Dr. Sumit Shah – Oral cancer Surgeon in Pune
Mouth cancer or oral cancer (also known as oral cavity cancer) can occur anywhere in the mouth. It is named according to part of oral cavity it involves. It can on the surface of the tongue, the lips, inside the cheek, in the gums, in the roof and floor of the mouth, in the tonsils, and in the minor salivary glands.
It belongs to a larger group of cancers called head and neck cancers. Most develop in the squamous cells that line mucosa (covering) in your cheek, tongue, and lips.
- In India, in men, Oral cancer is about 16.1% of all cancer types. According to Globcon, in 2018, 92011 new cases of oral cancer cases are registered.
- Whereas in women it is 10.4% of all cancers.
- Total no. of deaths due to mouth cancer are 72,616.
- It has been observed that about 80-90% patients of oral cancer are due to tobacco consumption.
Survival rate (5-year)
- Patients with early stage oral cancer: 82%
- Patients with advanced stages: 27%
Prolife is the leading Hospital for Oral cancer Treatment in Pune. At prolife we understand your problem, we diagnose it properly & we provide the best treatment which suitable for you.
Types Of Oral Cancer
Every oral cancer patient is different. Our Oral Cancer Surgeon develop a treatment plan tailored to each patient’s specific type of oral cancer listed below:
- Squamous cell carcinoma: Normally, the throat and mouth are lined with so-called squamous cells, which are flat and look like fish scales on a microscopic level. Squamous cell carcinoma develops when some squamous cells mutate and become abnormal.
- Verrucous carcinoma: The type of very slow-growing cancer made up of squamous cells. This type of oral cancer rarely spreads to other parts of the body, but it may invade nearby tissue.
- Minor salivary gland carcinomas: This disease includes several types of oral cancer that may develop on the minor salivary glands, which are located throughout the lining of the mouth and throat.
- Lymphoma: Oral cancers that develop in lymph tissue, which is part of the immune system, are known as lymphomas. The tonsils and base of the tongue both contain lymphoid tissue.
- Benign oral cavity tumors: Several types of non-cancerous tumors and tumor-like conditions may develop in the oral cavity and oropharynx. Sometimes, these conditions may develop into cancer. For this reason, benign tumors are often surgically removed.
- Leukoplakia and Erythroplakia: These precancerous(those having the potential to become cancer conditions develop when certain types of abnormal cells form in the mouth or throat.
When leukoplakia develops, a white area is visible, while Erythroplakia is marked by a red area, which may be flat or slightly raised and often bleeds when scraped. Both conditions may be precancerous, meaning they may develop into types of cancer.
When these conditions occur, a biopsy and other test are performed to determine whether the cells are cancerous. About 25 percent of leukoplakias are either cancerous when first discoveredand almost 4to 10 % has potential to become cancer. Erythroplakia is usually more serious, with about 17 of cases deemed to be cancerous, either at the time of diagnosis or later.
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What are the symptoms of oral cancer?
Symptoms of oral cancer vary from person to person. But since early detection is important for successful treatment of oral cancer, see your doctor or dentist if you notice abnormal areas in your mouth. These may include the following:
- Leukoplakia (literally a “white patch”) is a persistent white area or spot in the oral cavity. About 25% of leukoplakias are cancerous or precancerous.
- Erythroplakia (red patch) is a persistent red, raised area or spot in the oral cavity that bleeds if scraped. Erythroplakia often arises out of an area of leukoplakia, so a mixed red and white appearance is common.
Potential signs of oral cancer include:
- A sore in the mouth that doesn’t heal
- Unexpected loose teeth
- A lump in the neck
- A mass or thickening in the face, jaw, cheek, tongue or gums
- A persistent sore or mass in the mouth that causes pain or a poor fit while wearing dentures
- Difficulty chewing, swallowing or moving the tongue or jaw
- Persistent bad breath
- Unexplained weight loss
These symptoms do not necessarily mean you have cancer. However, it is important to discuss any such symptoms with your doctor, since a correct and early diagnosis can help improve your chance for successful treatment. Also, these symptoms may signal other health problems. If you see any symptoms of Oral cancer then Meet Dr. Sumit Shah at Prolife Cancer Centre, renowned Mouth/Oral cancer Surgeon in Pune.
