Oral Cancer

Cost of Oral Cancer Treatment in India

Oral cancer is a malignant growth in any of the tissues of the mouth. The treatment for oral cancer in India costs around USD 3,000 (Indian Rupees approx. 2,32,794) for approx. 20 days. The price includes consultation, diagnostic tests, and chemotherapy and radiation therapy if needed.

What is Oral Cancer?

Oral cancer is cancer that develops in the mouth, including the lips, gums, cheeks and tongue, soft and hard palate, the floor of the mouth, sinuses, and throat. Oral cancers occur among individuals who are aged over 40. Even this type of cancer is more common among men than women. It can be caused by tobacco use (both smoked and smokeless), excessive alcohol intake, infection with the human papillomavirus (HPV), and other factors. Oral cancer is 2nd most prevalent cancer in India and is the 6th leading cause of cancer death globally. In India every year approximately 1 lakh new cases of oral cancers are detected. But, unfortunately, half of the people die within one year of detection as 60-70 percent of these cases are detected in advanced stages which is the main reason behind it the deaths.

Types Of Oral Cancer

When it comes to cancer, knowing what type you have is a big deal. Not only does it help you figure out the best treatment options, but it also gives you an idea of how likely your cancer is to spread and what kind of treatments will work best for it. Here are the main types of oral cancers:

Squamous Cell Carcinoma: This cancer is most common in the mouth, but it can also appear at other sites such as under the skin or inside of the mouth. Squamous cell carcinoma is a common form of oral cancer, and it can also happen in other areas of the body, like on the vocal cords or inner ear.
Adenocarcinomas: This rare type of mouth cancer grows within the salivary glands and can cause visible symptoms such as a lump in your cheek or under the tongue, sores on your lips that do not heal, or ulcers on your gums.
Oral Malignant Melanoma: This is also a rare type of mouth cancer that begins in cells known as melanocytes. These melanocytes are responsible for providing the skin with its color. This disease does not cause symptoms until it has grown and spread to nearby lymph nodes, or has already metastasized to another part of the body.

Symptoms Of Oral Cancer

The symptoms of oral cancer can vary from person to person, but it’s important to remember that if any of the below occur, visit your physician immediately.

Tongue pain
Sore throat
Loosened teeth
A lump in the neck
Bleeding from the mouth
Ear pain or hearing loss
Pain or stiffness in the jaw
Problems in wearing dentures
Speech problems/change in voice
Pain or difficulty in swallowing
A persisting earache Dramatic weight loss
Lip or mouth sore that doesn’t heal with time
If a growth or mass is seen anywhere in the mouth
Numbness on the lower lip, face, neck, or chin White, red, or red and white-colored patches in or around the mouth or lips

Causes Of Oral Cancer

There is no guaranteed way to prevent oral cancer, but there are several factors that have been identified as increasing the risk of developing it. The following factors are known to affect the risk of developing oral cancer:

Tobacco

Alcohol Consuming

Tobacco

The biggest risk factor for oral cancer is the use of tobacco products. This includes the use of smoking cigarettes, cigars, pipes, and chewing tobacco. Smoking is one of the most common causes of oral cancer. It can also be caused by chewing tobacco, bidi, cigarette, and gutka. Areca nut or supari also causes mouth cancer. If you have ever smoked or used any tobacco product, be sure to talk with your doctor about steps you can take to help protect yourself against oral cancer.

Alcohol Consuming

Alcohol has been identified as another cause of oral cancer. It is seen that people who consume alcohol and tobacco together face a greater risk of developing floor-of-mouth cancers than people who do not consume either alcohol or tobacco.

The other risk factors which can lead to oral cancer are as follows:

Certain genetic disorders.
Previous history of oral cancer.
Family history of cancer - oral or other types of cancer.
Gender: Men are twice as likely to develop oral cancer than women.
Age:As with the age the risk of developing oral cancer also grows.
Exposure to Human papillomavirus (HPV): It increases the risk of oral cancer in the beings.
Chronic sun exposure (sunburn) to the face: While lip cancer is rare, it is possible to develop the condition if you are exposed to UV light for prolonged periods.
Weak immune system and Malnutrition: Poor nutrition and excess body weight can lower your defenses against oral cancer, making it more likely that you'll get this disease.

Oral Cancer Diagnosis and Tests

Oral cancers are often difficult to detect and diagnose since they don't always cause signs or symptoms. There are various tests used to detect and diagnose oral cancers, and your dentist can help determine if you should undergo any of these options. The most common tests for oral cancer include:

Physical Examination

Biopsy

A Barium Swallow and Meal Test

Endoscopy

Imaging

X-rays

Physical Examination

If your mouth is itchy or sore, you might have a form of cancer called mouth cancer. The doctor will examine your lips and mouth to check for abnormalities in the areas of irritation, such as sores or white patches (leukoplakia). You may be referred to an ENT specialist for further examination.

