1. MEDICAL-SURGICAL
CASE PRESENTATION

2. PRESENTED BY – Mr SIMON RAJU

3. Patient’s history

4. Definition
• Oral cancer: a disease that is found in the
tissues of the lip or mouth; cancer of lip
and oral cavity
• Associated with a group of cancers
referred to as head and neck cancers
• Begin in the tongue and in the floor of the
mouth, but they can spread to parts of the
neck, lungs, and other body parts

5. Anatomy & Physiology

6. Contd ..
• Blood supply – facial artery
• Nerve supply – facial nerve , hypoglossial
nerve & glossopharyngeal nerve

7. Incidence
• 30% of all head and neck cancers.
• Predominant in males
• Use of tobacco, alcohol, betel nuts
• Poorly fitting dentures, nutrition & dental care,
• HSV, HPV 6 & 16

9. Contd …
• 29 Mar 2012
New research analyses cancer death
rates across India, and shows that oral,
stomach, and lung cancers are important
causes of death in Indian men, while
cervical, stomach, and breast cancers
cause the most cancer deaths among
Indian women.
The article, published in the The Lancet, is by Professor Prabhat
Jha, Centre for Global Health Research, St. Michael’s Hospital and
University of Toronto, ON, Canada,

10. Contd ..
• Popular Articles About Oral Cancer
• LUCKNOW
• Oral cancer chewing up Indians
• March 19, 2005 | TNN
• LUCKNOW: Oral cancer dominated the discussions on the
concluding day of the international symposium on Diet in Causation
and Prevention of Cancer, here on Saturday. Prof. MC Pant of King
George Medical University, Lucknow discussed the Indian
perspectives on oral cancer ? one of the 10 leading forms of cancer
in the world today. "About 56,000 new cancer cases are detected
every year and about 1,87,000 patients exist at any point of time,"
said Pant.

11. Contd ..
• Oral cancer cases on the rise in India,
reveals study
• May 31, 2011
• CHENNAI: The number of oral cancer cases is on the
rise in India. But what is mainly driving the numbers up is
more people getting addicted to chewing tobacco than
smoking it, says a study. India accounts for 86% of the
world's oral cancer cases, says the study conducted by
the National Institute of Public Health in February 2011.
Ninety percent of these cases are due to chewing
tobacco, unlike in the West where smoking is the main
reason. ...

12. Contd ..
• Chewing tobacco exposing youths to
oral cancer
• February 15, 2012 | TNN
• VARANASI: Addiction to non-smoking forms of tobacco,
especially khaini (chewing tobacco) and pan masala, is pushing the
youngsters towards oral cancer. Professor T P Chaturvedi, dean,
Faculty of Dental Sciences, Banaras Hindu University (BHU), said
that more and more teenagers are turning up at the out patient
department and most of them are witnessing sub-mucosal fibrosis, a
condition that is associated with difficulty in opening the mouth. "

13. Contd ..
• 17-year-old gutka user is in the last
stage of oral cancer
• August 11, 2011 | Pratibha Masand , TNN
• MUMBAI: Roshan Wankhede is all of 17 years. He is from a
small village in the Amravati district. The family lives on farming;
money is difficult to come by. Roshan's parents are waiting for him
to finish his education and start earning so that their monetary
problems can be solved. Roshan would have passed his HSC
exams next year, but he will not be able to. Doctors say that Roshan
is suffering from last-stage mouth cancer and may not live another
year. Roshan was 13 years old when he first started consuming
tobacco because of peer pressure.

14. Incidence
• Accounts for 2% of all cancers
• 40 years of age and older are at a higher
risk
• Over 35,000 people will be diagnosed
• Over 7,600 will die from the disease
• Mortality Rate Is Higher Than Other
Cancers

15. DID YOU KNOW????
Going back a ways, the most famous
psychiatrist of all time, Sigmund Freud,
died or oral cancer. Freud, who was often
photographed with a cigar, died of oral
cancer. Despite dozens of operations,
cancer killed him.

16. “
“Ultimately, everyone
makes their own choices
in life,” says oral cancer
survivor Rick Bender, 49.
“I made mine. I have to
deal with that. But if I can
give these kids the
information, hopefully
they can make the right
choice.”
Oral cancer survivor Rick Bender shows Pasco students the consequences of chewing tobacc
By Alex Orlando, Times Staff Writer
In Print: Saturday, March 31, 2012

17. Etiology
Book picture
• Smoking
• Tobacco
• Alcoholism
• Sun exposure
• Chronic irritation
• Viral infection
• Poor oral hygiene
Patient picture
• Chronic tobacco chewing
• Smoking bidi

18. Pathophysiology

19. Sign and Symptoms
 Sores that do not heal
within 14 days
 Bleeding in mouth
• Lump in neck
• Earache
• Loose teeth
• Dentures will not fit well
 Pain or numbness in
mouth
 Difficulty chewing or
swallowing
 Bad breath
• Patches on the lip or in
the mouth that are red,
white, or a mixture of both

20. BUCCAL MUCOSA
Pain
Bleeding
Trismus
Cervical lymphadenopathy
Infection
Mastication become difficult
HARD PALATE
As the mass grows it can bleed
Foul odour
Loose teeth
Changes in speech
Difficulty in swallowing
Trismus
A lump in the neck
GINGIVA
ill-fitting dentures
Ulceration around teeth that fails to
heal
Bleeding during mastication
Trismus
Otalgia due to secondary infection
Pain can result from bone invasion
ORAL TONGUE
Present as small ulcers and gradually
invade the musculature of the tongue.
Advanced lesions may be either
ulcerative or exophytic
Pain
present with an exophytic growth
pattern
induce trismus