Oral Cancer Risk Factors
Anything that increases your chances of getting cancer is called a risk factor. Many cases of oral cancers are linked to risk factors. Some patients will develop oral cancers without any known risk factors. The main risk factors for oral cancer are:
- Tobacco use: Many people diagnosed with oral cancer use tobacco in some form. The longer people use tobacco and the amount they use increases that risk. People who use chewing tobacco or snuff are more likely to develop cancer of the gums, cheek and lips. Pipe smoking increases the risk of cancer of the lip and the soft palate. Living with a smoker or working in a smoking environment can cause secondhand or passive smoking, which also may increase risk.
- Alcohol: Many people diagnosed with oral cancer are heavy drinkers, consuming more than 21 alcoholic drinks each week. The combination of tobacco and alcohol is particularly dangerous. People who drink alcohol and smoke are six times more likely to get oral cancer than people who do not drink or smoke.
Other risk factors include:
- Gender: About two thirds of people diagnosed with oral cancer are men.
- Age: These cancers are found most often in people over 45.
- Prolonged sun exposure, which can lead to lip cancer
- Long-term irritation caused by ill-fitting dentures
- Poor nutrition, especially a diet low in fruits and vegetables
- Immunosuppressive drugs
- Previous head and neck cancer
- Radiation exposure
Oral Cancer Stages
If you are diagnosed with oral (mouth) cancer, your doctor will determine the stage of the disease. Staging is a way of classifying cancer by how much disease is in the body and where it has spread when it is diagnosed.
Disease stage is determined by the size of the primary tumor, how much it has invaded the tissues and whether cancer has spread to the lymph nodes and whether it has spread to other organs like lung, liver, bone or brain.
Oral Cancer Stages
Precancerous stage: Abnormal (dysplastic) cells are found on the surface of the lining of the lips and/or oral cavity. These abnormal cells may invade deeper to become cancer.
Early Stage (1-2):
The tumor is 4 centimeters (about 1 ½ inch) or smaller
Tumor has not spread to lymph nodes or other parts of the body
Locally Advanced Stage (3-4A):
The tumor is larger than 4 centimeters (1½ inches), invading deep muscle or bone OR
Tumor has spread to the lymph nodes .
Unresectable/Metastatic (4B-C): cancer involves tissues that cannot be removed, such as the carotid artery, vertebra, skull base or has spread to other parts of the body
Recurrent: oral cancer has reappeared after it was treated. It may reappear in the oral cavity or another part of the body.
For more detail staging see AJCC2010/NCCN GUIDELINES
How is oral cancer diagnosed?
Early diagnosis dramatically improves your chances for successful treatment. Prolife cancer centre uses the most advanced techniques and technology to determine if a tumor is benign (not cancer), pre-cancer or cancer. Prolife is the best location for Diagnosis & Treatment of Oral Cancer.
Oral Cancer Diagnostic Tests
If you have signs or symptoms of cancer, the doctor will examine the inside of your cheeks and lips, the floor and roof of the mouth, the tongue and the lymph nodes in your neck. Be sure to tell your doctor or dentist if you use or have used tobacco in any form.
If your doctor suspects you may have oral cancer, one or more of the following tests may be used to find out if you have cancer and if it has spread.
i.Brush biopsy (exfoliative cytology): This relatively new type of biopsy is painless and does not require an anesthetic. The doctor rotates a small stiff-bristled brush on the area, causing abrasion or pinpoint bleeding. Cells from the area are collected and examined under a microscope by an Onco-pathologist .
ii.Incisional biopsy: This is the traditional, most frequently used type of biopsy. The surgical oncologist surgically removes part of tumor tissue by giving local anesthesia. It is completely painless procedure and the patient goes home in the next 2 hours.
- Excisional biopsy: rarely, if the size of the tumor is very small all of the tissue where cancer is suspected is removed with a surrounding rim of normal tissue. This confirms the diagnosis and at the same time patient does not requires a second surgery. Excisional biopsy in the mouth needs to be done in an operating room with general anesthesia.
iii. Fine-needle-aspiration biopsy (FNA): This type of biopsy often is used if a patient has a lump in the neck that can be felt. In this procedure, a thin needle is inserted into the area. Then cells are withdrawn and examined under a microscope.