Biopsy

It is another form of test used to detect cancer. A biopsy is done to diagnose and/or confirm the presence of cancer. The selected treatment is based on the severity and type of cancer in addition to the size of the tumor. It's a painless test in which the cells from a tumor are collected by brushing them onto a slide. The results are viewed under the microscope and can tell your doctor whether you have cancer and how far it has spread.

A Barium Swallow and Meal Test

his test requires a patient to swallow a drink containing barium. An x-ray will show images of abnormal growths in the digestive system down to the stomach. This test may also determine whether any leaks exist in your intestines or rectum that would prevent you from receiving adequate nutrition.

Endoscopy

This test helps in viewing the body from within. An endoscope (a narrow and flexible tube having a telescopic camera) is used for performing this test. A small endoscopic instrument called a gastroscope is passed through the esophagus, stomach, and duodenum to check if there is any problem with these organs.

Imaging

Imaging is done to know tumor extent in all dimensions including deeper tissues. CT scan, MRI, or PET CT is done based on tumor location, size, and size. These imaging procedures help doctors determine the type of cancer a patient has and guide them to treat it appropriately.

X-rays

X-rays are a quick, painless, and easy method of diagnosing problems in your mouth or jaw. They are used to detect tooth decay and hidden tooth infection, or whether there are any broken bones due to injury, such as the jaw.

Stages Of Oral Cancer

Staging is a very important part of the treatment process. It helps in choosing the right treatment option depending on the extent of the spread of cancer. If a biopsy is indicative of cancer, imaging studies are the next step. Imaging studies help in staging and planning treatment accordingly. Various stages of oral cancer include:

Stage 0 (Carcinoma in situ)

Stage 1

Stage 2

Stage 3

Stage 4

Stage 0 (Carcinoma in situ)

This is the pre-cancer stage of oral cancer. This stage involves abnormal cells growing in the lining of your mouth. If left untreated, these cells can develop into invasive cancer

Stage 1

Early-stage squamous cell carcinoma of the mouth is when cancer has started to develop through the mouth lining and also in the deep tissues below. Cancer has not spread close to other organs, tissues, or lymph nodes and this cancer is smaller than 2 cm across.

Stage 2

In the second stage of lung cancer, the tumor has grown to a size of more than 2cm but no more than 4cm. Cancer cells have spread to other organs or lymph nodes

Stage 3

These are the conditions that are true in this stage:

The tumor is of any size that has spread to 1 lymph node on the same side of the neck. The cancer is more than 4 cm and has not spread to any part of your body or any lymph at all.

Stage 4

The advanced stage of oral cancer is defined as the presence of tumor spread that leads to a severe reduction in functionality. This stage of oral cancer is categorized into three stages:

Stage 4A: At this stage, the growth of cancer through the tissues around the mouth and lips can be seen. It is possible that lymph nodes may or may not possess any cancer cells.
Stage 4B: At this stage, the spread of cancer can be noted as to any lymph node which is bigger than 6 cm or to lymph nodes on both neck sides, or more than one lymph node on the same side of the neck.
Stage 4C: Here at this stage cancer spreads to different body parts such as bones and lungs.

Treatment Options for Oral Cancer

The treatment of Oral cancer lies on a variety of factors, including the stage of cancer, its location, and the patient’s medical condition. Overall, various combination of different modes of treatment is necessary. These may include various surgical and non-surgical treatments such as:

Surgery

Biological Therapy

Chemotherapy

Radiotherapy

Plastic Reconstruction

Surgery

It is the primary treatment for oral cancer. The surgery generally includes the removal of a tumor, removal of certainly affected tissues in the mouth or lymph nodes in the neck, and ultimately results in a better quality of life. The surgical procedure may also involve the removal of a small tumor in the mouth which may not result in any problems. On the other hand, large tumors may also require removal of a part of the jaw, palate, or tongue which is attended by some complications like swelling in the affected area, difficulty in chewing, etc.

Biological Therapy

Cancer cells, which are present in the body, grow quickly and destroy a person. The activity of the cancer cells is changed with the help of biological therapy. A type of biological therapy is known as Cetuximab which is also referred to as a monoclonal antibody. The surface of the cancer cells that trigger the development of cancer cells is blocked with the help of Cetuximab.

