Fighting oral Cancer Is Our Goal. We Can Do It It’s In Our Soul!

Fighting oral Cancer Is Our Goal. We Can Do It It’s In Our Soul!

Hello all….. Warm greetings…… today we are back with a new topic related to oral precancerous lesions which can lead to oral cancers….

A premalignant lesion is a disease, syndrome, or finding that, if left untreated, may lead to cancer. Precancerous lesions of oral mucosa, known as potentially malignant disorders in recent years, are consists of a group of diseases, which should be diagnosed in the early stage. Oral leukoplakia, oral submucous fibrosis, and oral erythroplakia are the most common oral mucosal diseases that have a very high malignant transformation rate.

Now, our first question is that do anyone of you noticed white patches on your oral mucosa?

If the answer is yes……. Then it can be a precancerous condition…. In this type of cases, after your first notice it’s better to visit the dentist, get the exact diagnosis and accordingly treatment plan.

Long-term outcomes associated with oral cancer and its management over the past several decades has caused concern and the value of mass oral cancer screenings has come under scrutiny. Though not all oral carcinomas are preceded by premalignant lesions as clinically visible morphological alterations occur secondary to the cellular or molecular changes, certain high risk lesions have been identified. Their management remains controversially polarized between surgical excision to prevent malignant change and conservative medical or surveillance techniques. Though oral cancer is one of the “major killers” of modern times, there seem to be no widely accepted criteria for decision making in clinical practice, the evidence base is scanty and uncertainty persists throughout investigation, diagnosis, and treatment.

Common precancerous lesions include…….

• Leukoplakia and erythroplakia or erythroleukoplakia, when both coexist are two very common clinical lesions
• Oral submucous fibrosis (OSMF)
• Lichen planus (very low risk of turning malignant)
• Other lesions (smokeless tobacco keratosis, leukoedema, and leukoderma)

Varied appearances of these lesions make it extremely difficult to classify them into a said group and are likely to be interpreted subjectively by the clinician. A histopathologic diagnosis is generally more indicative of premalignant change than clinically apparent alterations

1. Leukoplakia: a white patch or plaque that cannot be characterized, clinically or pathologically, as any other disease”. These lesions are potentially premalignant and vary in size, shape, and consistency, and macroscopically said to be homogenous and nodular.

2. Erythroplakia: It is a red or erythematous patch of the oral mucosa and is associated with significantly higher rates of dysplasia, CIS, and invasive carcinoma than leukoplakia.

3.   Oral submucous fibrosis (OSMF): It is a chronic, debilitating disease characterized by inflammation and progressive fibrosis of the submucosal tissues (lamina propria and deeper connective tissues). It results in marked rigidity and an eventual inability to open the mouth. The buccal mucosa is the most commonly involved site, but any part of the oral cavity can be involved, even the pharynx. The condition is well recognized for its malignant potential and is particularly associated with areca nut chewing, the main component of betel quid.

4. Oral lichen planus

In cases of oral lichen planus, the mucous membranes inside your mouth are the only area affected. Oral lichen planus presents symptoms different from other cases of lichen planus. Instead of a rash, people may experience swollen tissues, white patches, and open sores. Oral lichen planus isn’t contagious, and it can’t be spread to another person.

RISK FACTORS which include……

    Genetic predisposition

    tobacco chewing,

    tobacco smoking and

    alcohol intake

The treatment options include the following

Chemoprevention

“Chemoprevention” should be considered in a patient if the size of the lesion, its location, or the medical status would make surgical removal difficult to try to prevent progression to carcinoma. However, although antioxidant supplements have shown promise, they have an uncertain success rate and no long-term results.

Beta-carotene and the retinoids are the most commonly used antioxidant supplements for chemoprevention of oral cancer.

The other options include

·        careful watching (active surveillance) and frequent follow-up

·        surgery

·        cryosurgery

·        laser surgery

Overall, the take home point is that if anyone of you is suffering from white patches in oral cavity…. Be alert it can be a precancerous condition…… so please hurry me and take our expert advice.

For any other quires please contact

Dr.Dilip Kumar BDS, MDS (Oral and Maxillofacial Surgeon)

Certified Implantologist (Noble Bio-care Germany)

Certified Smile Care Dentist (New York University)

Hyderabad Smiles Dental Hospital

Phone Number: 9247864642, 8801627272.