Once the diagnosis is confirmed we need to stage the disease. (Stagging is a process where we determine the exact extent how much the tumor has spread locally as we as in rest of the body). Not all patients require all these investigations. the doctor will decide which investigation is to be used depending on the clinical stage of the disease.
Ultrasound(USG) neck: If the tumor in the oral cavity is very small easily removable in that case we need to know only whether it has spread to neck lymph nodes. In this case, USG neck is sufficient. It’s a safe ,simple,quick and cheap investigation
- CT scan Oral cavity and Neck with contrast: This is the most common investigation performed to see tumor size and extent in the mouth as well as whether it has spread to neck lymph nodes.CT scan typically helps to know whether the tumor is away, touching or involving jawbone(mandible) or cheekbone (maxilla). This information is crucial while planning surgical resection.
- MRI (magnetic resonance imaging) scans: MRI is also an important investigation in mouth cancer. When the tumor is involving only cheek(buccal mucosa), tongue or soft tissue (ie tumor is away from the bone ) MRI is the investigation of choice.
- At Prolife we prefer to combine both CT scan and MRI (CT-MR ORAL CAVITY AND NECK) in this we get combined information from both. It helps our surgical oncologist to define the exact stage of the disease. It also helps to plan surgical resection in a better way so that the tumor is removed completely without compromising oncological principles at the same time maximum normal tissue is preserved.
- Chest Xray: it’s a simple investigation which gives information whether the tumor has spread to lungs or not . (lung is the most common other organs where mouth cancers spread in the body)
Whole-body PET-CT Scan: This is a recent most investigation in oncology. This entire body is scanned to know whether mouth cancer has spread to other parts and organs of the body. Not all patients require a PET-CT scan. Only those who have clinical symptoms of distant organ spread of cancer(i.e. metastasis) or when oncologist suspect metastasis or if mouth cancer is large and has spread to multiple neck lymph nodes in that case possibility of other organ involvement is very high.
Treatment options for oral cancer
The face is the most visible part of body and mouth(oral cavity) serves important functions of speech, chewing, swallowing and eating food. Treating cancers originating from this part requires in-depth understanding of normal functioning and physiology of various organs in this part. Along with knowledge it requires skills and expertise to plan various resections (removal of affected part) and reconstructions making new part) and Prolife cancer centre takes special care to customize your oral cancer treatment so that we maximize the chances of the cure while minimizing the impact on your body and lifestyle
We at Prolife have dedicated team of surgical oral oncologist, Oncoplastic surgeon, dentist, ENT surgeon specialize in organ and function preservation techniques as well as oncoplastic reconstructive techniques. We also have speech and swallowing therapist, physiotherapist and dedicated nurses who help to restore normal functioning and speed up the recovery of patients. For each and every patient we prepare a personalized care plan. We take special care to work with each patient to restore optimum physical function and is a cosmetic appearance.
Our Oral Cancer Treatments
Prolife cancer centre has best Oral Oncologist who customizes oral cancer treatment to your particular needs. One or more of the following therapies may be recommended to treat cancer or help relieve symptoms.
Surgery is the most frequent first treatment for oral cancer. The type of surgery depends on the type, extent, and stage of cancer. Surgical techniques are designed to remove all of cancer in the mouth, and lymph nodes confirmed or suspected to have cancer cells. At Prolife, a Surgical oncologist (Mouth Cancer Specialist) generally leads the team along with the onco-plastic surgeon, dentist, ENT surgeon, radiation therapist, and a supportive teams like speech and swallowing therapist.
As part of treatment, some patients with oral cancer need plastic or reconstructive surgery to help regain the ability to speak or swallow and/or restore their appearance.
At Prolife we follow three basic principles while planning surgery for any cancer patient.
- Oncologic clearance: i.e. Not a single viable cancer cell should remain behind. We use intraoperative pathological examination called a frozen section to confirm that all resected margins are free of the cancer cell. This innovative technique confirms that no viable cancer cell remains behind. Complete resection of cancerous growth(R0 resection) is the most important thing to achieve a cure in any cancer patient.
- Preservation or restoration of function: Each the part of oral cavity serves a specific functions. Our surgeons at Prolife meticulously plan how to restore the function of the affected part once it’s removed. This is the newer concept in cancer operation called ‘organ and function preservation surgery’. Onco-Plastic surgeon plays an important role in this situation.
