Malignant neoplasms of the oral cavity. Malignant tumors of the oral cavity

Date: 03.03.2020

The oral cavity is prone to a wide variety of diseases. Some of them negatively affect only the mucous membrane and teeth, others lead to more serious consequences, affecting all systems of the body.

These diseases include oral cancer.

Types and forms

Cancer that occurs in the oral cavity is divided into several types, differing in the place of localization:

bottom of mouth... It is characterized by the active growth of a tumor that rapidly grows into the salivary glands, the lower part of the tongue and the muscles of the jaw. Further spread occurs through the artery system of the language department;
language... It is mainly localized on the lateral surfaces of the tongue and its root. Root cancer occurs in 40% of cases. Occasionally found on the tip, dorsum and bottom;
cheeks... Oncology, most often develops at the level of the corners of the mouth in the area of the molars. Often, the disease at first looks like an ordinary ulcer;
palate... This cancer is characterized by rapid spread to the alveolar ridge.

The listed types of cancer can manifest themselves in various forms:

Papillary... It is characterized by the appearance of small elongated seals hanging into the oral cavity.
This form is considered the mildest and rarely spreads beyond the site of localization.
Knotty... It is manifested by the formation of rounded seals that have the correct shape. The structure and color of the mucous membrane does not change.
In some cases, the seals may be covered with a whitish coating.
Ulcerative... The most common form of pathology.
It is distinguished by the appearance of long-term non-healing manifestations of the mucous membrane of the lips or cheeks, which are constantly increasing in size.

Causes

Numerous studies and observations have made it possible to identify the main causes that act as factors provoking the disease. Smoking is the main reason. Because of it, a tumor occurs in 95% of cases.

Rest 5% of pathology is caused by the following reasons:

alcohol abuse;
papilloma virus (type 16);
lichen planus;
chronic dental diseases, which lead to pathological changes in the structure of the tissues of the mouth;
leukoplakia;
erythroplasia;
mechanical injuries of a permanent nature that remain without treatment;
lack of vitamin A.

Symptoms and Signs

It is impossible to detect cancer on your own at home, but there are a number of certain symptoms, the manifestation of which should alert a person.

With the following symptoms, which may be the first signs of the disease, the patient must visit a doctor:

long-term non-healing ulcers;
pronounced swelling or induration, which can be detected by palpation or visually;
decrease or complete loss of sensitivity;
discoloration of the mucous membrane. Manifestations of white or red spots on it;
difficulty swallowing and chewing;
causeless pain radiating to the temporal part, or sensation of a foreign body in the larynx;
swelling of tissues;
disruption of the vocal cords;
increased salivation;
bleeding.

Data symptoms are not always precursors of malignant tumors.

By their appearance, it is possible to diagnose more than one dental disease, therefore, for an accurate diagnosis, it is imperative to visit a specialist.

Phases and stages

The development of a malignant neoplasm is a complex process that consists of several phases and stages.

Depending on the nature of the general clinical picture distinguish between the following degrees:

Initial... This phase is characterized by the appearance of painful sensations in the oral cavity and shallow ulcers and seals.
Active... Seals grow, taking the form of a pronounced tumor. Ulcers develop into deep wounds. The pain intensifies, accompanied by general weakness and sudden weight loss.
Launched... The tumor grows, penetrating the surrounding tissues and nearby organs, gradually destroying them.

Based on the size of the lesions and the depth of penetration of the tumor into the tissue, distinguish between certain stages:

Initial (zero)... The development of education cannot be detected visually. Often, cancer at this stage is discovered by chance, during third-party examinations.
The first... Unlike zero, it is characterized by the appearance of neoplasms up to 2 cm in diameter, which are located on the surface.
The second... At this stage, the tumor grows up to 4 cm, affecting the deep layers of tissues.
The third... Differs in an increase in the diameter of cancerous areas from 4 cm or more. As a rule, at this stage, the tumor affects the lymph nodes located nearby, the temperature may rise.
Fourth... It is characterized by intense tumor growth and the onset of metastasis.

Diagnostics

All types of cancer can be in the body without showing any signs for a long time. In this case, only a thorough diagnosis will help to identify the disease.

Analyzes

To determine if cancer is in the body, the doctor must order a blood test.

Typically assigned several types of this analysis:

General... He is not able to show the presence of cancer cells, but the development of inflammation can indicate an increased ESR and decreased hemoglobin.
For tumor markers... This assay aims to identify proteins and antigens produced by cancer cells. Tumor markers are also found in the blood of healthy people, but with serious pathologies, this indicator increases several times.

In both cases, blood is donated in the morning and only on an empty stomach.

Normally, a fence should be taken for analysis several times, this will allow, without additional examinations, to trace the dynamics of the development of pathology.

Surveys

For the need for regular examinations for the early diagnosis of oral cancer, see the video:

For detailed information, use additional examination methods:

visual method. It consists in a routine examination of the inflamed area, assessing the quality of the tissue structure, size and shape of the tumor;
roentgenologic... Used to determine pathologies from a secondary lesion that has spread to the jaw bone;
morphological... For research using this method, a biopsy material is taken. He is sent for histology to determine the structure, volume and spread of the tumor into the surrounding tissue. Most often, it is on the basis of this method that treatment is prescribed;
MRI... Use to determine the volume of cancerous lesions and the presence of metastases.

Therapy

Oral cancer responds well to conventional treatment, even if it is detected at an advanced stage. The therapy process is developed individually, based on data obtained only after a comprehensive examination.

One of the methods is used to treat cancer or their complex:

Radiation therapy... It is prescribed only with constant monitoring of the thyroid gland. During the procedure, the patient is inside the chamber, where he receives a dose of radiation.
Surgical intervention... It is carried out with a clear localization of the tumor, without spreading to surrounding healthy tissues.
Chemotherapy method... As a rule, it is carried out after surgical removal of the formation in order to suppress the active growth of pathological tissue.

How effective is it?

The prognosis of the effectiveness of the treatment will depend not only on the method used, but also on the stage of the disease.

The radiation technique is especially effective in the initial and first stages of cancer. To obtain the effect, remote gamma therapy or its combination with the intracavitary one is most often used.

Even as an independent method, it has a positive result: in the first stage of tongue and cheek cancer in almost 90% of cases, and in the second - about 70%.

In the treatment of cancer of the floor of the oral cavity, this figure is slightly lower, and for stage 1 it is 60%, and for stage 2 - 43%.

Radiation therapy does not cope well with stage 3 of the disease... The percentage of people cured does not exceed 25.

Combined technique, which includes surgery and chemotherapy, on the contrary shows high efficiency in later stages:

The results in the treatment of stage 3 cancer of the mucous membrane or tongue are 95%.
When treating cancer of the cheek and floor of the mouth, the rate drops to 37%.

Side effects

Methods for eliminating cancers are aggressive, and therefore have many side effects that harm the entire body.

After chemotherapy and the following side effects I am:

violation of the stool;
nausea and vomiting;
baldness;
decrease in the body's immune defenses.

Radiation therapy also causes side effects:

disruption of the thyroid gland;
skin burn;
deterioration of the elasticity of the vocal cords, which leads to a change in the timbre of the voice;
the appearance of pain in the nasopharynx.

Photo: squamous cell keratinizing cancer of the oral cavity

Are relapses possible?

Unfortunately, even after effective treatment, 20% of patients have relapses.

As a rule, they develop within 3 years after the therapy. The cause of relapses can be both treatment carried out in the late stages, and disturbances in the work of body systems.

Due to the possibility of relapses, doctors recommend visiting specialists for a preventive examination at least once a quarter in the first 3 years after therapy.

Are there ways to prevent this?

To prevent cancer from occurring or to reduce the risk of cancer recurrence, certain rules must be followed:

Quit smoking and drinking alcohol completely.
Balance your diet with a variety of vegetables and fruits.
Do not avoid preventive examinations.
In the presence of dental pathologies, timely qualified treatment should be carried out.
Eliminate the possibility of injury to the mucous membrane.

Oral cancer is a serious disease that cannot be treated with home remedies and requires comprehensive diagnosis and treatment.

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20.04.2019

Mouth pain

Loss of teeth

Difficulty swallowing

Red spots on the oral mucosa

Bleeding in the mouth

Inability to chew food normally

Numbness in the mouth

Hoarseness of voice

Swelling in the mouth

Swelling of the neck

Spreading pain to other areas

Oral cancer is characterized by the formation of a malignant tumor, which is located on the mucous membrane. The group of possible ailments includes cancer of the tongue, bottom of the mouth, cheeks, gums, hard palate, palatine-lingual arch, salivary glands. Pathologies manifest themselves in ulcers, which take a long time to overgrow, and in tissue overgrowth.

Etiology

According to doctors, males are much more likely to develop oral cancer. The core of the group is made up of people over the age of 50. The provoking factors include the following indicators:

nicotine;
smokeless tobacco use;
alcohol;
heredity;
prolonged sunbathing.

Also, an ailment can develop with damage to the oral cavity. People with weak immune systems may be at risk of developing cancer. Such reasons can also provoke the appearance of pathology - unbalanced diet, lack of vitamins, contact with asbestos.

Classification

The disease can manifest itself in various forms, depending on the form of development. Thus, doctors have identified three main types of cancer:

ulcerative - manifests itself in the form of an ulcer, which heals for a long time and can increase in volume;
knotty - seals form in different parts of the oral cavity, progress rapidly, have clear outlines and shape, sometimes become covered with white spots;
papillary - outgrowths of a dense formation that hang in the mouth and bring significant discomfort to the patient.

The tumor can also be localized in different places. By location, doctors have identified several forms of cancer:

cheeks;
the bottom of the mouth;
language;
in the area of the alveolar processes;
palate.

