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Oral Cancer – Part 2

4.26.16 in General

Last blog we began our discussion of Oral Cancer. I hate admitting that it seems I am seeing more patients with this diagnosis, even since I started the blog. Clearly, this is certainly a relevant topic. We know that 40,000 to 50,000 new diagnoses will be made this year in America alone. We know that many of these will be diagnosed in a later stage, and we know there are two general categories of risk factors: Alcohol and tobacco exposures, and HPV-16 exposures. Let’s talk now about, “where” do these cancers occur?

Oral cancer and Oro-pharyngeal cancers occur in the head and neck- above your collar bones. So, we can see cancers of the lip, tongue, floor of the mouth, salivary glands, throat, larynx, and any associated lymph nodes.

Doctors use a system to describe cancers called the TNM system. That stands for Tumor, Nodes, and Metastasis. Numbers related to each of these letters also tell us something about the cancer. This creates a common “language” to communicate cancer information within the health care community.

T stands for tumor and is graded 0-4, which tells us about the size of a tumor. T0, would mean no tumor is evident. T2 would mean a 2 cm. tumor is present; T3 would mean that a 4 cm. tumor is present; and T4- describes tumor with spread into adjacent tissues.

N stands for nodes. We would designate a 2 cm. tumor, with no lymph node involvement as a T2, N0 cancer. With a solitary lymph node invaded, we would call that N1. N2 designates lymph nodes that are 2 cm in diameter; N3 is for nodes of 6 cm size.

M stands for metastasis, or spread elsewhere. We either see MX (spread cannot be evaluated), M0 (no spread evident), or M1 (spread of cancer is evident).

Based on these notations then, doctors will “stage” the cancer. So stage I, II and III, have no nodes involved, nor any spread, merely a single tumor of varying size. Once cancer has spread to nodes or other sites, the stage is stage IV.

The most common cell type associated with oral cancer is the epithelial cell, meaning locations are areas lined with mucosa or skin. So, the lip, tongue, floor of mouth, tonsils and throat, are the most common locations for oral cancer.

So, how do we find these cancers, in order to prevent them? Next blog we are going to describe these lesions, so that all of us can be diligent observers of our own heads & necks. So, stay tuned in, and keep smiling. Dr W.

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Gary Williams, DMD

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