- Cosmesis: The head and neck area is a visible part of the body. So the surgery performed should restore normal facial symmetry, contour and looks. We at Prolife take utmost care while doing surgeries and taking each and every stitch. Majority of skin scars are hidden in natural skin crease lines which at closest look are difficult to recognize.
Radiation therapy may be used after surgery, either alone or with chemotherapy for more advanced tumors. The method of radiation treatment used depends on the type and stage of cancer.
External-beam radiation therapy is the most frequently used method to deliver radiation therapy to the mouth.
Internal radiation or brachytherapy delivers radiation with tiny seeds, needles or tubes that are implanted into the tumor. It is used sometimes for treating small tumors or with surgery in advanced tumors.
Proton therapy delivers high radiation doses directly into the tumor, sparing nearby healthy tissue and vital organs. For many patients, this results in a higher chance for successful treatment with less impact on the body.
Prolife Cancer Centre offers the most advanced chemotherapy options. We provide painless chemotherapy. Chemotherapy may be used to shrink cancer before surgery or radiation, or it may be combined with radiation to increase the effectiveness of both treatments. It also may be used to shrink tumors that cannot be surgically removed. At Prolife we have dedicated chemotherapy unit. In this along with medical oncologist, a specialized nurse gives chemotherapy. All the concerns and queries are resolved prior to the start of treatment. We see to it that patients feel at home along with minimum side effects.
Cancer cells need specific molecules to survive, multiply and spread. These molecules are usually made by the genes that cause cancer, as well as the cells themselves. When mouth cancer is at an advanced stage and patients are not fit for active treatment targeted therapies are utilized to shrink a tumor and make the patient comfortable.
Cancer cells need to evade the immune system to survive, multiply and spread. A new class of cancer medicines, immunotherapies, work to unmask cancer to the immune system.
After Treatment: Rehabilitation
Oral cancer and its treatment often cause difficulty with speaking, chewing, swallowing. We work with you, defining your needs and making sure you receive the care you need to increase the likelihood of returning to normal speech and function. Therapy may include speech, occupational and physical therapies and other methods.
After surgery or primary treatment all patients need some time to restore and relearn the affected function. All supportive team members at Prolife help our patients during the rehabilitative phase and guide them stepwise.
Usually, reconstruction is performed at the same time as your cancer surgery Your do. In some cases, the surgery site is left to heal on its own. A doctor will recommend the method that is best for you.
Prognosis & Follow-up
A prognosis is the Oncologist’s best estimate of how cancer will affect someone and how it will respond to treatment.
Prognosis and survival depend on many factors. Only an Oncologist familiar with your medical history, the type, stage and characteristics of your cancer, the treatments are chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognostic factor is an aspect of cancer or a characteristic of the person that the oncologist will consider when making a prognosis.
A predictive factor influences how cancer will respond to a certain treatment. Prognostic and predictive factors both play a part in deciding on a treatment plan and a prognosis.
Oncologist uses different prognostic and predictive factors for newly diagnosed and recurrent breast cancers.
In Oral cancer , “Operating surgeon is one of the most important Prognostic and and Predictive factor”
Oral Cancer Videos
मुँह (Oral) का कॅन्सर कैसे दिखता है | Mouth-Oral Cancer in Hindi | By Dr. Sumit Shah
मुँह(Oral) के कैंसर के बारे में पूरी जानकारी | Mouth – Oral Cancer Treatment | By Dr. Sumit Shah
Oral Cancer Symptoms and Treatment Explained by Dr.Sumit Shah | Prolife Cancer Centre, Pune
Why choose Prolife Cancer Centre for your oral cancer care?
Prolife Cancer centre is one of the best Hospital for Oral Cancer Treatment in Pune. At Prolife Cancer Centre, your care for oral cancer is personalized. Your cancer care team, will communicate closely and work together, and with you, to customize your care, including the most advanced therapies with the least impact on your body.
We offer new strategies to maintain dental and oral health treatment. Our highly specialized speech pathologists and therapists are among the most experienced in the nation, particularly in the newest methods of voice restoration and speech.
And at Prolife Cancer Centre, you’re surrounded by the strength of India’s largest and most experienced comprehensive cancer centre, which has all the services needed to treat the whole person – not just the disease.
Patient Testimonial Videos
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Kishor Relekar – Oral Cancer Patient Testimonial Video