The disease develops with varying intensity depending on the etiological factor. However, in each patient, the pathology is formed in 5 stages:

zero - the neoplasm does not go beyond the mucous membrane, the size of the tumor is relatively small;
the first - in the volume of the tumor is not more than 2 cm, growth further along the cavity does not occur;
the second - the neoplasm reaches 4 cm in diameter, the progressive ailment has not yet struck the lymph nodes;
the third - the tumor is more than four centimeters, the lymph nodes are damaged;
fourth - metastases spread to internal organs, a pathological process develops in the lungs, spreads to the bones of the face, nasal sinuses.

Doctors and patients should take into account that if the disease is started up to stages 3 and 4, then no therapy will help the patient. During this period, only supportive treatment is prescribed to a person, which is aimed at minimizing the improvement of the patient's health.

The fourth stage of the disease is characterized by the appearance of metastases, and they, in turn, can spread further with varying strength. Therefore, doctors have identified another classification, which perfectly helps to determine the degree of metastatic lesion:

N1 - the only metastasis in the lymph node, the volume is not more than 3 centimeters;
N2 - foci of inflammation are formed in one or more nodes, the size increases to 6 cm;
N3 - metastases exceed six centimeters;
M - separate metastases appear.

Symptoms

At the initial stage of the pathology, the patient does not feel any significant pain syndromes. At this point, the patient may experience specific symptoms of oral cancer:

minor pain in the damaged area;
with an increase in the volume of the tumor, pain syndrome also progresses;
attacks of pain can be given to the ear, temple;
difficulty swallowing and chewing food;
the work of the salivary glands increases.

The disease at the last stage can be recognized by its characteristic feature - a stench from the oral cavity. This symptom indicates infection and decay of the tumor.

In addition to the aforementioned indicators, the following signs can inform about the appearance of a malignant formation:

spots of a red or white tint on the mucous membrane;
a feeling of swelling and swelling of some parts of the mouth;
numbness and bleeding in the mouth;
slightly swollen neck;
hoarseness of voice;
ear pain;
strong weight loss;
loss of teeth.

Such indicators are typical not only for cancer, but also for other dental problems. Therefore, if you consult a doctor in time, it is possible to avoid complications and eliminate malignant neoplasms.

Diagnostics

After oral cancer has shown its symptoms and the patient has experienced significant discomfort, he should definitely seek the help of a doctor. If the initial stage of cancer is detected in time, then it is possible to eliminate it without serious surgical intervention.

During the examination by the doctor, the patient is assigned several laboratory and instrumental examination methods:

nasopharyngoscopy;
X-ray of the chest and skull bones;
biopsy;
blood for tumor markers;
scintigraphy;

Carrying out a study by all possible methods allows you to accurately determine the disease, the progression of the tumor process and identify the stage of development of the neoplasm.

Treatment

Cancer treatment consists in providing the patient with prompt help, radiation exposure to the tumor, or chemotherapy to reduce the number of cancer cells.

Surgical treatment of a tumor in the oral cavity and oropharynx involves the removal of the neoplasm with nearby lymph nodes.

If a patient has a mobile formation, then he is prescribed an operation to remove the tumor without excising the bone tissue. Depending on the progressive degree of pathology, surgical care can also be provided with partial removal of the jaw bones or the affected part of the tongue, with the removal of a part of the skin and its restoration with taken particles in a different place.

In some cases, patients are prescribed a micrographic operation, which is based on the removal of the damaged part of the tissues in a layer-by-layer manner and studying them during the operation.

Radiation therapy is very often given to those patients who have small tumors in the mouth or oropharynx. If a formation of significant size is found in a patient, then such therapy is carried out together with the operation and is characterized by the same removal of the tumor. Similar treatment is also prescribed to eliminate some of the symptoms - pain, bleeding, difficulty swallowing.

In chemotherapy, doctors select drugs for each patient individually. This treatment helps to get rid of cancer cells completely. Chemical therapy can be given in conjunction with surgery and radiation treatment.

Chemotherapy is prescribed to the patient after the provision of surgical assistance. This is necessary in order to accurately eliminate all malignant cells.

When carrying out therapy with a similar method, the patient may experience several unpleasant side effects - nausea, vomiting, stool disturbance, baldness, fatigue. All manifestations that happen to a patient after intravenous administration of drugs must be reported to the doctor so that he can analyze the effect of the drug on the body.

When treating pathology, it is also very important to monitor oral hygiene. To cleanse, dentists recommend following these rules:

brush your teeth;
use dental floss;
reduce the amount of spices and solid foods in the diet;
exclude nicotine and alcoholic beverages;
chewing gum and hard candy should be sugar-free.

Prophylaxis

To avoid malignant formation of oral pathology, doctors advise to monitor oral hygiene, regularly brush your teeth, and remember to rinse your mouth after each meal. It is also worth giving up all negative habits, balancing your diet. The main advice concerns regular visits to the dentist. Thanks to constant consultations, the doctor will be able to quickly identify even the smallest diseases and the patient will be able to quickly cope with the pathology.

Is everything in the article correct from a medical point of view?

Only answer if you have proven medical knowledge

The asymptomatic course of a malignant tumor of the oral mucosa at an early stage makes it impossible to start therapy in a timely manner.

But there are signs that cannot be ignored, because you can completely recover from the disease at the initial stage of its development. The reasons, symptoms and methods of treatment of oral cavity cancer will be discussed in the article.

Forms of cancer of the oral mucosa

Oncological diseases of the oral cavity are conventionally divided into three types, differing in etiology and external signs:

Oral mucosa cancer
Name	Description
Knotty	Seals with clear edges are observed on the tissues. The mucous membrane either has whitish spots, or remains unchanged. Neoplasms in the nodular form of cancer rapidly increase in size.
Ulcerative	The neoplasms look like ulcers, they do not heal for a long time, which causes severe discomfort to the patient. Pathology in the ulcerative form is rapidly progressing. In comparison with other species, it affects the mucous membrane much more often.
Papillary	The neoplasm has a dense structure. It is impossible not to notice, since the tumor literally sags into the oral cavity. The color and structure of the mucosa remain almost unchanged.

Localization

Depending on the zone and nature of the localization of neoplasms, the following types of tumors are distinguished.

Cheek cancer

The lesions are often found more often on the line of the mouth at about the level of the corners. At the initial stage of development, it resembles an ulcer.

Later, the patient feels some restrictions when closing and opening the jaw. Discomfort is also noted when chewing food and talking.

Floor of the mouth

The location of the focal zone is observed on the muscles of the floor of the oral cavity with the possible capture of nearby areas of the mucous membrane (the lower part of the tongue with the transition to the salivary glands). The patient experiences severe pain and profuse salivation.

Language

The tumor is localized on the lateral surfaces of the tongue. Perceptible discomfort is noted when talking and chewing food.

This variety occurs more often than the location of the foci on the upper and lower tissues of the tongue with the capture of the tip and root.

The lesions can form on the upper and lower parts of the mouth with damage to the teeth. This causes bleeding of the gums and pain with light pressure on the dentition.

The palate is composed of hard and soft tissues. Depending on which of them were affected, a type of cancer is diagnosed.

Squamous cell carcinoma forms on soft tissues, and when the lesions are located on the hard palate, they identify: cylindroma, adenocarcinoma, squamous cell type. The resulting pain and discomfort during chewing and talking should alert you.

Metastases

Cancer is characterized by the ability to spread into adjacent layers. The direction of metastases is determined by the lymph nodes, it is to them that the tentacles crawl.

Each type of cancer has its own vector of movement:

with oncology of the cheeks and alveolar processes of the lower jaw, metastases advance to the submandibular nodes;
formations in the distal sections are directed to the nodes near the jugular vein;
in cancer of the tongue with a zone of damage to the tip or lateral sides, metastases start up in the lymph nodes of the neck, sometimes they capture the submandibular nodes;
with pathology, the tentacles crawl to the internal organs, and also affect the bone tissue.

Causes

The specific causes of the development of oral mucosa cancer are unknown.

But the opinion of scientists from different countries agrees that the following factors become the trigger:

Risk factors include:

bad habits (alcohol abuse, smoking, chewing and sniffing tobacco);
the presence of prosthetic structures in the oral cavity, which periodically injure the mucous membrane with sharp edges;
work at enterprises where there is an increased concentration of toxic substances, asbestos and other chemical compounds;
complications after complex injuries of the jaw system or operations to remove teeth.

Precancerous diseases

There are pathological processes that precede malignant formations. According to the medical classification, the following diseases are potential hazards.

Modern scientists consider the disease as intraepithelial oncology

The pathology was described as early as 1912 by Bowen and classified as a precancerous condition.

Modern scientists consider the disease as intraepithelial oncology, but in the International Histological Handbook it is identified as a risk factor.

Symptoms:

eruptions of a nodular-spotty nature;
location of the focus mainly in the posterior parts of the oral cavity;
the surface of the affected area of the mucous membrane is velvety;
over time, atrophy of the oral mucosa appears;
the formation of erosion on the surface of the focus.

When diagnosed, it differentiates with lichen erythematosus and leukoplakia. The disease proceeds with unpleasant symptoms.

The surgical method is chosen as the method of treatment. The affected areas of the mucous membrane and tissues are removed completely. In the presence of a large affected area, complex therapy is used.

One of the provoking reasons is the frequent exposure to irritants on the oral mucosa

The disease is characterized by increased keratinization of the mucous tissues, the foci are localized on the inner side of the cheeks, corners of the mouth, tongue.

One of the provoking reasons is the frequent exposure to irritants on the oral mucosa.

These can be both bad habits (tobacco, alcohol) and spicy or hot food.

An irregular shape of a denture can create favorable conditions for the development of leukoplakia.

Symptoms:

slight burning sensation;
tightening of the mucous membrane, which creates discomfort when talking and eating;
the formation of white or gray plaques (diameter 2-4 mm).

The essence of the treatment consists in eliminating irritating factors, taking a vitamin complex with a high content of vitamins A and E, treating lesions with special solutions or surgical intervention.

The scheme is selected individually, depending on the form of leukoplakia.

Papilloma

Both stressful situations and injuries can provoke the active growth of papillomas

To recognize the disease simply by the papillomas that are intensively forming on the oral mucosa.

