Cancer of oral cavity- Easy explanation for Nurses- Introduction Definition of Cancer of oral cavity risk factors of Cancer of oral cavity Clinical manifestations of Cancer of oral cavity Diagnostic tests of Cancer of oral cavity management of Cancer of oral cavity nursing Management 1. preoperative 2. post operative

1. Cancer of
the Oral
Cavity
PRESENTED BY
SWATILEKHA DAS
M.SC NURSING (Medical-
Surgical )
ASST. PROFESSOR

2. Cancer of the Oral Cavity and
Pharynx
Cancer of the oral cavity and pharynx can occur in any part
of the mouth (lips, lateral tongue, floor of mouth most
common) or throat and is highly curable if discovered early.

3. Risk factors
 Cigarette, cigar, and pipe smoking
use of smokeless tobacco
 excessive use of alcohol
 Oral cancers are often associated with the combined use of alcohol
and tobacco.
 Other factors include gender (male), age (older than 50 years)
 African American descent
Malignancies of the oral cavity are usually squamous cell cancers.

4. Clinical Manifestations
• Few or no symptoms; most commonly a painless sore or
mass that will not heal.
• Typical lesion is a painful indurated ulcer with raised
edges.
• As the cancer progresses, patient may complain of
tender-ness; difficulty in chewing, swallowing, or
speaking; coughing of blood-tinged sputum; or enlarged
cervical lymph nodes.

5. Assessment and Diagnostic
Methods
Oral examination, assessment of cervical lymph nodes, and
biopsies of suspicious lesions (not healed within 2 weeks)

6. Medical Management
• Management varies with the nature of the lesion,
preference of the physician, and patient choice.
Resectional surgery radiation therapy, chemotherapy, or
a combination may be effective.
• Lip cancer: Small lesions are excised liberally; larger
lesions may be treated by radiation therapy.

7. • Tongue cancer:Treated aggressively, recurrence rate is
high. Radiation and surgery (total resection or
hemiglossectomy) are performed.
• Radical neck dissection for metastases of oral cancer to
lymphatic channel in the neck region with reconstructive
surgery.

8. Nursing Management
Preoperative
• Assess the patient’s nutritional status preoperatively; a dietary consultation may be
necessary.
• Implement enteral (through the GI tract) or parenteral (IV) feedings as needed to maintain
adequate nutrition.
• If a radial graft is to be performed, perform an Allen test on the donor arm must to ensure
that the ulnar artery is patent and can provide blood flow to the hand after removal of the
radial artery.
• Assess the patient’s ability to communicate in writing as ver-bal communication may be
impaired by radical surgery for oral cancer (provide a pen and paper after surgery to patients
who can use them to communicate).
• Obtain a communication board with commonly used words or pictures (give after surgery to
patients who cannot write so that they may point to needed items).
• Consult a speech therapist.

9. Postoperative
• Assess for a patent airway.
• Perform suctioning if the patient is unable to manage oral
secretions; if grafting was part of the surgery, suctioning must
be performed with care to prevent damage to the graft.
• Assess the graft for viability; assess color (white may indicate
arterial occlusion, and blue mottling may indicate venous
congestion), although it can be difficult to assess the graft by
looking into the mouth.
• A Doppler ultrasound device may be used to locate the radial
pulse at the graft site and to assess graft perfusion.