Oral cancer

Introduction:-

• Oral cancer is also known as mouth cancer.
• Oral cancer is cancer that develops in tissue of the mouth or throat. It belongs to a large group of cancer called head and neck cancer. Most develop in squamous cell found in your mouth, tongue and lips. It can be fatal if not diagnosed in early stages.

Definition:-

• "Oral cancer is defined as uncontrolled growth or sore in mouth.that does not go away. "
• Oral cancer and high includes cancer of lips, tongue, cheeks,floor of mouth hard and soft palate, sinuses and pharynx (throat).
• Oral cancer is a type of head and neck cancer is any tissue growth located in oral cavity.
• It may arises as from distent site of origin or by extrusion from neighboring anatomic site such as nasal cavity.

Common sites of oral cancer :-

• Lower lips.
• Lateral or under surface of tongue.
• Buccal mucosa.
• Hard and soft palate.
• Pharyngeal wall.

Incidence:-

• More common after 45 yr of age - male : female is 2:1.
• Oral cancer accounts for 50% of 70% of total cancer mortality.

Clinical manifestation:-

1. Leukoplakia :- White patches on the mucosa of the mouth or tongue.
2. Hyperkeratosis :- Hard and lethargy White patches.
3. Erythroplakia :- Rad velvety patch on the mouth or tongue.

• Painful ulceration.
• Soreness of tongue.
• Increased salivation.
• Dysphagia.
• Slurred speech.
• Tooth ache.
• Ear ache.
• Difficulty in chewing/mastication.
• Mouth,lip,tongue,may be pale or dark color or disorder.

Diagnostic evaluation :-

• P.E.T.
• X-ray.
• CT scan.
• MRI.
• Biopsy.
• Oral exfoliative cytology.
• Toluidine blue test.

Management :-

Surgical management :-

• remove tumor.
• Removal of cancerous lymph node.
• Glossectomy (partial /complete).
• Removal of lower jaw.

Medical management:-

• Radiation therapy.
• Chemotherapy.
• Immunotherapies.
• Molecularly target therapy :- Targeted cancer therapies are drugs or other substances that block the growth and the spread of cancer by interfering with specific molecules that are involved in the growth progression and spread of cancer.

Management in case of metastatic cancer :-

• Radial neck desection:- It includes wide excision of involved area.
• Lesion with removal of regional lymph nodes the deep cervical lymph nodes and their lymphatic Channels (depending upon the extendiveness) the sternodomastoid muscle,internal jugular vein mendible,the sub maxillary gland.
• Modified neck desection:- It involves desection of major cervical lymphatic vessels and lateral cervical space with preservation of nerve blood vessels and jugular vein.

Palliative care :-

• It aims to treat symptoms and make patient more comfortable.
• Dysphagia - Gastrostomy
• Pain - Analgesic and narcotics.
• Increased salivary secretion :- Frequent suction of oral cavity .

Nursing management :-

• Risk for ineffective airway clearance related to oral surgery.
• Risk for imbalance nutrition less than body requirement related to oral surgery.
• Impaired verbal communication related to glossectomy.
• Disturbed body image related to surgical excision of tongue.