Cancer is a disease of the cells in the body. The body is made up from millions of tiny cells. There are several types of oral cancers, but around 90% are squamous cell carcinomas originating in the tissues that line the mouth and lips. Oral or mouth cancer most commonly involves the tongue.

1. Prepare by:
Arpana Bhusal
BNS

2. Cancer is a disease of the cells in the body. The body is made up from
millions of tiny cells. There are several types of oral cancers, but
around 90% are squamous cell carcinomas originating in the tissues
that line the mouth and lips.
Oral or mouth cancer most commonly involves the tongue.
It may also occur on the floor of the mouth, cheek lining, gingiva
(gums), lips, or palate (roof of the mouth). Most oral cancers look
very similar under the microscope and are called squamous cell
carcinoma.
INTRODUCTION

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4. “Cancer is defined as the uncontrollable
growth of cells that invade and cause
damage to surrounding tissue of oral
cavity.
Oral cancer appears as a growth or sore in
the mouth that does not go away. Oral
cancer, which includes cancers of the lips,
tongue, cheeks, floor of the mouth, hard
and soft palate, sinuses, and pharynx if not
diagnosed and treated early.”
DEFINITION

5. “Oral Cancer is a group of cancers in
the mouth include tongue, oral mucosa,
and gum. Oral cancer can develop in any
part of the oral cavity or oropharynx.
Most oral cancers begin in the tongue
and in the floor of the mouth. Almost all
oral cancers begin in the flat cells
(Squamous cells) that cover the surfaces
of the mouth, tongue, and lips. These
cancers are Called squamous cell
carcinomas.”

6. Tobacco and alcohol use. Most cases of oral cancer are linked to cigarette
smoking, heavy alcohol use, or the use of both tobacco and alcohol together.
Usingtobaccoplusalcoholposesamuchgreaterrisk thanusingeithersubstancealone.
HPV. Infection with the sexually transmitted human papillomavirus
(specifically the HPV 16 type) has been linked to
a subset of oral cancers.
Age. Risk increases with age. Oral cancer most often occurs in people
over the age of 40.
RISKFACTORSAND ETIOLOGICALFACTORSOF
ORAL CANCER

7. Sun exposure. Cancer of the lip can be caused bysun
exposure.
 Diet. A diet low in fruits and vegetables may play a role in oral cancer
development. Some studies suggest that not eating enough fruits and
vegetables and increase intake Junk food, soft drink may increase the
chance of oral cancer,
Alcohol: People who drink alcohol are more likely to develop oral cancer
than people who don't drink.
 A personal history of head and neck cancer: People who have head
and neck cancer are at increased risk of developing another primary
head and neck cancer. Smoking increases this risk
ORAL SEX
SPECIALLY IN LESBIAN AND GAY

8. Stage 1-
The cancer measures <2 cm (about 1 inch) and has not spread to area of
lymph nodes
Stage 2-
The cancer measures >2 cm but <4 cm (<2 inches) and has not spread to
area of lymph
nodes
Stage 3-
Any of the following may be true ; The cancer measures >4cm; the
cancer any size, but has spread to only one lymph node on same side of
neck as the cancer; the lymph node containing cancer measures <=3 cm
STAGES OF ORALCANCER

9. Stage 4-
Any of the following may be true: The cancer has spread
to tissue around the lip and oral cavity; area lymph nodes
may or may not contain cancer; the cancer is any size and
has spread to >1 lymph nodes on same side of neck as the
cancer, to lymph nodes on one or both side of neck, or to any
lymph node measuring >6cm; cancer has spread to other
parts of the body

10. Common symptoms of oral cancer include:
• Patches inside mouth or on lips that are white, a
mixture of red and white, or red
 White patches (leukoplakia) are the most
common. White patches sometimes become
malignant.
 Mixed red and white patches
(erythroleukoplakia) are more likely than white
patches to become malignant.
 Red patches (erythroplakia) are brightly
colored, smooth areas that often become
malignant.
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11.  A sore on lip or in mouth that won't heal
 Bleeding in mouth
 Loose teeth
 Difficulty or pain in chewing, swallowing, speaking
 Difficulty wearing dentures
 A lump in neck and enlarged cervical lymph nodes
 Numbness in the tongue or other areas of the mouth
 Swelling of the jaw that causes dentures to fit poorly or become
uncomfortable
 Pain in one ear without hearing loss
 Hoarseness, chronic sore throat, or change in voice
OTHER SIGN AND SYMPTOMS

