Mouth cancer

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What is it about ?

The term “head and neck cancer” includes all malignant tumors that develop in the area of ​​the head and neck. The World Health Organization (WHO) already classifies more than 50 types of cancer in the region of the head and neck alone. Most occur in the mucous membranes inside the mouth: tongue, palate, throat, nose, sinuses, ear canal, salivary glands, larynx.

Smoking andalcohol abuse greatly increase the risk of oral cancer. The combination of alcohol and tobacco particularly increases the risk of throat cancer. In recent years, an increase in the number of tumors due to human papillomavirus (HPV) was also found. This virus is the cause of Cervical cancer, but can also get into the lining of the mouth after oral sex and cause cancer there.

Where and how often?

In Belgium, there are around 2,500 new cases of head and neck cancer each year. This cancer mainly affects men over the age of 50. In 2011, it was even the fourth most common cancer in men.

This is totally different for women, in whom head and neck cancer does not even make the top 10. However, there has been an increase in the number of head and neck tumors among women over the course of the year. in recent years.

This is also the case in the younger population. The increase in the number of contamination by HPV perhaps explains this increase.

How to recognize it?

At first, symptoms are usually minimal or non-existent. Symptoms mainly depend on where the tumor is growing and its size. Very locally, changes may be visible in the mouth or throat. The unexplained appearance of white or red spots in the mouth or throat can thus suggest throat cancer. One of the first signs is often a lump in the neck. a hoarseness prolonged is also a very common symptom.

Other signs may suggest a tumor, for example:

How is the diagnosis made?

The diagnosis of oral cancer is made by means of a biopsy. This exam involves taking a small piece of tissue from the lesion and having it examined in more detail under a microscope. If the diagnosis of cancer is made, it must be confirmed by a second laboratory (the reference center). This laboratory may possibly request additional biopsies.

Once the diagnosis is made, the stage of the cancer is established (staging). This is usually done with an MRI of the head and neck. This exam allows you to assess the extent of the tumor and the presence of metastases in the lymph nodes in the neck. The PET scan can detect metastases anywhere in the body.

In addition, an examination of the trachea and esophagus will also be performed. Before the start of treatment, the teeth will also be checked and cared for if necessary.

What can you do ?

Stop smoking greatly decreases the risk of oral cancer. Moderate your alcohol consumption as well.

In addition to tobacco andalcohol, HPV (human papillomavirus) is also a major risk factor for throat cancer. It is difficult to avoid contamination because the HPV is a very widespread virus. You can get the virus through sex, including oral sex. Using a condom reduces the risk of contamination, but does not completely prevent it.

What can your doctor do?

Treatment of oral cancer without metastases

A multidisciplinary oncological consultation (COM) is organized before the start of treatment. All the healthcare professionals involved (cancer specialist (oncologist), radiotherapist, pathologist, general practitioner, dentist, etc.) meet to discuss the patient’s individual situation and determine treatment.

If possible, localized cancers are treated surgically, provided the tumor can be completely removed. The lymph nodes in the neck are also removed. This type of intervention can therefore in principle allow a cure (it is therefore a curative treatment). From the outset, special attention should be paid to reconstructing, by plastic surgery, the parts removed inside the mouth.

If the tumor cannot be completely removed, for example because it is too large or because the lymph nodes in the neck are affected, treatment consists of a combination of rays (radiotherapy) and drugs (chemotherapy).

When the tumor threatens to block the airways, a temporary opening can be made in the trachea (tracheostomy). Thanks to this procedure, air can go directly to the lungs through a tube.

Treatment of metastasized cancer of the mouth or a recurrence that cannot be removed

The chemotherapy is privileged. The patient will be informed that the treatment will no longer cure.

Treatment of a local recurrence

Surgery will be done to remove the new lesion, then followed by radiotherapy local.

Regular

All patients are followed for a minimum of 5 years: every 3 months for the first 2 years, then every 6 months for the following 3 years. Subsequently, an annual check is still recommended. It does not seem necessary to carry out scans at each control. These will only be requested in the event of a suspected recurrence.

During follow-up, special attention is paid to quality of life: ability to eat and speak correctly, condition of teeth, nutritional status, smoking, alcohol consumption, thyroid function, side effects of treatment. If necessary, it is possible to seek the help of specialized care providers, such as occupational therapists, speech therapists, stomatologists, …

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