1. ORAL Precancer &CANCER Clinical Research Program CLIN 213-50 –2007 Humber College North Campus Toronto

12. World Areas Studied C A C a n c e r J C l i n 1 9 9 9 ; 4 9 : 3 3 - 6 4 Vol. 49 No. 1 January/February 1999

18. Inter Relationship of Factors Associated with Oral Pre cancer & Cancer

23. Oral Leukoplakia

24. Squamous cell carcinoma ( Floor of mouth )

25. Geographic Tongue

26. Lichen Planus

37. Areca nut +Tobacco and Oral Precancer & Cancer Alkaloids of areca nut cause Sub mucous fibrosis And the tobacco leached N’-Nitro -amines Po (polonium) And NNN= N’nitrosonornicotine, Are known carcinogen and Also addictive in behavior

39. CLINICAL TRIALS Head and neck or oral neoplasm 337 studies found in this group 99 studies world wide in progress for oral neoplasm. And 5 Studies are in in progress in Canada

45. The UICC TNM staging System T represent tumor size , T is = Carcinoma in situ Ti = <2cms in greatest diameter., T 2= 2. - 4cm , T3 = 4 - -6 cm, t4 > 4cms and deeply penetrating underlying structures. No= no clinically detectable enlarged nodes. N1 = enlarged ipsilateral lymph nodes present < 3cms. N2 = ipsilateral single> 3-6 cm or ipsilateral multiple<6cm or bilateralor Or contra lateral < 6cm. N2 = any palpable node> 6cm. Mo and M1+ absent or distant blood born metastases. Stage 0 Tis No Mo Stage I T1 No Mo Stage II T2 No Mo Stage III T3 T1 T2 T3 No N1 N1 N1 Mo Mo Mo Mo Stage IV T4 Any T No or N1 Any N Mo M1

46. The TNM staging system Another method of staging oral carcinomas is referred to as the TNM method. In this method T describes the tumor, N describes the lymph nodes, and M describes distant metastasis . TX Primary tumor cannot be assessed. T0 No evidence of primary tumor Tis Carcinoma in situ T1 Tumor 2 cm or less in greatest dimension T2 Tumor more than 2 cm but not more than 4 cm in greatest dimension T3 Tumor more than 4 cm in greatest dimension. (Lip) Tumor invades adjacent structures (e.g., through cortical bone, into deep [extrinsic] muscle of tongue, maxillary sinus, skin) T4 (Oral cavity) Tumor invades adjacent structures (e.g., through cortical bone, into deep [extrinsic] muscle of tongue, maxillary sinus, skin) NX Regional lymph nodes cannot be assessed N0 No regional lymph node metastasis N1 Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest dimension N2 Metastasis in a single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension; in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension; in bilateral or contralateral lymph nodes, none more than 6 cm in greatest dimension N2a Metastasis in single ipsilateral lymph node more than 3 cm but not more than 6 cm in greatest dimension N2b Metastasis in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension N2c Metastasis in bilateral or contralateral lymph nodes, none more than 6 cm in greatest dimension N3 Metastasis in a lymph node more than 6 cm in greatest dimension MX Presence of distant metastasis cannot be assessed M0 No distant metastasis M1 Distant metastasis ( Ref : J Biomed Opt, September 1, 2004; 9(5): 940-950 )

71. THANK YOU Avoid Tobacco & Alcohol