Both stressful situations and injuries can provoke active growth.

Symptoms:

the formation of rounded papillomas on the leg with a warty, granular or folded surface (size 0.2-2 cm) on the oral mucosa;
localization mainly on the hard and soft palate, tongue;
pain, bleeding, deterioration in the physical condition of a person is not noted.

Treatment for papillomas includes surgery to cut off the formation from the mucous membrane, as well as antiviral and immunomodulatory therapy.

The course of the disease occurs in an acute form and with a benign clinical picture.

Erosive formations are localized on the oral mucosa and lips.

The course of diseases occurs in an acute form and with a benign clinical picture.

The exact provoking factors have not been identified, but there is an opinion that ulcers and erosion appear as a result of sensitization to various infections, as well as in case of failures of the immune system.

Symptoms:

the appearance of many red spots, which transform into erosion and ulcers;
feeling of dryness and roughness in the mouth;
in the area of the foci, the surface is covered with a fibrinous focus.

The treatment regimen includes the use of antifungal, anti-inflammatory, analgesic drugs.

Sedatives, immunostimulating agents, vitamins are also prescribed. If necessary, physiotherapeutic methods are used: phonophoresis, electrophoresis. In difficult cases, they resort to surgical intervention.

Complication of radiation sickness leads to the development of post-radiation stomatitis

Formed after procedures with the use of ionizing radiation, carried out with violations.

The disease can be provoked by careless handling of radioactive isotopes, as a result of which burns form on the oral mucosa.

Complication of radiation sickness leads to the development of post-radiation stomatitis.

Symptoms:

dizziness, physical weakness;
dullness of the face;
dry mouth;
pallor of the mucous membrane;
the formation of white spots in the mouth;
loosening of teeth.

Anamnesis, clinical picture of the disease, and blood test are used to diagnose the problem.

The treatment regimen includes:

development of a special diet;
thorough sanitation of the oral cavity;
treatment of the mucous membrane with an antiseptic solution.

Symptoms

The reason for contacting a specialist may be the following signs:

Development phases

Neoplasms, even of benign origin, after some time are reborn into a malignant tumor, which, as it progresses, goes through three stages of development:

Initial form characterized by unusual phenomena for the patient in the form of painful sensations, ulcers, seals in the oral cavity.
Advanced form of the disease- ulcers take the form of cracks, pain appears, radiating from the oral cavity to different parts of the head. There are cases when the patient does not feel pain at this stage.
Launched form- the active phase of cancer, when the lesions spread quickly. Concomitant symptoms are also noted: pain in the mouth, difficulty swallowing food, a sharp decrease in body weight, a change in voice.

Stages

Cancer has several stages of development.

Each stage is characterized by certain tumor parameters and the extent of the affected area:

Diagnostics

If there is a suspicion of damage to bone tissue, the doctor prescribes a referral for X-ray

Oral cancer is diagnosed by visual examination and palpation.

When in contact with a neoplasm, the location, the density of the structure, and the degree of growth are taken into account.

If there is a suspicion of damage to bone tissue, the doctor prescribes a referral for X-ray.

Differential diagnosis helps to make a diagnosis, when a set of symptoms is compared with other or concomitant diseases.

The following studies help to clarify the picture: ultrasound, CT, MRI.

The final diagnosis is made after the biopsy is obtained. The study is carried out in a laboratory way on the removed part of the tumor.

Treatment

In medicine, several methods of treating oral mucosa cancer are practiced.

When choosing a method, the following factors are taken into account:

the patient's health status, the presence of chronic diseases;
the form of the neoplasm;
stage of development of oncology.

Surgery

After surgery, procedures are performed to restore the patient's health and appearance

This method is used to cut off neoplasms in order to prevent tumor growth and the spread of metastases to nearby tissues, bones and organs.

After surgery, procedures are performed to restore the patient's health and appearance.

Sometimes the patient needs psychological rehabilitation (mainly with organ amputation).

Radiation therapy

A popular way to fight cancer, it is widely used to treat cancer in the oral cavity. It is used both independently and after a surgical intervention.

If the tumor parameters are small, it is rational to use radiation therapy without additional manipulations.

With extensive neoplasms, complex treatment is more suitable. The procedures neutralize the remainder of cancer cells, relieve pain, and improve the ability to swallow.

In some cases, the patient is prescribed brachytherapy. This method involves the introduction of special rods directly into the tumor in order to irradiate it from the inside.

Chemotherapy

This method of treatment involves taking special drugs that have the ability to reduce the parameters of the tumor.

Medicines are selected individually, taking into account the stage of the disease and the form of the neoplasm. Chemotherapy is used in combination with surgery, radiation therapy and alone.

The peculiarity of the effect of chemicals is to destroy cancer cells and reduce the tumor by almost half. But it cannot ensure complete recovery with the independent application of the method.

Forecast

It is possible to completely overcome the disease only in the case of early diagnosis and the right choice of treatment method.

The prognosis is that it is possible to completely overcome the disease only in the case of early diagnosis and the correct choice of treatment method.

The result also depends on the type of cancer.

For example, the papillary variety is much easier to cure. The most difficult thing is with an ulcerative neoplasm.

The relapse-free period (up to 5 years) after a course of isolated therapy is 70-85%, with the development of neoplasms at the bottom of the oral cavity, the indicator is lower (46-66%).

When diagnosing stage 3 oral cancer, according to statistics, the absence of relapses is observed in 15-25%.

Disease history

In the early stages, the disease can proceed without the manifestation of obvious signs or has poor clinical symptoms. An external examination of the oral cavity reveals: cracks, ulcers, seals.

Formations do not go away for a long time, even if the lesions are treated with wound-healing agents. Only a quarter of patients feel characteristic symptoms: pain in the mouth, inflammation of the nasopharynx, gums and teeth.

With the development of the disease, the manifestations become more pronounced, and the tumor increases in size. Pain sensations begin to give in the ear, head, neck.

Due to irritation of the oral mucosa by the decay products of cancer cells, an increase in salivation is noted, the cavity exudes a putrid odor. The increase in tumor parameters is reflected in the symmetry of the face. In the third stage, deformations become noticeable.

The lymph nodes located in the neck area enlarge, which is detected by pulpation. For some time after the defeat of the lymph nodes, they remain mobile; in the active phase of the third stage, they are soldered with the surrounding tissues.

In a neglected form, metastases are thrown out of the tumors.

Preventive measures

To prevent the formation of a malignant tumor, it is recommended to regularly follow simple rules:

An analysis of the statistics of mucosal cancer shows that the treatment of the disease with the location of the lesion in the front of the oral cavity is more successful than in the presence of a tumor on the back.

A disease such as cancer has been known since the time of the Neanderthals. This is confirmed by archaeological excavations. The name of the disease was given by Hippocrates. The percentage of cases is growing every year. The risk group is primarily middle-aged and older people. Oral cancer is uncommon. This is only 5%. Next, we will consider the initial stage of oral cavity cancer. It is very important to recognize the disease at this stage.

What can provoke the development of the disease

If you do not treat diseases of the oral cavity in a timely manner, this can cause the development of cancer. The dentist can detect the problem. Consider the diseases that pose a real threat to our health:

1. Leukoplakia. It has two forms - verrucous and erosive. In the mouth, on the mucous membrane, whitish, flat lesions appear. An integrated approach to treatment is required:

Oral cavity sanitation.
Vitamins are prescribed.
Glucocorticosteroid ointments.

2. Bowen's disease. Spotted nodules appear on the mucous membrane. They tend to merge into hyperemic plaques with a smooth surface. They are removed surgically or using close-focus X-ray therapy.

3. Papillomatosis. This is a whitish papillary growth of connective tissue on the leg. May harden over time. They are treated with a surgical method.

4. Erythroplakia. Red spots can degenerate into cancerous ones. Having found them on examination at the dentist, it is necessary to urgently begin treatment.

5. Also, the threat comes from the erosive form of lichen planus and lupus erythematosus. Characterized by erosion and non-epithelialized manifestations, as well as compaction of the stratum corneum. The solution to the problem should be based on the treatment of the underlying disease. In this case, appoint:

All of these diseases are precancerous. Cancer of the oral mucosa is clearly shown in the photo above. As a rule, it can be found with regular examination. Most often, the diagnosis is confirmed by a visit to the dentist.

Who is at risk

As a rule, oral cancer occurs in men after 40 years. Also, the risk group includes persons who:

They smoke and chew tobacco.
They have incorrectly fitted dentures.
They often drink alcoholic beverages.

Patients with such diseases are also at risk:

Leukoplakia.
Papillomatosis.
Bowen's disease.
Erythroplakia.
Red lichen.
Lupus erythematosus.

And also the human papillomavirus can provoke the development of cancer.

A few more causes of cancer

The reasons that can serve the development of oral cancer in any person should be indicated:

Early stage symptoms

At the initial stage of development, oral cancer can skillfully disguise itself as various pathological processes on the mucous membrane. It can be:

Wounds on the mucous membrane.
Persistent ulcers.
Seals.
Chronic fungal diseases.

The following symptoms can be distinguished in oral cavity cancer:

Oral cancer may not always be confirmed when these symptoms are present, but they should not be ignored. It is necessary to see a specialist and, if necessary, begin treatment. Bleeding wounds and an increase in pathological changes are an unfavorable sign during the course of the disease. A neglected disease can develop into cancer.

Sick patients at the initial stage believed that the cause was in the throat or associated with the teeth, therefore, it is very important to consult a doctor.

Location of cancer

Consider where the tumor process can be located:

On a hard and soft palate.
On the inside of the cheeks.
On the sides of the tongue. Very rarely, the root or tip of the tongue, as well as the upper and lower surfaces, is affected.
On the muscles of the floor of the mouth, on the salivary glands.
On the alveolar processes of the upper and

Also divided into stages of cancer of the oral cavity and forms.

