differentiation of oral cancer lesion

1. ORAL CANCER
NAJWA I. AZEEZ
HMU . College of Dentistry

2. TOPICS:
• Oral cancer definition
• Risk factors
• Warinng signs and symptoms
• Risk area
• Precancereous lesions &conditions
• Diagnosis & clinical features
• Management
• prevention & complications
• Points to remember

3. ORAL CANCER
• Cancer : malignant neoplasm
• Is an abnormal tissue that growths by cellular proliferation more rapidly than
normal tissue and continuous to grow after stimuli that initiated the new growth
cease.
• Oral cancer : malignant neoplasm of oral tissues

4. RISK FACTORS
• Tobacco
• Alcohol use
• Sunlight exposure (UVL…)
• Age ,…Gender ,…Race
• Nutrition ( low fruit & veg…)
• Immunodeficiency /suppression
• Habits ,…Chronic irritation
• occupations
• Fungal & viral infections

5. WARNING SIGN & SYMPTOM
1. White /red patches anywhere in mouth (leukoplakia
/erythroplakia)
2. lump or thickening of oral soft tissues
3. Pain & burning sensation
4. A lump in the neck.
5. Soreness or lump of throat
6. Unusual bleeding or numbness in the mouth or
tongue
7. Pain and difficulty when chewing or
swallowing.
8. Difficulty moving jaw or tongue
9. Swelling of jaw and mobility of teeth
10. Dentures not fitting properly.
11. A change in voice, or speech problems.
12. Weight loss.
13. Bad breath

6. RISK AREA
• Lateral border of the tongue
• Floor of the mouth
• Angle of the mouth
• Alveolus
• Lower buccal sulcus

7. PRECANCEROUS LESIONS & CONDITIONS

8. LUEKOPLAKIA & ERYTHROPLAKIA

9. DIAGNOSIS
1. History :
• General health history :chest pain, limited exercise tolerance, shortness of breath ,
anemia
• History of lesion: (mass or ulcer):onset of occurrence ,duration ,pain …
2. clinical examinations:
Extra oral : 1-inspection of head ,face, & neck for any asymmetry or changes in the color
of skin
II-examination of regional lymph nodes bilaterally
Intra oral :appropriate soft tissue examination , inspection and palpation of tumor for
checking borders, shape , size , tenderness

10. 3. Radiological examinations: OPG , CT scan , MRI for evaluation of primary
site & regional lymph nodes
4. Laboratory investigations : blood( Hb , blood sugar , blood urea) , enzymes
(liver function test) , electrolytes
5. Biopsy

11. CLINICAL FEATURES OF ORAL CANCER LESION
 Classically present either as non- healing ulcer , with very degree of pain & occasional episode
of bleeding of lesion usually have an irregular edge and indurations' of underlying soft tissues
 Exophytic growth of duration may be several weeks to few months , before patient seeks
treatment exophytic growth may present as a cauliflower like irregular or may be flat
 More advanced lesions can present with pain , bleeding or fixity of surrounding structures
 Involved infratemporal fossa present with recent onset of trismus ….& must distinguished from
long standing trismus ..which is sign of oral mucosal fibrosis
 Occationally lesions of alveolus in or around non- healing extraction sockets can manifest with
unexplaned loosing of the involved teeth

12. MALIGNANT CONDITION

13. MANAGEMENT
Surgery
Radiotherapy
Chemotherapy ……and
Combination
• The management depends:
• site and severity
• Patient preference
• General health
• Biological health

14. PREVENTION :
• Primery :
• Advice on stop smoking , tobacco chewing & alcohol intake
• Dietary advice
• Secondery
• Screen entire oral mucosa
• Recognize abnormalities
• Identify candida infection
• Refer any suspicious lesion to hospital

15. • Tertiary : importance of routine intraoral & extra examination
• Regular review
• Low threshold for referral
• chemoprevention

16. COMPLICATION :
• Stem either the cancer itself or from treating the cancer , if cancer spread to other
tissue often to neck or throat my prove fatal…..
• How ever the surgery , radiation and chemotherapy used to treat the oral cancer
can it self cause complication including difficulty swallowing and dry mouth , , an
inablity to produce enough saliva for good oral health …surgery may disfigure
the face, head and neck

17. POINTS TO BE REMMEMBER
1. Most of the cancer are located of lateral border of tongue ,floor of the mouth and lip so a special
attention should be focused in this area
2. Tell your patient what you are doing with every procedure and why
3. Always note any changes in color and texture of all soft tissue or any swelling ,if detecting any
abnormality ,determine a history of the lesion , if the abnormality has been of more than 2
weeks duration ,take appropriate action to doing biopsy
4. Follow up to ensure definitive diagnosis of an abnormality
5. Remove all removable prosthesis before staring the examination
6. Tech your patient the sign and symptom of oral cancer
7. If the patient uses tobacco products provide appropriate counseling or refer patient for
counseling

18. THANK YOU
‫دروستکر‬ ‫ماددەی‬ ‫ترین‬ ‫پرنهێنی‬ ‫مرۆڤ‬ ‫مێشکی‬ ‫کە‬ ‫بیرتکردوەتەوە‬ ‫قەت‬‫اوی‬
‫بێت‬ ‫گەردون‬.............‫؟؟؟‬!