Oral Cancers

Abstract

The most common type of oral cancer is squamous cell carcinoma and arises from the oral mucosa lining the mouth but most commonly as ulcers in the floor of the mouth, the lateral border of the tongue or inside the lips. They may also arise within pre-existing white, red or thickened areas of mucosa and at the earliest stage may not show obvious signs of ulceration. Malignant ulcers differ from other innocent ulcers by persisting for more than 2 weeks after any cause is removed, and they do not heal or resolve spontaneously. Any ulcer present for more than 3 weeks must be investigated without delay. Globally in men they account for 2.7% of all cancers and for 1.5% in women. In parts of India, oral cancer in men accounts for over 30% of all cancer cases with tobacco and betel nut chewing being major risk factors, whereas tobacco smoking and alcohol consumption are the major risk factors in Western developed countries. The human papilloma virus (HPV) is a major cause of cervical cancers and is linked to 90% of squamous carcinoma of the oropharynx (posterior tongue, throat and tonsils). The relatively poor prognosis of oral cancer is related to late presentation, and treatment is usually surgery and may be followed by radiotherapy and/or chemotherapy.