Forms of oncological pathology of the oral cavity

At the very beginning of development, cancer has three forms:

Ulcerative. It develops quickly, but it can also be slow. In each case individually. This is 50% of cases. Oral cavity cancer is clearly visible in the photo. The initial stage in the ulcerative form is successfully treated.
Nodal. Less common. These are white spots with seals around the perimeter. It develops more slowly than the ulcerative form.
Papillary. The development of this form is very fast. Dense growths over the mucous membrane.

Periods of cancer development

The process of cancer of the oral mucosa in its development goes through the following stages:

Elementary.
Process development.
Launched.

The absence of symptoms is one of the characteristic manifestations of the first stage of development of oral cancer. Wounds, cracks, nodular formations appear, which gradually increase.

No pain. The initial stage oral cancer is clearly depicted in the photo above. When pain occurs, patients associate this with diseases of the throat, teeth, but not with the formation of a tumor.

Stages of the tumor process

The evolution of cancer of the oral mucosa can be divided into 4 stages:

First stage. The tumor is not more than 1 centimeter in diameter. It is characteristic that the process does not go beyond the mucous and submucous layer. There are no metastases.
Second stage. The tumor does not exceed 2 centimeters in diameter. Germination into the underlying tissues to a depth of 1 centimeter is characteristic. There are no metastases. One regional metastasis is possible.
Third stage. The tumor does not exceed 3 centimeters in diameter. There are many regional metastases on the side. The absence of distant metastases is characteristic.
Stage four. The tumor is more than 3 centimeters in diameter. It is characterized by invasion into the hypoglossal region, cortical layer, bones, skin, lower alveolar nerve. Metastases are observed in all distant organs.

To diagnose and determine the stage of cancer of the oral mucosa is possible only after a complete diagnosis. More on this later.

Diagnosis of the disease

First of all, the doctor must find out the following questions:

How long ago there was discomfort in the oral cavity.
What is the nature of the pains, if any.
What anti-inflammatory or pain relievers the patient was taking.
What bad habits are there.
Did the family have similar diseases?

A physical examination of the oral cavity is carried out, regional palpation.Further, the doctor can send for an ultrasound examination. If there is a tumor, a fine-needle aspiration biopsy of the lymph node and tumor is performed. It is a biopsy that makes it possible to confirm or deny the diagnosis.

The diagnosis can be confirmed by conducting only a histological examination of the tumor. This is possible after surgery. The tumor and the removed organ are sent for research.

Also, diagnostic procedures include:

Such studies are necessary to determine metastases in distant organs.

Initial stage treatment methods

Oral cancer at the beginning of its development involves surgery. Used to treat the first stage.

The surgery depends on where the tumor is located. Sometimes you have to do radical operations and remove half of the tongue. On the soft palate, after its excision, restoration with the tissues of the tongue is possible. As a rule, reconstruction is required after surgery. It is also a huge risk for patients. A large number of deaths. The operations are very difficult and traumatic.

In the early stages, the technique of irradiation with gamma rays without surgery is used. It can be combined with complete or partial removal of the tumor. A popular method of treating the initial stage of oral cavity cancer is shown in the photo below.

X-ray radiation has a great influence on the tumor process.

The rest of the stages are treatable only by using the combined method.

Radiation therapy

This method is used before surgery. Also, radiation is used in the early stages of cancer development. It allows you to shrink the swelling up to 1 centimeter. The larger the malignancy, the more radiation dose is used. Before treatment with the radiation method, a complete sanitation of the oral cavity should be carried out. All teeth must be healthy, and metal crowns and fillings must be removed. Typically, radiation therapy is used if the tumor is small.

Gamma rays kill not only cancer cells, but also healthy ones. The following side effects are possible:

Redness of the skin.
Increased dryness of the skin, cracks.
Voice change.
Dry mouth.
Difficulty swallowing.

All side effects disappear after treatment.

It is also possible to use the brachytherapy method. A rod is immersed in the cancer, which provides radiation.

Radiation therapy can reduce the growth and reproduction of cancer cells, and also reduces the risk of recurrence.

Chemotherapy

Chemotherapy can be used in combination treatment both at the initial stage and in advanced cases. It is used both before and after surgery. Can be combined with radiation therapy. Preparations in each case are selected individually. Medicines are given through a drip. Which one depends on the stage, type and progressiveness of the tumor process.

Chemotherapy drugs can shrink the tumor, remove metastases, and reduce the risk of repeated relapses. The chemotherapy procedure is also shown at the initial stage of oral cancer. The photo shows the procedure.

In the early stages, chemotherapy can also be prescribed.

During chemotherapy, the following side effects may occur:

Nausea.
Vomit.
Prostration.
Fungal infections.
Diarrhea.
Pain.

When the first symptoms of the disease appear, you should consult a doctor. Your life depends on it. What is the prognosis for oral cancer? More on this later.

Disease prognosis

The effectiveness of treatment depends on many factors:

The size of the tumor.
The presence of metastases.
How long the process takes.

It is also important to know the degree of differentiation of the malignant process. She may be:

High.
Low.
Moderate.

The forecast is good when the processes are less aggressive. In this case, the tumor responds well to treatment and the risk of spreading metastases is reduced.

In the early stages, oral cancer is curable. The chances of a full recovery are very high. The third and fourth stages reduce the likelihood of complete recovery, especially if the process of metastasis has spread to all organs. However, science does not stand still, and oncologists have achieved a 60% survival rate even at the third and fourth stages.

The prognosis of treatment depends on how timely you consulted a doctor. In the early stages, it is favorable, but the third, fourth stages are treatable. It is necessary to strictly follow the doctor's recommendations.

Prevention of oral cancer

If you are at risk or have a hereditary predisposition, there are some simple guidelines you should follow to reduce your risk of oral cancer:

Give up bad habits. Smoking, chewing tobacco increases the risk by 4 times.
Practice good oral hygiene.
Treat your teeth and gums in a timely and efficient manner.
Make sure there are no traumatic fillings or dentures in your mouth.
Nutrition should be balanced. Vegetables and fruits, grains must be included in the diet.
Avoid very hot and cold foods, foods with preservatives, fried and spicy foods.
Limit your time in the sun. Use sunscreen.
If you are at risk, get regular check-ups with your doctor.
Treat fungal diseases, stomatitis and chronic diseases in a timely manner.

Take care of your health! Remember, seeing a doctor early can save your life.

The human oral cavity is lined with a mucous membrane formed by epithelial cells that are capable of transforming into malignant - this is how cancer of the oral mucosa develops. In the general structure of oncological diseases, this pathology ranges from 2% (in Europe and Russia) to 40-50% (in Asian countries and India). Mostly male patients over 60 years old suffer from it, it is extremely rare in children.

Causes

The exact cause leading to the appearance of neoplasms in the mouth has not been established. Researchers have only identified a number of factors that greatly increase the likelihood of developing this disease. The key among them are bad habits - smoking, chewing nasvay or betel nut, as well as alcohol abuse.

Additional factors are:

Chronic mechanical trauma to the oral cavity.
Use of substandard or poorly fitted dentures.
Poor filling treatment and dental injuries - Sharp edges of fillings and broken teeth cause permanent injury to the mucous membrane of the cheeks and tongue.
Injuries to the gums with dental instruments.
Poor hygiene.
The use of metal prostheses made of different metals in dental prosthetics - galvanic voltage can occur between different metals, which leads to damage to cells and their malignancy.

According to the latest research in virology and medicine, human papillomaviruses, which can be transmitted through kissing, play a role in the development of oral oncology.

An increased frequency of the development of this pathology was noted in persons working in difficult and harmful conditions: in constant contact with harmful substances, in conditions with high or excessively low temperatures and high humidity.

Exposure to spicy and hot food also contributes to the formation of tumors in the oral mucosa. The situation is aggravated by a deficiency of vitamin A in food and the presence of inflammation or precancerous diseases in the oral cavity.

Precancerous diseases that can degenerate into cancer of the oral mucosa

Leukoplakia... It looks like a whitish speck on the mucous membrane in any area of the oral cavity: on the palate, on the cheeks near the lips from the inside. It is characterized by areas of keratinization of the epithelium.
Erythroplakia. It is characterized by the appearance of red foci, abundantly permeated with blood vessels. Up to half of cases of erythroplakia are transformed into oncology.
Dysplasia- actually precancer. The study of dysplastic foci under a microscope shows that some of the cells have already acquired the features of malignancy. If this pathology is ignored, in 99% of cases, oral cancer develops after a few months.

Symptoms and stages of oral cancer

Photo: this is how the initial stage of oral cavity cancer looks

At the very initial stage, cancer of the oral mucosa may not bother anything, only a part of patients feel some kind of unusual discomfort in the mouth. On examination, you can see a fissure in the mucous membrane, a small tubercle or induration. About a third of cancer patients complain of unexpressed pain, which is disguised as symptoms of inflammatory diseases: glossitis, gingivitis.

The progress of the disease is usually accompanied by an increase in pain syndrome, even if the inflammation has already passed. The pain can radiate to the forehead, temple, jaw. Very often, patients associate these pains with toothaches.

Photo: this is how advanced oral cancer looks like

Late diagnosis allows the disease to go into an advanced stage, when the following symptoms of oral cancer develop:

An ulcer or growth appears on the mucous membrane.
The disintegration of the tumor is accompanied by an unpleasant putrid odor.
The pain becomes constant.

In advanced cases, deformity of the face is added to the symptoms of cancer of the oral mucosa due to the growth of pathological tissue into the surrounding structures: muscles and bones. Symptoms of intoxication are increasing: patients complain of general weakness, rapid fatigue, and nausea.

Lack of treatment at an advanced stage of cancer leads to the fact that the patient develops metastases. First, regional lymph nodes (cervical, submandibular) are affected. Then the parenchymal organs - the liver and lungs - can be affected. Metastatic bone lesions often occur.

