue, lip, or other areas of the mouth, jaw pain or swelling, and loosening teeth can also indicate OSCC.
Factors That Increase Risk
Several factors increase an individual’s risk of developing oral squamous cell carcinoma. Tobacco use is a primary contributor, encompassing smoking, chewing tobacco, and snuff. The harmful chemicals in tobacco products can cause DNA damage in oral epithelial cells, promoting cancer development.
Excessive alcohol consumption also elevates risk. When tobacco and alcohol are used together, the risk multiplies, potentially increasing by 30 to 100 times compared to non-users. Human papillomavirus (HPV) infection, specifically high-risk types, is another factor, especially for cancers affecting the tonsils and base of the tongue.
Prolonged exposure of the lips to ultraviolet (UV) light from the sun or tanning lamps increases the risk of lip cancer. A weakened immune system, whether due to medication or illness, can also elevate susceptibility to oral cancer. Additionally, a diet lacking in fruits and vegetables is associated with an increased risk.
Diagnosis and Treatment Approaches
Diagnosing oral squamous cell carcinoma begins with a thorough clinical examination of the oral cavity by a healthcare professional. If any suspicious areas, such as persistent sores, lumps, or discolored patches, are found, a biopsy is performed to obtain a tissue sample for microscopic examination.
Following a confirmed diagnosis, imaging techniques are used to determine the extent and stage of the cancer. Common modalities include computed tomography (CT) scans, magnetic resonance imaging (MRI), and positron emission tomography (PET) scans. These scans help assess the tumor’s size, its invasion into surrounding tissues, and whether it has spread to nearby lymph nodes or distant parts of the body.
Treatment for OSCC often involves a combination of modalities, with surgery being the primary approach for most oral cavity cancers. Surgical excision involves removing the tumor along with a margin of healthy tissue. If the cancer has spread to lymph nodes in the neck, a neck dissection may be performed to remove them. Radiation therapy, which uses high-energy rays to destroy cancer cells, is often used after surgery, especially if the tumor is large, has spread to lymph nodes, or if there is a risk of recurrence. Chemotherapy, using powerful medicines to kill cancer cells, may be administered alongside radiation therapy for advanced stages or to enhance the effects of other treatments.
Prevention and Long-Term Outlook
Preventing oral squamous cell carcinoma involves adopting several lifestyle changes and maintaining consistent oral health practices. Quitting all forms of tobacco use, including smoking and chewing tobacco, significantly reduces risk. Limiting or eliminating alcohol consumption is also advised, as heavy drinking increases susceptibility, especially when combined with tobacco use.
Protecting the lips from prolonged sun exposure by using lip balms with SPF or wearing hats can help prevent lip cancer. Considering the human papillomavirus (HPV) vaccination is another preventative measure, as certain HPV strains are linked to a subset of oral cancers, particularly those in the oropharynx. Regular dental check-ups are also important for early detection, as dentists are often the first to spot suspicious lesions during routine examinations.
The long-term outlook for individuals with oral squamous cell carcinoma depends on several factors, with the stage of cancer at diagnosis being the most significant predictor of survival. Cancers detected at an early stage generally have a more favorable prognosis compared to those found at later stages, which may have spread to lymph nodes or distant sites. Regular follow-up care is important after treatment to monitor for any signs of recurrence, which can include new sores, lumps, or persistent symptoms.