The management of oral cavity malignancies is extremely complex and involves interaction between many disciplines to deliver effective and sustainable treatment. It is critical that our patients are appropriately counseled and informed regarding the latest research of their condition. Our aim is to give you the latest evidence to use in your practice.
Signs of mouth neoplasms may include a black (melanotic) appearance on the tongue, swollen and tender lymph nodes, or an enlarged neck mass. Malignant lesions may have a foul-smelling, bad breath, or painful and dry lips.\n
Oral neoplasms are a very common condition with almost one third of all new patients in tertiary general/dermatology/plastic surgery centres presenting with them. Most oral tumors are benign and, by and large, can be managed effectively by careful use of modern local excision techniques. However, recurrences are likely and repeated treatment required. However, in the early stages, the clinical picture is frequently that of a malignant lesion. Further work is required to define the best management protocol for benign and malignant lesions. In addition, a greater understanding of the genetic and environmental factors that lead to malignant transformation of oral mucosa is required.
Many treatment options are employed in the management of a vast range of oral cavity cancers. These options may range from simple supportive care to radical surgery and complex adjuvant approaches. Despite the potential for complex multimodal treatment, most of the procedures used in managing these diseases are simple and straightforward.
The current literature reviewed identifies no studies that have addressed the oral cavity as a site for tumors. Despite its location and proximity to the mouth, oral cancer does not appear to be a common neoplasm on the oral.
1,600 new cases of oral cancer were diagnosed in the United States in 2006. The average age was 58.2 years. The male to female ratio was approximately 1.5:1. Approximately 85% of the tumors were squamous cell carcinomas and approximately 11% of the tumors were adenocarcinomas. A majority (62%) of the tumors were in the gingiva.
Data from a recent study suggest that treatment with oral agents can modify some aspects of tumor biology and consequently, can result in significant tumor shrinkage. Further studies regarding the biologic interactions between tumor and oral environment and their correlation with tumor-specific treatments should be conducted.
There are many different types of mouth neoplasms, they may vary in their type and location, and require surgery, radiation therapy, and chemotherapy. Patients that may benefit from these treatments may not have their treatment or disease progression monitored. It is important for patients to start their treatment with the right physician.
Cisplatin is an exciting regimen for patients with oral squamous carcinoma because of its excellent degree of antitumor activity and reasonably few toxicities, as well as its low frequency of use and low cost of treatment relative to other chemoradiotherapy regimens.
Many subjects were treated with topical drugs while not taking pills or injectons. The only medications (with the possible exception of some antifungals and antitoxins) taken by more than half of the patients were [pain killers (pain-relieving drugs)] and topical medications. There was no single class of medicines (anti-inflammatory, anti-bacteria, anti-fungal, etc.) that was more frequently used than others.
At the present time, only two clinical trials have been published and no large trial has been completed. Nevertheless, these trials have shown that there is a positive overall survival and DFS when comparing treatment with a placebo, and that when the cancer has received a new type of treatment, an improvement in survival is also obtained. However, we only need to administer treatment to patients whose cancer has not received new treatment; we can thus infer that other treatments would be required in these situations.
In order to make definitive decisions on the need of a full-scale dental examination for high-risk people, epidemiological, behavioral factors, and clinical history should be considered together, as there is almost a 100% chance of acquiring some form of oral neoplasms.