Classification

By its microscopic structure, cancer of the oral mucosa belongs to the squamous cell type. There are several of its forms:

Keratinizing squamous cell carcinoma. Looks like an accumulation of keratinized epithelium ("cancer pearls"). It accounts for up to 95% of cases of development of pathology of this localization.
Non-keratinizing squamous. It is manifested by the proliferation of cancer cells of the epithelium without areas of keratinization.
Poorly differentiated (carcinoma). This is the most malignant and difficult to diagnose form.
Cancer of the oral mucosa in situ. The rarest form.

Depending on the characteristics of tumor growth, the following forms are distinguished:

An ulcer is one or more ulcers that gradually grow and tend to grow and merge. Usually, the bottom of the ulcers is covered with an unpleasant-looking bloom.
Nodular - characterized by the appearance on the mucous membrane of a dense growth in the form of a knot covered with whitish spots.
Papillary - manifests itself as fast-growing, dense growths that resemble warts. Outgrowths are usually accompanied by edema of the underlying tissues.

Certain forms of cancer of the oral mucosa

Possible localization of the neoplasm

Diagnostics

The diagnosis is made on the basis of the patient's complaints and after examination of the oral mucosa. A biopsy of the tumor helps to confirm the diagnosis. Technological diagnostic methods, such as ultrasound or tomography, are not very informative for these tumors. To identify damage to the bone tissues of the lower and upper jaws, the patient is prescribed an x-ray of the facial skeleton.

Doctors usually do an abdominal ultrasound and a chest x-ray to detect metastatic lesions. Perhaps the appointment of computed or magnetic resonance imaging.

More often, dentists are the first to notice neoplasms in the oral cavity due to the peculiarities of their profession. When the first signs of oncology in the mouth are detected, the patient must be sent for a consultation with an oncologist.

Treatment methods

When treating tumors of the oral mucosa, doctors use the entire arsenal of available tools:

Radiotherapy (radiation therapy).
Chemotherapy.
Surgical operations.

Depending on the stage of the cancer process, both mono methods and combined cancer treatment are used. At the 1st and 2nd stages of the disease, radiotherapy gives a good effect. The advantage of this method is that after it the appearance of cosmetic or functional defects is almost completely excluded. In addition, it is relatively easy for patients to perceive and has a minimum of side effects. However, at stages 3 and 4 of the disease, the effectiveness of this method of treatment is very low.

Surgical operations are in demand at stages 3 and 4 of oral cancer. The volume of the operation depends on the extent of the process. It is important to excise the tumor completely (within healthy tissue) to eliminate the risk of recurrence. In radical surgery, muscle excision or bone resection is often required, leading to severe cosmetic defects.

After operations to treat tumors of the oral cavity, in some cases, plastic surgery is required. If the patient has difficulty breathing, a tracheostomy (hole in the throat) may be placed.

Of all the methods of treatment, chemotherapy for oral cancer is the least effective, but it can reduce the volume of the neoplasm by more than 50%, which greatly facilitates the surgical operation. Since chemotherapy cannot cure this type of cancer, it is used only as one of the stages of complex treatment.

In cases where a patient with an advanced degree of oncology has very little left to live due to metastases or cancer intoxication, palliative therapy comes to the fore in treatment. This treatment is aimed at combating concomitant complications (bleeding, pain) and is to provide the hopeless patient with a normal quality of life. In palliative care, narcotic pain relievers are used.

The use of rather aggressive methods in the treatment (radiation and chemotherapy) affects the patient's health. During the course of treatment, the following side effects from medications may occur:

Stool disorder, profuse diarrhea.
Constant nausea with vomiting.
Baldness.
Development of immunodeficiency (patients should avoid ARVI during chemoradiation treatment).

During the treatment of oncopathology of the oral mucosa, patients need to eat well - the diet should be rich in proteins of both animal and plant origin. If oral nutrition is impossible (through the mouth), food can be administered through a pre-installed tube or intravenously (special mixtures for parenteral nutrition are used).

Prophylaxis

The main preventive value in the fight against cancer of the oral mucosa is the rejection of bad habits. You should definitely quit smoking, chewing betel nut, and use nasvay. It is recommended to give up alcohol.

Reducing trauma to the cheeks, tongue, gums also reduces the risk of tumors of the described localization. All teeth must be healed, and the filled fillings must be processed. If necessary, prosthetics should be very carefully selected prosthesis so that it is easy to use and does not cause discomfort.

Foods with irritating effects should be excluded from the diet, and very hot foods should not be consumed. When the first signs and symptoms of oral oncology appear, you should immediately contact a specialist.

To reduce the likelihood of oncology, people employed in hazardous industries should actively use personal protective equipment - overalls, respirators.

With regularity at least once a year, and if precancerous conditions are detected every quarter, you need to undergo preventive examinations with a dentist and oncologist.

Forecast

When treating cancer at an early stage, with an insignificant degree of damage to surrounding tissues, the prognosis is very favorable - after recovery, you can live without any special fears for your health. In 80% of people with a tumor of the tongue who have undergone isolated radiotherapy, no relapses are recorded within 5 years. Tumors of the floor of the mouth and cheeks are more unfavorable in this respect - for them, a five-year relapse-free period is noted in 60 and 70% of cases, respectively.

The larger the tumor, and the more surrounding tissues it affects, the more sad the prognosis. Some patients with stage 4 have several months to live, especially if distant metastases develop. With surgical treatment, the prognosis may depend on the fact whether there are any malignant cells left after the operation in the body, the re-proliferation of which will give a relapse.

Oral cancer is an oncological disease that involves the formation of a malignant tumor on the surface of the epithelium in the oral cavity. The course of the disease, its form, degree of spread and many other factors depend on the location of the neoplasm.

This type of cancer is relatively rare and occurs in 3% of all those diagnosed with this or that cancer. But this fact should not lead to the idea that this disease will not affect us.

Any abnormalities in the body should alert a person and become a reason for going to a doctor, since early diagnosis of oral cancer gives a 100% guarantee of recovery.

According to statistics, oral cancer is more common in men than in women. The number of men with this diagnosis exceeds women by an average of 5 times. Often, the disease occurs in the elderly and adults who abuse bad habits, but there are cases of detection of the disease in children.

Causes of the disease

Scientists still have not come to an unambiguous decision about what causes malignant tumors, but numerous statistical data, as well as studies, highlight several factors that provoke the appearance of cancer cells in the oral cavity:

Leading clinics in Israel

Precancerous conditions

Malignant growths in the mouth are preceded by the following conditions:

Classification of the disease and their symptoms

Consider oral cancer and manifestations of the disease at different stages:

The course of the disease also depends on the location of the neoplasm. Let's consider some of them:

The first signs of the disease do not depend on the location of the neoplasm. Any kind of swelling, red or white stripes, black dots or spots, ulcers, balls, sores, growths, hematomas formed after blows should alert a person.

If you do not pay attention to them, then painful sensations, a feeling of numbness in various parts of the oral cavity join, the sensitivity to hot or cold food decreases, and soreness occurs (pain and viscous sensation in the teeth when using certain types of products).

A harbinger of oral cancer can be the so-called erythroplakia - thinning of the epithelium of the oral cavity. When it forms, red spots form on the surface of the oral mucosa. Subsequently, they may bleed, plaques form in their place. This type of education at the onset of the disease does not bother a person in any way, but it tends to become malignant. If you completely start the disease, a headache, pain in the ears are added to the above symptoms, and causeless bleeding occurs.

Diagnostics

As soon as a person discovers the above initial symptoms, it is necessary to consult a specialist. The presence of the described symptoms does not always indicate a cancer. But you can only be sure of this during an internal examination with a doctor.

A doctor, most often an otolaryngologist, will examine the soft tissues of the oral cavity (pharynx, larynx, throat, nasal cavity) using special instruments, and feel the neck and lymph nodes. If roughness, loosening of the gums, the formation of ulcers, and seals inside the oral cavity are found, the specialist will prescribe an additional examination to find out the cause of these formations. If cancer is suspected, the doctor may take tissue samples (biopsies) to determine the type of growth, whether it is malignant or benign. Also, to assess the state of the patient's body, it is possible to take a general and biochemical blood test.

Computed tomography (CT) and magnetic resonance imaging (MRI) are used as diagnostic methods for suspected oncological lesions of soft tissues, airways and lymph nodes.

X-ray and ultrasound diagnostics are used to assess the spread of metastases in the body.

Don't waste time looking for an inaccurate cancer treatment price

* Only on condition that data on the patient's disease is received, a representative of the clinic will be able to calculate the exact price of treatment.

Treatment

Treatment for oral cancer depends on the type and stage of the tumor. The earlier the symptoms of the disease are detected, the more effective are the results of treatment measures.

Today, three types of therapy are used in medicine:

After the treatment measures have been taken, life projections depend on the stage at which treatment is started. The predictions for recovery are optimistic if the disease is detected at the initial stages and its timely treatment. The later the oral cancer is detected, the worse the prognosis for life. So, at 3-4 stages of the disease, according to statistics, 20-50% of patients survive. Relapses of the disease are possible, which is a weighty basis for regularly visiting specialists after therapy.

The role of disease prevention is invaluable. Proper nutrition, giving up bad habits, and avoiding long-term exposure to the sun greatly reduce the risk of oral cancer.

Causes

Additional factors are:

Chronic mechanical trauma to the oral cavity.
Use of substandard or poorly fitted dentures.
Poor filling treatment and dental injuries - Sharp edges of fillings and broken teeth cause permanent injury to the mucous membrane of the cheeks and tongue.
Injuries to the gums with dental instruments.
Poor hygiene.
The use of metal prostheses made of different metals in dental prosthetics - galvanic voltage can occur between different metals, which leads to damage to cells and their malignancy.

According to the latest research in virology and medicine, human papillomaviruses, which can be transmitted through kissing, play a role in the development of oral oncology.

