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Oral cancer
- 3. Epidemiology , Etiology and Prevention of Oral cancer
- 5. Defined as:_ • An uncontrolled, uncoordinated, excessive and abnormal growth of cells is called cancer.
- 6. Benign Vs. Malignant • Does not spread • Rarely life threatening • Can be removed • Spreads to other parts of the body • Life threatening • Can be removed, but it may grow back
- 7. Types of Cancer • Benign • Malignant – Carcinoma • epithelial origin • E.g. squamous cell carcinoma – Sarcoma • Mesenchymal origin
- 8. Oral cancer • Defined as:_ Indurated, ulcerated lump or sore that may or may not be painful and is often associated cervical lymph adenopathy.
- 10. Why is it such an important public health issue? • Closely associated with tobacco and alcohol. • 2nd most common cause of death • In 2003-according to world health report 7.1 million deaths were reported. • Estimated 50% increase in death rate in next 20 years. • In Bangladesh, Sirilanka and Pakistan most common type of cancer. • And 1/3rd of all the cancers.
- 11. Signs and Symptoms • Sores that do not heal within 14 days • Bleeding in mouth • Lump in neck • Earache • Loose teeth • Dentures will not fit well • Pain or numbness in mouth • Difficulty chewing or swallowing • Bad breath • Patches on the lip or in the mouth that are red, white, or a mixture of both
- 12. Epidemiology of oral cancer
- 13. Host factors 1. Age – Incidence increases with age. – 98% cases in the west are over 40yrs old. – More than 50% of cases include ages above 50yrs. 2. Gender – Incidence is more in • Men • Industrial areas – Women have more incidence of lip carcinoma – Men have high incidence of buccal carcinoma 3. Occupation – Textile workers and leather industries have high incidence of buccal cavity and larynx carcinoma.
- 14. Host Factors 4. Immunity – AIDS patients are prone to Kaposi carcinoma. 5. Social Class 6. Custom and habits 7. Race
- 15. Agent Factors • Biological – HIV – Candida • Chemical – Arsenic,dyes,nickel,chromium • Mechanical – Ill fitting dentures – Sores from jagged teeth
- 16. Agent factors • Nutritional – – – – – Precarcinogens in food Increase consumption of fat Deficiency in folic acid Deficiency of proteins Increase in red chili
- 17. Environmental factors • Water contamination • Air pollution • Geographic variation – Netherland buccal mucosa – Switzerland lip and tongue – Canadian Eskimos salivary glands • Solar heat – Prolonged exposure causes melanoma
- 18. Etiology • Due to – – – – – – – Tobacco Unhealthy diet Alcohol Physical inactivity Infection Nutrients Physical irritants
- 19. Risk Factors • Tobacco is the main culprit – Mainly chewing tobacco – 75% of those diagnosed are tobacco users. • Alcohol 2nd largest risk factor • Combination of alcohol and tobacco use – 15x greater risk for oral cancer • Excessive sun exposure – Lip cancer 1/24/2014 Oral Cancer 19
- 20. Risk Factors • X-rays – Cumulative exposure • Other biological factors – Viruses and fungus – HPV 16 • Main agent in cervical cancer • Now has been linked to oral cancer 1/24/2014 Oral Cancer 20
- 21. Tobacco • Its an important risk factor of oral cancer. • 90% of cancers are caused by tobacco • Tobacco can be broadly classified into smokeless and smoking forms.
- 23. Bidi • Most popular form of tobacco • Estimated nictinic content is 1.7-3mg
- 24. Cigar • Cured tobacco wrapped in dried tobacco leaves.
- 25. Chilum • Conical clay pipe for smoking tobacco • Filed with coarsely cut tobacco pieces • Glowing charcoal is kept on top of tobacco
- 26. Hookah • Indinan origin • Also known as water pipe.
- 27. Cigerrete • 1gram tobacco cured by sunlight is coverred by paper. • 1-1.4mg Nicotinic content. • More common in urban areas
- 29. Paan • Most common habit of smokeles tobacco. • May also include • • • • • Cardamom Cocnut Clove Sugar Tobacco wraped in beetle leave
- 30. Snuff • Finely powdered air cured and fire cured tobacco leaves.
- 31. Mishri • Prepared by roasting tobacco on hot metal plate then powdered • Also used to clean the teeth
- 32. Khaini • Powdered sundried tobacco. • Simply placed in mouth and chewed
- 36. Primary Program to educate adolescence Program for tobacco users Regular check up good oral hygiene
- 38. Tertiary • Surgery • Chemotherapy – Cytotoxic drugs • Radiotherapy
- 39. What you can do: • • • • • Make yourself aware or your mouth Stop smoking and drinking excessively Be informed Have a good diet and stay healthy Behavioural modification
- 40. Prevention as a dentist • Regular check up • Suspected patients be thoroughly checked • Patient should be educated about the preventive aspects of oral cancers including – Behavioral – Physical – community