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Mouth Cancer

About the Department

An abnormal and uncontrollable growth of cells may start developing in the lining of the mouth, on the surface of the tongue, the insides of the cheeks, the roof of the palate, the lips or the gum. This forms a mass known as a tumour and in time, it can lead to mouth or oral cancer. Lesser known areas of mouth cancer include glands that produce saliva, the tonsils at the back of the mouth, and the part of the throat connecting your mouth to your windpipe.

The healthy functioning of a body is dependent on two key factors – the oral cavity and the oropharynx. These two key components help in basic activities including breathing, eating and speaking. An essential part of the digestion process is when the salivary glands in the oral cavity help in breaking down the food that we chew. However, the oral cavity is also at risk of developing cancerous cells. Since the oral cavity is composed of several parts, the mouth cancer comprises of a number of cancer types that requires different treatment routes. 

The most common form of mouth cancer originates from the membranes of the mouth, nose and throat that are line with flat, firm cells called squamous cells. If treatment is delayed or not provided in time, these malignant cells can penetrate deep in to the layers of tissues that includes muscle and bone. In due course of time, it can also infiltrate nearby structures like the throat or lymph glands of the neck. If it finds an access to the bloodstream, mouth cancer can easily spread and metastasise to other parts of the body. 

Men are twice as likely to develop mouth cancer in comparison to women. The critical age barrier for mouth cancer is 45 years and above. While researchers have found it difficult to pinpoint particular causes of mouth cancer, most largely believe that smoking is the foremost reason for it. Chewing tobacco, alcohol consumption are also probable causes of mouth cancer. 

If diagnosed and treated in its early stages, mouth cancer is curable. However, in most cases, patients fail to consult a specialist until the disease has reached an advanced stage. The Department of Head and Neck Cancer at Fortis Hospitals, Bannerghatta Road, is a leading centre of treating mouth cancer patients in the city. 

The mouth cancer treatment at Fortis Hospital is tailored to suit the patient’s medical condition. Treatment of mouth cancer may possibly include targeted therapies as well as surgeries. If surgical therapy is required, Fortis has some of the leading surgeons who are well versed in modern, non-invasive operative techniques. 

Mouth cancer treatment may alter the patient’s ability to talk, swallow, eat and breathe. At the Department of Head and neck Cancer at Fortis, a team of highly skilled surgeons, medical and radiation oncologists, plastic surgeons, dental oncologists and speech and swallowing specialists will work in collaboration to provide the patient with the best possible opportunity towards making the treatment successful. 

Areas of Care

Fortis Hospitals at Bannerghatta Road have state-of-the-art facilities along with an enormously talented team of experts who have dealt with all types of mouth cancers. Mouth cancer can be classified in their distinctive types in accordance with these criteria:

- Depending on the location of the mouth cancer, it can be of two types:

- Oral Cavity Cancer including the tongue, lining of the cheeks, gums and teeth, upper or lower jaw, the hard palate, the mouth’s floor and salivary glands
- Oropharyngeal Cancer including soft palates, the base of the tongue, uvula, and tonsils

- Depending on where the cancerous cells start growing, mouth cancer may again be classified in to two types:

- Squamous Cell Carcinoma
- Minor Salivary Gland Cancer

At Fortis, we aim to diagnose the type of mouth cancer as early on as possible as that gives the patient a chance for the treatment to be more successful. With a specialised facility for diagnostic screenings, monitoring and therapy, it is more than possible to detect the disease at its early stages.

Symptoms & Diagnosis

Signs and Symptoms of Mouth Cancer

There are no noticeable symptoms in the early stages of mouth cancer. Nevertheless, the most common mouth cancer symptoms include:

- If you observe an inflammation or thickenings, bumps or lumps, rough crusts or spots on the lips, gums or any other parts inside the mouth
- If you notice eroded regions on the gums, lips and in the inside parts of the mouth
- If you observe bleeding in the mouth without any plausible reason
- If you experience a numbness, loss of sensation, tenderness or pain in any part of the mouth, face or neck
- If you notice sores on the mouth, face and neck that are persistent in nature, are easily bleeding and show no signs of healing within a couple of weeks
- If you experience a sensation such as an object is stuck in the back of your throat accompanied with a feeling of soreness
- If you experience problems in chewing, swallowing, speaking or movements of the jaw and tongue
- If you experience pain in the ears
- If you notice a transformation in the manner your teeth or dentures fit together
- If you observe that you have undergone a sudden bout of weight loss

Most of these symptoms may also be the result of less harmful conditions. Nonetheless, if you observe that one or more of these symptoms are persisting for a period of three weeks or more, then it prudent to consult your general physician or dentist immediately. If you are a smoker or consume alcohol regularly, then it is all the more important to seek medical attention right away.

Our Diagnostic Services

If your general physician or dentist suspects mouth cancer, the initial screening will involve a physical examination. This will involve a close check-up of the floor and roof of the mouth, the backside of the throat, cheeks and tongue including the lymph nodes located in your neck region. To confirm the diagnosis further, your specialist may recommend the following diagnostics tests:

- Biopsy:

A sample of the suspected cancerous tissue is collected and examined for the presence of malignant cells under a microscope. There are several methods of how the biopsy may be performed:

- Incision biopsy is performed under local anaesthesia if the tissue in the affected region is easily accessible. The procedure is painless, and the wound is closed with dissolvable stitches.

