Cancer of the lips, mouth and throat( throat) - Causes, symptoms and treatment. MF.

Malignant tumors of the lip, mouth and pharynx have a single origin, a similar structure and the same causes of development.

Causes of cancer of the lips, mouth and pharynx

The main place among the causes of tumors of the lips, mouth and throat are chronic inflammatory diseases: cheilitis( inflammation of the lips), stomatitis( inflammation of the mucous membrane of the mouth and gums), pharyngitis( inflammation of the pharynx).In turn, the cause of the above diseases is the constant traumatization of the mucosa by irritants: the use of excessively hot and spicy food, strong coffee, strong alcoholic beverages, smoking tobacco( especially tubes), chewing tobacco, betel and nasal, intense exposure to sunlight( insolation), sudden changes in temperature and humidity, viral infections, non-compliance with oral hygiene and others. The direct role of smoking in the development of cancer of the oral and pharyngeal organs has been proved.

Among the tumors of the oral cavity and pharynx, squamous cell carcinoma is most common.

Lip cancer

Lip cancer is a malignant tumor from the elements of the integumentary epithelium of the red border of the lips. Men are more often ill, accounting for more than 70% of the cases. Cancer is more often affected by the lower lip.

Pre-cancerous processes are most often: chronic lip cracks and inflammation, papillomas and other diseases of the lips. Tumors of the lips are related to neoplasms by external localization, therefore 85% of tumors are detected in the 1-2 stages of the disease.

On the photo of lip cancer

Symptoms of lip cancer

Externally, the lip cancer looks like a small formation, or the compaction site protruding above the lip surface, in the center it forms ulceration. There is a formation on the red border of the lower lip away from the midline. The tumor is characterized by a dense consistency and gradually increases in size, acquires an irregular shape. Often the tumor grows in the form of a papilloma or a crack, covered with scales, and bleeds. The tumor can initially appear in the form of an ulcer deep in the tissue of the lip, with infiltration( transfer) to nearby tissues, rapid metastasis.

Oral Tumors

Oral tumors can develop from the following organs: tongue, mucous membrane of the bottom of the mouth and palate, mucosa of the upper and lower jaw( and gums), mucous cheeks.

Tumors of the oropharynx develop from: tonsils, root of the tongue, soft palate, posterior pharyngeal wall. More often, the tongue, the mucous bottom of the mouth and tonsils are affected by the tumor.

The structure of the tumor can be: squamous cell carcinoma, a variety of soft-tissue malignant tumors( sarcomas), a high degree of malignancy, sometimes there are melanomas and other, more rare tumors, such as angiosarcomas( vascular tumors).

According to the growth form, the cancer can be exophytic( grows into the oral cavity or on the surface of the lip) and is infiltrative( there is no clearly visible component of the tumor, the cancer "spreads" along the surface of the organ, changing its color and structure, such tumors are most aggressive), can be mixedand infiltrative-ulcer crawfish. The symptoms of oral cancer include the following:

- nonspecific symptoms: weakness, body temperature rises to 37-38 degrees C, sweating, weight loss and appetite, fatigue.
- presence in the oral cavity or on the lip of a painless or uncomfortable seal or ulceration that does not occur against the background of treatment and gradually increases in size. As the tumor grows, pains are attached, which are usually given to the corresponding ear shell, temple or jaw area.

Further symptoms depend on the nature of the affected organ:

- when swelling of the oropharynx is often disturbed by "foreign body sensation," swallowing, choking, when involved in the process of epiglottis or closure of the entrance to the larynx, there is a pronounced difficulty in breathing, sometimes requiring urgent tracheostomy( forming a hole in the trachea to facilitate breathing of the patient);
- with swelling of the tongue there is edema and disturbance of its mobility and proneness of sounds, speech, difficult painful swallowing;
- in tumors of the upper palate, there is a disturbance of nasal breathing and a change in the timbre of the voice( nasal congestion), in this case, pain can be intensified up to the painful ones.
- when the tumor grows muscles of the face and lips appears trism( tight twitching of the contracted muscles);
- with far-reaching, decaying, tumors, there is abundant salivation with an admixture of blood, pus and pieces of tumor, the presence of malodorous odor from the mouth. When the tumor spreads to the side of large vessels, a different intensity of bleeding may appear, in some cases requiring a vessel ligation to stop it.

Stage of cancer of the lip and oral cavity:

Stage 1: tumor up to 2 cm;
Stage 2: tumor up to 4 cm;
Stage 3: a tumor larger than 4 cm, as well as any tumor size in the presence of metastases in nearby lymph nodes( single on the lesion side no larger than 3 cm);
Stage 4: a tumor with spread to adjacent structures: bones, deep muscles, soft tissues of the neck, sinuses, skin or tumor of any size with metastases in several nearby lymph nodes of more than 3 cm in size, or the presence of distant metastases in other internal organs.

A characteristic property of cancer of the oral cavity and pharynx is frequent lymphogenous metastasis( to nearby lymph nodes), sometimes on both sides.

In this case, the lymph nodes are affected step by step: first metastases appear in the chin and submaxillary nodes, then in the cervical nodes, and finally, the last barrier is the deep cervical and supraclavicular nodes. Distant metastases in other internal organs occur sharply, even at stage 4 of the disease.