Precancerous diseases that can degenerate into cancer of the oral mucosa

Leukoplakia... It looks like a whitish speck on the mucous membrane in any area of the oral cavity: on the palate, on the cheeks near the lips from the inside. It is characterized by areas of keratinization of the epithelium.
Erythroplakia. It is characterized by the appearance of red foci, abundantly permeated with blood vessels. Up to half of cases of erythroplakia are transformed into oncology.
Dysplasia- actually precancer. The study of dysplastic foci under a microscope shows that some of the cells have already acquired the features of malignancy. If this pathology is ignored, in 99% of cases, oral cancer develops after a few months.

Symptoms and stages of oral cancer

Photo: this is how the initial stage of oral cavity cancer looks

Photo: this is how advanced oral cancer looks like

Late diagnosis allows the disease to go into an advanced stage, when the following symptoms of oral cancer develop:

An ulcer or growth appears on the mucous membrane.
The disintegration of the tumor is accompanied by an unpleasant putrid odor.
The pain becomes constant.

Lack of treatment at an advanced stage of cancer leads to the fact that the patient develops metastases. First, regional lymph nodes (cervical, submandibular) are affected. Then the parenchymal organs - the liver and lungs - can be affected. Metastatic bone lesions often occur.

Classification

By its microscopic structure, cancer of the oral mucosa belongs to the squamous cell type. There are several of its forms:

Keratinizing squamous cell carcinoma. Looks like an accumulation of keratinized epithelium ("cancer pearls"). It accounts for up to 95% of cases of development of pathology of this localization.
Non-keratinizing squamous. It is manifested by the proliferation of cancer cells of the epithelium without areas of keratinization.
Poorly differentiated (carcinoma). This is the most malignant and difficult to diagnose form.
Cancer of the oral mucosa in situ. The rarest form.

Depending on the characteristics of tumor growth, the following forms are distinguished:

An ulcer is one or more ulcers that gradually grow and tend to grow and merge. Usually, the bottom of the ulcers is covered with an unpleasant-looking bloom.
Nodular - characterized by the appearance on the mucous membrane of a dense growth in the form of a knot covered with whitish spots.
Papillary - manifests itself as fast-growing, dense growths that resemble warts. Outgrowths are usually accompanied by edema of the underlying tissues.

Certain forms of cancer of the oral mucosa

Possible localization of the neoplasm

Diagnostics

Doctors usually do an abdominal ultrasound and a chest x-ray to detect metastatic lesions. Perhaps the appointment of computed or magnetic resonance imaging.

Treatment methods

When treating tumors of the oral mucosa, doctors use the entire arsenal of available tools:

Radiotherapy (radiation therapy).
Chemotherapy.
Surgical operations.

After operations to treat tumors of the oral cavity, in some cases, plastic surgery is required. If the patient has difficulty breathing, a tracheostomy (hole in the throat) may be placed.

Of all the methods of treatment, chemotherapy for oral cancer is the least effective, but it can reduce the volume of the neoplasm by more than 50%, which greatly facilitates the surgical operation. Since chemotherapy cannot cure this type of cancer, it is used only as one of the stages of complex treatment.

The use of rather aggressive methods in the treatment (radiation and chemotherapy) affects the patient's health. During the course of treatment, the following side effects from medications may occur:

Stool disorder, profuse diarrhea.
Constant nausea with vomiting.
Baldness.
Development of immunodeficiency (patients should avoid ARVI during chemoradiation treatment).

Prophylaxis

To reduce the likelihood of oncology, people employed in hazardous industries should actively use personal protective equipment - overalls, respirators.

With regularity at least once a year, and if precancerous conditions are detected every quarter, you need to undergo preventive examinations with a dentist and oncologist.

Forecast

Parfenov Ivan Anatolievich

The asymptomatic course of a malignant tumor of the oral mucosa at an early stage makes it impossible to start therapy in a timely manner.

Forms of cancer of the oral mucosa

Oncological diseases of the oral cavity are conventionally divided into three types, differing in etiology and external signs:

Oral mucosa cancer
Name	Description
Knotty	Seals with clear edges are observed on the tissues. The mucous membrane either has whitish spots, or remains unchanged. Neoplasms in the nodular form of cancer rapidly increase in size.
Ulcerative	The neoplasms look like ulcers, they do not heal for a long time, which causes severe discomfort to the patient. Pathology in the ulcerative form is rapidly progressing. In comparison with other species, it affects the mucous membrane much more often.
Papillary	The neoplasm has a dense structure. It is impossible not to notice, since the tumor literally sags into the oral cavity. The color and structure of the mucosa remain almost unchanged.

Localization

Depending on the zone and nature of the localization of neoplasms, the following types of tumors are distinguished.

Cheek cancer

The lesions are often found more often on the line of the mouth at about the level of the corners. At the initial stage of development, it resembles an ulcer.

Later, the patient feels some restrictions when closing and opening the jaw. Discomfort is also noted when chewing food and talking.

Floor of the mouth

Language

The tumor is localized on the lateral surfaces of the tongue. Perceptible discomfort is noted when talking and chewing food.

This variety occurs more often than the location of the foci on the upper and lower tissues of the tongue with the capture of the tip and root.

The lesions can form on the upper and lower parts of the mouth with damage to the teeth. This causes bleeding of the gums and pain with light pressure on the dentition.

The palate is composed of hard and soft tissues. Depending on which of them were affected, a type of cancer is diagnosed.

Metastases

Cancer is characterized by the ability to spread into adjacent layers. The direction of metastases is determined by the lymph nodes, it is to them that the tentacles crawl.

Each type of cancer has its own vector of movement:

with oncology of the cheeks and alveolar processes of the lower jaw, metastases advance to the submandibular nodes;
formations in the distal sections are directed to the nodes near the jugular vein;
in cancer of the tongue with a zone of damage to the tip or lateral sides, metastases start up in the lymph nodes of the neck, sometimes they capture the submandibular nodes;
with pathology, the tentacles crawl to the internal organs, and also affect the bone tissue.

Causes

The specific causes of the development of oral mucosa cancer are unknown.

But the opinion of scientists from different countries agrees that the following factors become the trigger:

Risk factors include:

bad habits (alcohol abuse, smoking, chewing and sniffing tobacco);
the presence of prosthetic structures in the oral cavity, which periodically injure the mucous membrane with sharp edges;
work at enterprises where there is an increased concentration of toxic substances, asbestos and other chemical compounds;
complications after complex injuries of the jaw system or operations to remove teeth.

Precancerous diseases

There are pathological processes that precede malignant formations. According to the medical classification, the following diseases are potential hazards.

Modern scientists consider the disease as intraepithelial oncology

The pathology was described as early as 1912 by Bowen and classified as a precancerous condition.

Modern scientists consider the disease as intraepithelial oncology, but in the International Histological Handbook it is identified as a risk factor.

Symptoms:

eruptions of a nodular-spotty nature;
location of the focus mainly in the posterior parts of the oral cavity;
the surface of the affected area of the mucous membrane is velvety;
over time, atrophy of the oral mucosa appears;
the formation of erosion on the surface of the focus.

When diagnosed, it differentiates with lichen erythematosus and leukoplakia. The disease proceeds with unpleasant symptoms.

One of the provoking reasons is the frequent exposure to irritants on the oral mucosa

The disease is characterized by increased keratinization of the mucous tissues, the foci are localized on the inner side of the cheeks, corners of the mouth, tongue.

One of the provoking reasons is the frequent exposure to irritants on the oral mucosa.

These can be both bad habits (tobacco, alcohol) and spicy or hot food.

An irregular shape of a denture can create favorable conditions for the development of leukoplakia.

Symptoms:

slight burning sensation;
tightening of the mucous membrane, which creates discomfort when talking and eating;
the formation of white or gray plaques (diameter 2-4 mm).

The scheme is selected individually, depending on the form of leukoplakia.

Papilloma

Both stressful situations and injuries can provoke the active growth of papillomas

To recognize the disease simply by the papillomas that are intensively forming on the oral mucosa.

Both stressful situations and injuries can provoke active growth.

Symptoms:

the formation of rounded papillomas on the leg with a warty, granular or folded surface (size 0.2-2 cm) on the oral mucosa;
localization mainly on the hard and soft palate, tongue;
pain, bleeding, deterioration in the physical condition of a person is not noted.

Treatment for papillomas includes surgery to cut off the formation from the mucous membrane, as well as antiviral and immunomodulatory therapy.

The course of the disease occurs in an acute form and with a benign clinical picture.

Erosive formations are localized on the oral mucosa and lips.

The course of diseases occurs in an acute form and with a benign clinical picture.

Symptoms:

the appearance of many red spots, which transform into erosion and ulcers;
feeling of dryness and roughness in the mouth;
in the area of the foci, the surface is covered with a fibrinous focus.

The treatment regimen includes the use of antifungal, anti-inflammatory, analgesic drugs.

Complication of radiation sickness leads to the development of post-radiation stomatitis

Formed after procedures with the use of ionizing radiation, carried out with violations.

The disease can be provoked by careless handling of radioactive isotopes, as a result of which burns form on the oral mucosa.

Complication of radiation sickness leads to the development of post-radiation stomatitis.

Symptoms:

dizziness, physical weakness;
dullness of the face;
dry mouth;
pallor of the mucous membrane;
the formation of white spots in the mouth;
loosening of teeth.

Anamnesis, clinical picture of the disease, and blood test are used to diagnose the problem.

The treatment regimen includes:

development of a special diet;
thorough sanitation of the oral cavity;
treatment of the mucous membrane with an antiseptic solution.

Symptoms

The reason for contacting a specialist may be the following signs:

Development phases

Neoplasms, even of benign origin, after some time are reborn into a malignant tumor, which, as it progresses, goes through three stages of development:

Initial form characterized by unusual phenomena for the patient in the form of painful sensations, ulcers, seals in the oral cavity.
Advanced form of the disease- ulcers take the form of cracks, pain appears, radiating from the oral cavity to different parts of the head. There are cases when the patient does not feel pain at this stage.
Launched form- the active phase of cancer, when the lesions spread quickly. Concomitant symptoms are also noted: pain in the mouth, difficulty swallowing food, a sharp decrease in body weight, a change in voice.

Stages

Cancer has several stages of development.