- Punch biopsy is also carried out under local anaesthesia where a tiny portion of suspected tissue is collected. No stitches are required in this instance.

- Fine needle aspiration cytology is carried out if there is an inflammation in the neck region if secondary form of mouth cancer is suspected. It is performed at the time of carrying out an ultrasound of the neck. It is similar to undergoing a blood test. The process is quick and there’s no discomfort as such.

- Nasendoscopy involves using an instrument known as a nasendoscope which a long, thin, flexible tube with a camera and light is attached on one end. If it inserted via the nose into the throat. It is used to remove the suspected tissue from the nose, pharynx or larynx. The process takes around 30 seconds under local anaesthesia to reduce any possible discomfort. 

- Panendoscopy is performed under general anaesthesia used in order to investigate similar regions to a nasendoscopy. However, this biopsy uses a larger telescope which for patient can be uncomfortable. The telescope provides better access and can be used to remove small tumours too. 

- Panorex Films:

Using X-rays, images are taken of the upper and lower jawbones. It can also be used to check if the cancer has penetrated to the bones. 

Upon receiving confirmation of the presence of cancerous cells in the mouth through the results of the biopsy, the specialist may recommend further diagnostic tests to check if the cancer has started infiltrating the tissues of the jaw, skin and the lymph glands on the neck. The screenings include:

- X-ray
- Ultrasound Scan
- Magnetic Resonance Imaging (MRI) Scan
- Computerised Tomography (CT) Scan
- Positron Emission Tomography (PET) Scan
- Barium Swallow / Upper Gastrointestinal Series

The outcomes of all these diagnostic tests will help determine the type of mouth cancer, the stage and its grade. For the patient, being diagnosed with mouth cancer is a life-changing experience. At Fortis Hospitals, our team of caregivers are always there to support the patient and their families that will assist them in making informed decisions about the route to mouth cancer treatment. Our cancer specialists are there to reassure the patient and boost their morale during the diagnostics and treatment phases. 

At Fortis, we encourage the patients and their loved ones to learn more about the particular cancer and have an understanding of what lies ahead before treatment begins. Answering patient questions and addressing concerns is part of your treatment process too. Our specialist support groups are always there to help you make sense of it all. 

Treatment Options

Depending on the location, type, stage and grade of the mouth cancer will determine its treatment path. However, most plans constitute of one or more of the following therapies.

- Surgical therapy is carried out especially if the mouth cancer is detected at the early stages. Using surgical procedure, the malignant tumour is removed. Additionally, sample tissues from the mouth and neck regions may also be collected for further testing and analysis under laboratory conditions later. 

- Radiation therapy uses high powered energy beams that are targeted at the tumour. The patient can undergo up to two rounds of radiation therapy in a single day, consecutively for up to five days in a row for a period spanning two to eight weeks. If the mouth cancer has progressed to an advanced stage, radiation therapy may be used in combination with chemotherapy. 

- Chemotherapy is a form of treatment where medication is used to destroy the cancerous cells in the mouth. It is mostly administered through an IV line or orally. While some patients may require hospitalisation, other patients can undergo chemotherapy as an outpatient too. 

- Targeted therapy is particularly useful in early as well as advanced stages of mouth cancer. Using drugs, it binds certain proteins on the malignant cells that disrupts their expansion pattern. 

- Nutritional therapy is a significant part of treating mouth cancer. Patients undergoing such strenuous therapy are at an increased risk of side effects including facing difficulty in swallowing and eating, undergoing loss of weight and appetite. With proper nutritional care, the patient has a much better chance of recovery. 

- Oral hygiene is a critical part of mouth cancer treatment. The patients should ensure that their mouth is moist, and the gums and teeth are always clean.

The recovery times of individual patients vary greatly. Many may experience side effects such as pain and inflammation. Discuss what you are experiencing with your consulting specialist at Fortis. A lot of patients who may have undergone surgery may additionally need reconstructive surgery that will assist in re-building bones and tissues in the facial region. 

During your treatment at Fortis, our patients specifically benefit from having access to a variety of specialists from several medical disciplines who are part of the cancer care team. The patient’s case is periodically reviewed in order to formalise a personalised treatment plan. Coordinating the care through multidisciplinary teams, Fortis aims to focus on key aspects of patient care including treatment, reconstruction and palliative care. 

Our Team That Cares

Fortis Hospitals, Bannerghatta Road, is one of leading cancer centres in Bengaluru, that is at the forefront in working towards prevention of cancer and precancers. The objective is to offer our cancer patients with cutting-edge diagnostic technologies and facilities and engaging in putting forward the most modern forms of cancer therapy available in India. Fortis provides new strategies to mouth cancer patients in order to maintain oral and dental hygiene and overall health. 

We realise that being diagnosed with mouth cancer has an overall affect on the patient’s life. In order to adequately support the patient and their loved ones through this, we have specialist support groups and counsellors who put the patient’s need first. Guiding the patient every step of the way starting with the initial consultation, through diagnostic screenings, treatment, rehabilitation and recovery is a mammoth journey that is undertaken by our support groups. At Fortis, the mouth cancer patients are reassured to know that they are surrounded by some of the country’s leading specialists in this type of cancer treatment. At Fortis, our goal is to provide the best services that are required to treat the whole person – not cancer alone.