The results of treatment depend on the stage of the disease and the affected organ: at stage 1-2, 90% of patients with lip cancer survive, at stage 3-4, even with the entire set of therapeutic measures, no more than 50% of patients survive for 5 years.

Throat cancer

Of the tumors of the lips, oral cavity and the throat, the most dangerous and aggressive are the latter. They have higher growth rates, an earlier and wider metastasis to nearby lymph nodes, the presence of which, often, is the first symptom of the disease.

Tumor tumors are divided into the following, depending on the location: nasopharynx( the uppermost compartment), oropharynx, larynx( transition to the larynx).

Diagnosis of cancer of the lips, mouth and throat

If you see a tight nodular formation on the lip or in the oral cavity or a long-term non-ulcerative one, you should contact your dentist. In the presence of these formations in the field of tonsils or throat, an examination of the otolaryngologist( ENT doctor) is required.

Diagnosis of tumors of the mouth and pharynx is not a problem, since it is a tumor of visual localization. The boundaries of the prevalence of tumor lesions are determined by examination of the oral cavity and oropharynx, sometimes, by means of special instruments( laryngoscopy, oropharyngeal fibrosis, nasopharynx and larynx).

For the detection of tumor damage to the bones of the facial skull or the germination of their tumor using radiography and computed tomography of the skull.

Ultrasonic examination of the submaxillary, cervical and supraclavicular areas is performed to diagnose metastases in nearby lymph nodes.
After a visual examination and ultrasound, a biopsy( a small piece of tumor tissue for microscopic examination) is performed and a puncture of the suspicious lymph nodes is performed.

Tumors of the oropharynx tend to give metastasis to distant organs, more often the lungs, liver, brain and bones of the skeleton are affected. To identify the defeat of these organs, ultrasound examination of the abdominal cavity, radiography of the lungs, in the presence of indications, computed tomography of various internal organs.

Treatment of cancer of the lips, mouth and throat.

In the treatment of cancer of the lip, mouth and throat is an important and perhaps the leading role belongs to radiation therapy. This is due to the fact that tumors of these localizations are highly sensitive to radiation effects. Radiation therapy can be of several types:

• remote( the source of radiation is at a distance),
• brachytherapy - the source of irradiation is injected directly into the affected organ, in this case, the oral cavity,
• application - the source of irradiation is laid directly on the tumor( plates or needles)and a combination of several methods.

With early cancer of the lip or small tongue, radiation therapy, cryogenic action( liquid nitrogen) or photodynamic therapy( intravenous administration of special drugs that enhance the sensitivity of the tumor with subsequent irradiation of the affected area) is effective. In case of cancer more than 1 stage, a complex method of treatment is used: irradiation of the tumor and cervical lymph nodes in small doses, followed by surgery( removal of part of the lip or tongue with a tumor or removal of the lymph nodes of the neck).

In some cases( with small tumors of 1-2 stages), radiation therapy is used as an independent method of treatment, while a large dose of irradiation is given.

In tumors of 3-4 stages, treatment usually involves several stages: radiation, chemotherapy and surgery. Usually, treatment starts with chemotherapy or radiation.

In the presence of cancer of the bottom of the oral cavity and growth of tumors of neighboring organs( tongue, jaw, lip) in 3-4 stages, a complex surgical intervention involving partial or complete removal of the lip, tissues of the bottom of the mouth and lower jaw is required. After such crippling operations, patients need to replace the removed tissue. When detecting metastatic affected cervical lymph nodes, they need to be completely removed, often the operation is performed in several stages from two sides.

In tumors of stage 4, when removal of the affected organ is impossible or metastasis is present, chemotherapy or radiation therapy is used to reduce the size of the tumor or relieve painful symptoms( pain, swelling).Complications of cancer of the lips, tongue and pharynx.

Associated with tumor growth and direct spread to surrounding tissues: bleeding( with the emergence of large vessels), suppuration of the tumor and surrounding tissues, fistula formation with surrounding organs( holes in the decaying tumor that are not normal), asphyxia caused by overlapping of the tumor by upper respiratoryways.

Prevention:

- protection of the face against direct sunlight( wearing wide-brimmed hats);
- smoking cessation;
- change in working conditions( avoid contact with chemicals);
- hygiene of the oral cavity and regular visits to the dentist;
- refusal from the use of spirits;
- treatment of chronic diseases of the oral cavity( cheilitis, cracks, papillomatosis);
is a diet rich in vitamins.

Doctor's consultation:

Question: How can oral cancer be detected at an early stage?
Answer: There is no difficulty in identifying the lip tumors, since often the patient himself discovers a suspicious area. To identify tumors of the oral cavity, an annual examination is required at the dentist, since the cancer tumors grow slowly enough.

Question: What methods of treatment are used in cancer of the above organs?
Answer: In small tumors, the most effective surgical method( complete removal of the affected area).But, often tumors of the oral cavity reach large sizes and affect adjacent organs, their removal is associated with a high risk for the patient and crippling operation characters. In view of the above, the most suitable combination therapy( surgery, radiation and chemotherapy).Leading in the treatment of cancer of the oral cavity and pharynx, is radiation therapy.

Question: Who is most susceptible to the appearance of cancer of the mouth and pharynx?
Answer: Most men are ill( more than 70%), this is due to the prevalence of smoking tobacco, drinking strong spirits and hot, spicy food. The disease is common in Asian countries, where chewing tobacco and nasal is introduced into the culture.