Smoking is by far the major risk factor for
developing oral cancer. The use of alcohol and smoking
further increases the risk of oral cancer, along with cancer of the
larynx, and esophagus. According the the American Cancer Society
statistics, there were 28,000 new cases and 7,400 deaths from oral
cavity and pharynx cancer in the United States in 2002.
Patients
with head and neck cancer that smoke are more likely to develop spread
of the cancer to their lymph nodes and once in the nodes the cancer is
more likely to spread into the soft tissues.
View Article's Abstract
The picture on the right shows a cancer
of the uvula in a patient that had a 75 pack year history of smoking and
consumed alcohol. Both smoking and alcohol are risk factors for
oral cancer. This patient also had a second cancer in his lungs and
eventually developed spread of the cancer to his brain.
Click on Pictures to Enlarge
Use of tobacco products produces changes in all of the cells that are
exposed. Thus, the entire oral cavity, lungs and larynx are at
risk for developing tumors. Patients do not just develop one tumor
but may develop a second or a third lesion. Vaamonde (2004) found
that of 636 patients with head and neck cancer 48, or 7.5%,
developed a second lesion.
View Article's Abstract
The
picture on the right is from a 22 year old male who has used over 1 can
per day
of snuff for the past 15 years. He has high blood pressure
from the vasoconstrictive (contraction of blood vessels) effect of
nicotine and gastroesphageal reflux disease (stomach acid coming up from
the stomach towards the mouth) which is also made worse from using
tobacco products. The picture on the right shows extensive
leukoplakia forming between his gums and lips. This is a
pre-cancerous condition and if it does not resolve with his cessation of
using tobacco products, it will need to be surgically removed.
Click on Pictures to Enlarge
Below is a picture from the New Mexico Dept
of Health of a patient who had a "Jaw-Tongue-Neck" procedure.
Surgery and radiation therapy or combination of chemotherapy and
radiation therapy are the treatments of choice.
The picture on the right shows a patient
undergoing a jaw, tongue, neck operation. The lip is split and the
neck skin and cheeks are reflected. The jaw, tongue, neck and part
of the soft palate and uvula can then be removed.
*** Click on Picture to
Enlarge ***
The
picture to the right shows the removed surgical specimen.
***
Click on Picture to Enlarge ***
Even
if treated, many cancers may recur. In this patient, a cancer is
recurring in his neck with a massive slowly growing fungating mass.
The mass will slowly erode into the carotid artery causing massive
bleeding and sudden death.
This patient is a 87 year old who used to
smoke 1 pack per day for many years. She was not sure how long she
smoked. This patient has a tumor on both her tongue and right
floor of the mouth. The tumor is over her
alveolus
and extends onto the anterior tonsillar pillar.
These types of tumors are sometimes treated with a commando operation which consists of
resection of the
mandible,
floor of mouth and tongue; along with a radical neck dissection which
removes the muscles and lymph nodes in the neck.