Each stage is characterized by certain tumor parameters and the extent of the affected area:

Diagnostics

If there is a suspicion of damage to bone tissue, the doctor prescribes a referral for X-ray

Oral cancer is diagnosed by visual examination and palpation.

When in contact with a neoplasm, the location, the density of the structure, and the degree of growth are taken into account.

If there is a suspicion of damage to bone tissue, the doctor prescribes a referral for X-ray.

Differential diagnosis helps to make a diagnosis, when a set of symptoms is compared with other or concomitant diseases.

The following studies help to clarify the picture: ultrasound, CT, MRI.

The final diagnosis is made after the biopsy is obtained. The study is carried out in a laboratory way on the removed part of the tumor.

Treatment

In medicine, several methods of treating oral mucosa cancer are practiced.

When choosing a method, the following factors are taken into account:

the patient's health status, the presence of chronic diseases;
the form of the neoplasm;
stage of development of oncology.

Surgery

After surgery, procedures are performed to restore the patient's health and appearance

This method is used to cut off neoplasms in order to prevent tumor growth and the spread of metastases to nearby tissues, bones and organs.

After surgery, procedures are performed to restore the patient's health and appearance.

Sometimes the patient needs psychological rehabilitation (mainly with organ amputation).

Radiation therapy

A popular way to fight cancer, it is widely used to treat cancer in the oral cavity. It is used both independently and after a surgical intervention.

If the tumor parameters are small, it is rational to use radiation therapy without additional manipulations.

With extensive neoplasms, complex treatment is more suitable. The procedures neutralize the remainder of cancer cells, relieve pain, and improve the ability to swallow.

In some cases, the patient is prescribed brachytherapy. This method involves the introduction of special rods directly into the tumor in order to irradiate it from the inside.

Chemotherapy

This method of treatment involves taking special drugs that have the ability to reduce the parameters of the tumor.

Medicines are selected individually, taking into account the stage of the disease and the form of the neoplasm. Chemotherapy is used in combination with surgery, radiation therapy and alone.

The peculiarity of the effect of chemicals is to destroy cancer cells and reduce the tumor by almost half. But it cannot ensure complete recovery with the independent application of the method.

Forecast

It is possible to completely overcome the disease only in the case of early diagnosis and the right choice of treatment method.

The prognosis is that it is possible to completely overcome the disease only in the case of early diagnosis and the correct choice of treatment method.

The result also depends on the type of cancer.

For example, the papillary variety is much easier to cure. The most difficult thing is with an ulcerative neoplasm.

The relapse-free period (up to 5 years) after a course of isolated therapy is 70-85%, with the development of neoplasms at the bottom of the oral cavity, the indicator is lower (46-66%).

When diagnosing stage 3 oral cancer, according to statistics, the absence of relapses is observed in 15-25%.

Disease history

In the early stages, the disease can proceed without the manifestation of obvious signs or has poor clinical symptoms. An external examination of the oral cavity reveals: cracks, ulcers, seals.

With the development of the disease, the manifestations become more pronounced, and the tumor increases in size. Pain sensations begin to give in the ear, head, neck.

In a neglected form, metastases are thrown out of the tumors.

Diagnosis of Malignant tumors of the mucous membrane and oral cavity organs
Treatment of Malignant tumors of the mucous membrane and oral cavity organs
Which doctors should you contact if you have Malignant tumors of the mucous membrane and oral cavity organs?

What are Malignant tumors of the mucous membrane and oral organs

Oral mucosa and the underlying tissues are of particular anatomical complexity, which determines the specificity of the clinical course and treatment of malignant neoplasms of a given localization.

As epidemiological studies show, the incidence of malignant tumors of the oral cavity is associated with certain patterns: the influence of environmental factors, everyday habits, and the nature of the diet. Thus, the number of cases of malignant tumors of the oral cavity in the European part of Russia per 1 0 0 thousand population is 1.3-2.7. In the countries of Central Asia, this number rises to 4.3. In general, in the Russian Federation, the incidence of malignant tumors of the oral cavity is 2-4% of the total number of human malignant tumors.

In Uzbekistan, it is equal to 8, 7%. In India, malignant tumors of the oral cavity account for 52% of the total number of malignant tumors from all locations. In SSA, such patients make up 8% of all cancer patients.

Among the neoplasms of the oral cavity, 65% are malignant tumors of the tongue. Among other localizations of malignant tumors of the oral cavity, 12.9% are on the mucous membranes of the cheeks, 10.9% - on the bottom of the oral cavity, 8, 9% - on the mucous membrane of the alveolar processes of the upper jaw and hard palate, 6.2% - on the soft palate , 5.9% - on the mucous membrane of the alveolar process of the lower jaw, 1.5% -. on the uvula of the soft palate, 1.3% - on the anterior palatine arches.

Malignant tumors of the oral cavity develop in men 5-7 times more often than in women. Most often people are sick at the age of 60-70 years. Usually, after 40 years, the number of cases increases and decreases significantly at the age of more than 80 years. However, malignant tumors of the oral cavity also occur in children. According to our clinic, tongue cancer is diagnosed in patients from 14 to 80 years old. A.I. Paces cites cases of the disease in children 4 years of age.

Analysis of the incidence of malignant neoplasms of the oral cavity showed its dependence on a number of so-called predisposing factors. In this series, mention should be made of harmful household habits (smoking, alcohol abuse, the use of "nasa", betel nut chewing). The combination of smoking and drinking alcohol is especially dangerous, for the reasons for which, see the section " Precancerous diseases", chronic mechanical trauma by a crown of a decayed tooth, a sharp edge of a filling or a poorly manufactured prosthesis. Some patients have a history of a single mechanical trauma (biting the tongue or cheek while eating or talking, damage to the mucous membrane with an instrument during treatment or tooth extraction). In some cases, harmful production factors (chemical production, hot workshops, work in dusty rooms, constant exposure to the open air, in a humid environment at low temperatures, excessive insolation) play a role in the development of malignant neoplasms of the oral cavity.

The nature of the diet is of some importance. An insufficient content of vitamin A in food or a violation of its digestibility leads to a violation of the processes of keratinization, on the basis of which a malignant tumor may arise. Systematic consumption of too hot food, spicy foods is harmful. The role of oral hygiene is great (timely and high-quality dental treatment, prosthetics of dentition defects). It is unacceptable to make fillings and prostheses from dissimilar metals, since this causes galvanic currents in the oral cavity, as a result of which one or another pathological condition of the oral mucosa develops. The neglected forms of periodontitis lead to displacement of the teeth, the formation of dental calculus, and the addition of infection.

This contributes to damage to the oral mucosa, preceding the development of a malignant tumor. An undoubted role in the occurrence of malignant neoplasms of the oral cavity is played by precancerous diseases.

They more often occur in men in the age range of 40-45 years. According to A.L. Mashkillyson, malignant tumors of the oral cavity are preceded by various diseases in 20-50% of cases. Most often they are found on the tongue (50-70%) and the mucous membrane of the cheeks (11-20%). Work on the systematization of a large group of diseases preceding malignant neoplasms of the oral cavity continues to this day.

Analysis of etiological factors preceding the onset of precancerous diseases, malignant neoplasms of the oral cavity makes it possible to determine a complex of sanitary and hygienic measures, including the elimination of harmful household habits, full protection from the effects of the external environment (excessive insolation, industrial hazards), rational nutrition, observance of oral hygiene, high-quality sanitation oral cavity. This must be taken into account by the practitioner in his daily work.

Pathogenesis (what happens?) During Malignant tumors of the mucous membrane and oral cavity organs

Among the malignant neoplasms of the oral cavity, the leading place is occupied by epithelial tumors (cancers). Sarcomas (connective tissue tumors) and melanomas are much less common. Possible malignant tumors from the epithelium of small salivary and mucous glands, localized in various parts of the oral mucosa (palate, cheeks, floor of the mouth).

Malignant tumors of the epithelial structure in most cases are represented by squamous cell carcinoma (90-95%).

International histological classification of malignant tumors of the oral cavity No. 4 identifies the following types of malignant epithelial neoplasms:

Intraepithelial carcinoma(carcinomanoma in situ). It is rare in clinical practice. It is characterized by the fact that the epithelium everywhere has features of malignancy and pronounced cellular polymorphism with a preserved basement membrane.
Squamous cell carcinoma- the underlying connective tissue grows. The tumor is represented by malignant epithelial cells, which can be located in the form of bundles, strands or nests of irregular shape. The cells are similar to stratified epithelium.

Varieties of squamous cell carcinoma:

keratinized squamous cell carcinoma (verrucous carcinoma) - characterized by large layers of keratinized epithelium with endophytic outgrowths ("cancer pearls"). Quite quickly destroys the surrounding tissue;
non-keratinizing squamous cell carcinoma is characterized by the proliferation of atypical layers of squamous epithelial cells without the formation of "cancer pearls"; the form is more malignant;
Low-grade cancer consists of spindle-shaped cells that resemble sarcoma.

This often leads to diagnostic errors. This type of cancer is significantly more malignant than the previous ones.

In recent years, the degree of malignancy of squamous cell carcinoma has been actively studied. This is a difficult and very important problem. The degree of malignancy allows planning treatment not only taking into account the prevalence and localization of the neoplasm, but also the characteristics of its microscopic structure. Determination of the degree of malignancy allows you to more accurately predict the course and outcome of the disease. In the international histological classification of tumors of the oral cavity and oropharynx No. 4, the main criteria for determining the degree of malignancy (malignancy) are:

proliferation;
differentiation of tumor tissue.

Established 3 degrees of malignancy:

1st degree: characterized by numerous epithelial pearls, significant cellular keratinization, absence of mitosis, minimal nuclear and cellular polymorphism. Atypical mitoses and multinucleated giant cells are rare. Intercellular bridges are preserved;
2nd degree: epithelial pearls are rare or absent, neither keratinization of individual cells nor intercellular bridges are found. There are 2-4 figures of mitosis with atypism, moderate polymorphism of cells and nuclei, rare multinucleated giant cells;
3rd degree: epithelial pearls are rare. Negligible cellular keratinization and the absence of intercellular bridges, more than 4 mitotic figures with a large number of atypical mitoses, distinct cellular and nuclear polymorphism, multinucleated giant cells are frequent.