12. HISTORY OF THE PATIENT
PHYSICAL EXAMINATION OFTHE
MOUTH
EXTRAORAL
EXAMINA
TION
INTRAORAL
EXAMINA
TION
CONT……….
DIAGNOSIS OF ORALCANCER

13. BLOOD TESTS
LABORATORY VALUES MA
Y BE
AN ELEVATED
NOT
ABLE FOR
ALKALINE PHOSPHA
T
ASE, AND
POSSIBLY AN ELEVATION OF THE
WBC COUNT.
BIOPSY
DENTAL X RAY
CT SCAN
MRI

14. After knowing about the stages of the disease, than doctors decided to give treatment of the patient….
MEDICAL MANAGEMENT:
RADIATION THERAPY: Radiation therapy (also called radiotherapy) affects cells only the treated area. It may be used
before surgery to kill cancer cells and shrink the tumor. It is used for small cell carcinoma. It also may be used after
surgery to destroy cancer calls that may remain in the area. Radiation therapy uses high-energy rays to kill cancer cells.
Doctors use two types of radiation therapy to treat oral cancer:
EXTERNAL RADIATION: The radiation comes from a machine. Patients go to the hospital or clinic once or
twice a day, generally 5 days a week for several weeks.
INTERNAL RADIATION (IMPLANT RADIATION): Radioactive implant is inserted directly in tissue with
the use of needles and thin plastic tubes for several days. Patient has to stay in the hospital.
CHEMOTHERAPY: Medical oncologist administers chemotherapy if cancer has spread to lymph nodes or other
organs. The medicine circulates in the blood and disrupts the growth of the cancer cells. Chemotherapy medications are
taken by mouth or given through a vein for several months.
Chemotherapy is not curative for this type of tumor, but when combined with surgery it is helpful in controlling the
tumor. Chemotherapy is the prescribed for:
TREATMENT FOR ORALCANCER

15. After surgery to decrease the risk of the cancer returning
To slow the growth of a tumor and control symptoms when the cancer cannot becuredSURGICAL
MANAGEMENT:
Surgery to remove the tumor in the mouth or throat is a common treatment for oral cancer. Sometimes
the surgeon also removes lymph nodes in the neck. Other tissues in the mouth and neck may beremove
as well. Patients may have surgery alone or in combination with radiation therapy.
•
•
•
•Maxillectomy (removal of the part of the maxilla) Mandibulectomy
(removal of the mandible or lower jaw or part of it)
Glossectomy (tongue removal, can be total, hemi or partial)
• Radical neck dissection
Combinational e.g., glossectomy and laryngectomy done together.

16.  Dry mouth
 Cavities
 Oral communication with the sinuses
 Difficulties speaking, drinking and eating
 Malocclusion(misalignment or incorrect relation
between the teeth of the two dental arches)
 Facial deformities Isolation from society
COMPLICATIONS OF ORALCANCER

17.  Pre-treatment dental
examination to prevent or
reduce oral complications
 Osteoradionecrosis
 Bone which can not heal
 Hyperbaric oxygen treatment
REDUCING COMPLICATIONS

18. • Prostheses fabricated by a
maxillofacial prosthodontist to
restore form and function
Obturators
Facial prostheses
Palatal augmentations
Resection prostheses
Implants
RESTORING FUNCTION

19. Dental implants
RESTORING FUNCTION

20. FACIALPROSTHESES
RESTORING FUNCTION

21. 1.
2.
Inflammed/altered oral mucus membrane related to a pathologic condition or infection
Disturb body image- related to a physical change in appearance resulting from a disease condition
or its treatment
3.
4.
Fear of pain and social isolation related to disease or change in physical appearance
Imbalance nutrition less then body requirement related to inability to ingest adequate nutrition
secondary to oral or dental conditions
5.
6.
7.
Deficit knowledge about disease process and treatment plan Risk for
infection related to disease condition or treatment Impaired verbal
communication related to treatment
NURSING DIAGNOSIS AND IT’S
INTERVENTION

22. • Tellpatient to avoid cold drinks, banana, cold milk, curd
preparations, ice cream, refrigerated food items and also tell about
take salt restricted diet because hypertension
• Protein is essential for a healthy immune system, without which
the body takes longer to recover from illness and lowers resistance
to infection
• Carbohydrates and fats assist the body by supplying the calories
required for a healthy living.
DIET PLAN

23. DRYMOUTH
SORE OR
BLEEDING
GUMS
TOOTH
DECAY
INFECTION
SORE
THROATIN
MOUTH
DELA
YED
HEALING
AFTER
DENTAL
CARE
HEALTH TEACHING