Of course, the assessment of the degree of malignancy of squamous cell carcinoma, based only on various morphological criteria, is subjective. It is also necessary to take into account the localization, prevalence and features of the clinical course of the tumor process. For example, there is evidence of a different origin of cancer cells in the proximal and distal parts of the tongue. The former are of ectodermal origin, the latter are endodermal and, in addition, varying degrees of differentiation. These circumstances mainly explain the difference in the clinical course of tumors and their unequal radiosensitivity. Sarcomas arising in the oral cavity are quite diverse, but they are more rare than malignant tumors of epithelial origin.

Distinguish (International classification No. 4) fibrosarcoma, liposarcoma, leiomyosarcoma, rhabdomyosarcoma, chondrosarcoma, hemangioendothelioma (angiosarcoma), hemangiopericytoma.

Symptoms of Malignant tumors of the mucous membrane and organs of the oral cavity

The initial period of development of malignant neoplasms of the oral cavity is often asymptomatic, which is one of the reasons for the late treatment of patients for medical help. Initially, the tumor may appear as painless nodules, superficial ulcers or cracks that gradually increase in size. Soon, other signs of the disease join: gradually increasing pain, excessive salivation, putrid odor, which are caused by a violation of the integrity of the oral mucosa. For malignant tumors of the oral cavity, the addition of a secondary infection is characteristic, which always lubricates the typical clinical picture and greatly complicates not only clinical, but also morphological diagnostics, and can also serve as a reason for choosing the wrong treatment tactics.

There are numerous classifications of malignant tumors of the oral cavity, which are based on the anatomical manifestations of tumors of this localization. So, N.N. Petrov singled out papillary, ulcerative and nodular tumors.

Another group of classifications provides for two forms of malignant tumors of the oral cavity: warty and infiltrating, or ulcerative and nodular, or exo- and endophytic (Paches A.I. et al., 1988). Thus, at present there is no generally accepted classification of the anatomical forms of malignant tumors of the oral cavity. Clinical experience, however, demonstrates the extreme importance of this issue. It is known, for example, that endophytic forms of tumors are more malignant and have a worse prognosis than exophytic ones.

According to A.I. Paches, the clinical course of oral malignant tumors should be divided into 3 phases or periods:

Elementary.
Developed.
The period of neglect.

Initial period. Patients note discomfort in the area of the pathological focus. During examination, various changes can be found in the oral cavity: thickening of the mucous membrane, superficial ulcers, whitish spots, papillary formations. During this period, in almost 10% of cases, during the initial visit to the doctor, local lesions of the mucous membrane are not detected. The reason for this is often an inattentive examination carried out in violation of the examination scheme of a dental patient. Pains that force you to see a doctor are noted during this period in only 25% of patients. However, even when visiting a doctor in the initial period, in more than 50% of cases, pain is associated with angina, dental diseases, neuritis and neuralgia, but not a malignant tumor. Especially often, an incorrect interpretation of the pain symptom occurs with hard-to-reach distal localizations of oral tumors. The direction of the doctor's thoughts on the wrong path is often the reason for the neglect of the tumor process.

In the initial period of the course of malignant tumors of the oral cavity, it is advisable to distinguish 3 anatomical forms:

ulcerative;
knotty;
papillary.

Most common ulcerative form... In about half of the cases, the size of the ulcer increases slowly, in 50% - the growth is rapid. Conservative treatment is ineffective. The same can be said for the other two forms.

Knotty shape- manifested by the compaction of the mucous membrane, hardening of tissues in a limited area. The mucous membrane over the area of the seal may not be changed. The boundaries of the pathological focus can be clear. Its size increases faster than in the ulcerative form.

Papillary form-characterized by the presence of dense outgrowths above the mucous membrane, which remains unchanged. The outbreak tends to grow rapidly.

Thus, cancer of the oral cavity organs, always forming in the outer layers of the mucous membrane, in the initial period of its development can grow not only deep into the tissue, but also outward, as a result of which exo- and endophytic anatomical forms of tumors with productive and destructive changes appear.

Developed period... It is characterized by the appearance of numerous symptoms. Almost all patients have pains of varying intensity, although sometimes, even with large tumor sizes, they may be absent. The pains become excruciating, at first they are local, and as the tumor process develops, they acquire an irradiating character. More often pains radiate to one or another area of the head, ear, temporal region, jaw, throat. Salivation is enhanced as a result of irritation of the mucous membrane by tumor decay products. A symptom of the decay of a tumor and the addition of an inflammatory process is a characteristic putrid odor. During this period, A.I.

Pachez proposes to distinguish 2 clinical forms of the tumor:

exophytic (papillary and ulcerative);
endophytic (ulcerative-infiltrative and infiltrative).

Exophytic form:

the papillary form is presented in the form of a mushroom tumor with papillary outgrowths. The tumor is located superficially and is observed in 25% of patients.
the ulcerative form is more common than the previous one. It is characterized by the presence of an ulcer with a dense marginal ridge of active growth. As the ulcer grows, it takes on a crater-like shape.

Endophytic form:

The ulcerative-infiltrative variant occurs in 41% of patients. It is characterized by the presence of an ulcer located on a massive tumor infiltrate without clear boundaries. Ulcers are often slit-like and small in size.

Period of neglect... Malignant tumors of the oral cavity, spreading rapidly, destroy the surrounding tissues and are exclusively malignant. Thus, cancerous tumors of the tongue infiltrate the floor of the oral cavity, palatine arches, and the alveolar process of the lower jaw. Cancer of the mucous membrane of the alveolar processes of the jaws - the underlying bone tissue, cheek, floor of the mouth. In general, malignant neoplasms of the posterior oral cavity are more aggressive and malignant than the anterior ones. Their treatment is very difficult and the prognosis is unfavorable.

The division of oral cancer into anatomical forms aims to clarify the nature of tumor growth and determine the optimal type of treatment. Clinical experience suggests that endophytic forms of tumors characterized by diffuse growth have a more malignant course than exophytic forms with more limited growth.

Clinic of malignant tumors of various localizations

Cancer of the tongue often develops in the middle third of the lateral surface of the organ (62-70%) and at the root. Much less often the lower surface, the back (7%) and the tip of the tongue (3%) are affected. Cancer of the tongue root occurs in 20-40% of patients. Squamous cell carcinoma of the anterior parts of the tongue is more often I-II degrees of malignancy and comes from the small salivary glands. Patients often find malignant tumors of the tongue on their own and quite early (with the exception of hard-to-reach distal parts). This occurs as a result of the appearance of painful sensations, early arising functional disorders (chewing, swallowing, speech). With the help of a mirror, patients often examine the diseased part of the tongue themselves, while identifying pathological formations. Difficulty and limited mobility of the tongue indicate the presence of a tumor infiltrate and are of great diagnostic value. Particularly clear data is given by palpation. Sometimes the discrepancy between the size of a small ulcer and a large, deep infiltration around it is striking. The size of the tumor of the tongue increases in the direction from the tip to the root. It is necessary to take into account the possibility of tumor spread beyond the midline of the tongue. Pain in cancer of the tongue is initially localized, of low intensity. As the tumor grows, they become permanent, become more and more intense, radiate along the branches of the trigeminal nerve. In the terminal stages, patients have difficulty talking, often cannot eat or even drink. Respiration may be impaired in distal localizations due to obturation by a tumor of the oropharynx.

A characteristic feature of malignant tumors of the tongue is frequent and early metastasis to regional lymph nodes. The presence of a dense lymphatic network, a large number of lymphovenous anastomoses between the vessels of both halves of the tongue explains the frequency of contralateral and bilateral metastases. The direct confluence of the lymphatic vessels of the distal parts of the tongue into the deep lymph nodes of the upper third of the neck leads to early detection of metastases in this group of lymph nodes. Often, patients find a lump in the neck, and not in the area of the tongue, and turn to a general surgeon or therapist. If the doctor assesses these manifestations as lymphadenitis, then incorrect therapeutic tactics leads to neglect of the tumor process.

Oral floor cancer... Mostly men aged 50-70 are ill. Topographic and anatomical features are associated with proximity and, therefore, the possibility of spreading to the lower surface of the tongue, the alveolar process of the lower jaw, the opposite side of the floor of the oral cavity, which is a poor prognostic sign. In the terminal stage, the tumor invades the muscles of the floor of the oral cavity, the submandibular salivary glands, making it difficult to determine the starting point of growth. Often, the spread of the tumor occurs paravasally along the lingual artery system. Initially, patients notice a swelling felt by the tongue. With ulceration, pain appears, hypersalivation; when talking and eating, the pain intensifies. Repeated bleeding is possible. Sometimes, as with tongue cancer, the first sign is a metastatic lump in the neck. With localizations in the posterior parts of the floor of the oral cavity, the ulcer often looks like a gap. According to the histological type of tumor of this localization, most often squamous cell) cancers.

Cancer of the mucous membrane of the cheeks... In the initial stage, a malignant tumor can be difficult to distinguish from a banal ulcer. The occurrence of cancer of this localization against the background of leukoplakia is typical, hence the characteristic localization of cancerous lesions of the cheeks: the corners of the mouth, the line of closing of the teeth, the retromolar region.

Symptoms: pain when talking, eating, swallowing. Damage to the distal regions of the region leads to restriction of opening of the mouth due to the invasion of the chewing or internal pterygoid muscles. Cancer of the mucous membrane of the cheeks is more common in older men than malignant tumors of other localizations of the oral cavity.

Cancer of the mucous membrane of the palate... Malignant tumors from small salivary glands (cylindromas, adenocystic carcinomas) often develop on the hard palate. Squamous cell carcinoma of this localization is rare. Secondary prolapse often occurs.