Chemotherapy

This therapy is performed through chemotherapy or radiotherapy. Chemotherapy is done in the doctor's office, where a small amount of medicine is injected into a vein to destroy cancer cells. The radiotherapy method uses radiation beams that pass through the body.

Radiotherapy

Radiation therapy uses high-energy radiation to shrink the tumor or cancer cells, and rays of radiation are directed at the affected area. This process is done by making use of a machine that sends out rays from a radioactive source. The types of machines differ in the dose, intensity, and type of radiation used during treatment. Radiotherapy may be used as an alternative to other treatments such as surgery, chemotherapy, or targeted therapy for treating certain types of cancer.

Plastic Reconstruction

It has various types such as:

Primary closure: If the tumor is small and the resulting defect is not much then sutures are placed to approximate the remaining tissues and closure is achieved. If, however, there is enough tissue loss that allows for placement of sutures then these may be used to close up this wound as well.
Local flap: This technique is used when the defect cannot be closed primarily, tissue from the adjacent region is used to repair the defect. This tissue can be taken from the adjacent tongue, buccal mucosa, palate, etc.
Regional flap: In case of larger defects, it is not possible to use adjacent tissues. In such situations, tissue from a distant site is used to cover the defects. Tissue from the chest, arm, neck, etc. can be utilized for this purpose and would require extensive surgery.
Microvascular free flap reconstruction: This technique is the latest advancement in flap surgeries. In this method, tissue from some distant site such as the forearm, thigh, or leg along with its blood supply is taken and sutured to the remaining tissue in the mouth to cover the defect. The flap can be used immediately after surgery or stored in a freezer for future use.

Follow-ups After the Treatment

If you have survived cancer, it is very important to be in regular follow-up after cancer treatment. This check-up is done to detect future recurrences at the earliest. At each follow-up visit, the oncologist will examine you and review your past medical and surgical history. Imaging may be required based on tumor stage, symptoms, and response to treatment. Follow-up is done at 2-3 months for the initial 2 years 3-6 monthly for the next 3 years and annually thereafter. Various precautions can be taken such as:

Say no to passive smoking
Stay away from tobacco and alcohol
Regular check-up if you have smoked or had alcohol in past

Best Hospital for Oral Cancer Treatment in India

There are many hospitals across India. But some places provide the best treatment for oral cancer. You should choose a hospital that has a reputation for treating all types of cancer. A well-known cancer hospital will employ the best and most experienced doctors. Some of them are listed below:

HCG Manavata, Nashik
Fortis BG Road, Bangalore
Fortis Hospital, Vadapalani
Kokilaben Ambani Hospital
Manipal Hospital, Whitefield
Fortis C-DOC, Chirag Enclave
Fortis La Femme, Greater Kailash
Manipal Hospital, Old Airport Road
BKL Superspeciality Hospital, New Delhi
Fortis Escorts Heart Institute, Okhla Road

FAQs

How common is oral cancer?

This is the fourth most common cause of cancer in women but in some parts of our country, it is one of the commonest cancer in women.

What are the warning signs of oral cancer?

The warning signs of oral cancer include Persistent ulcer for more than 3 weeks, Growth / rough area inside the mouth, White patch or red patch, sudden fall of the tooth, altered speech, Difficulty in eating, Pain at the backside of the throat radiating to the ear, and Neck swelling.

How to detect mouth cancer at home?

A self-oral examination, even if it is done once a month, can help you detect mouth and neck abnormalities. Common signs of problems include lumps and loose teeth and sockets, as well as white or red patches on the lining of the mouth. This is why it is important to look out for any changes in your mouth whenever you take a close look at yourself in the mirror.

Is it treatable?

Yes, oral cancer is treatable. However, early detection is important. The earlier the oral cancer is caught, the easier it is to treat.

What are the ways to prevent oral cancer?

Smokers and people who drink alcohol regularly are at a higher risk of getting oral cancer. Quitting tobacco and reducing alcohol intake, having a healthier lifestyle, practicing safe and healthy sex habits, reducing your exposure to UV light, and undergoing regular oral cancer screening can help reduce this risk.

Among all, what is the common type of oral cancer?

The main common type of cancer is squamous cell carcinoma as it covers more than 90 percent of cancers that occur in the oral cavity.

Are there any advantages of the early detection of oral cancer?

Detection of oral cancer is critical in helping to prolong life and improve the odds of treatment success. Early detection and early beginning of therapy can significantly diminish the mortality rate in oral cancer.

What is the prognosis of oral cancer?

It is important to know the location of cancer, and its first or second stage before you start treatment. Early diagnosis of oral cancer has a higher chance of survival. The 5-year survival rate for localized oral cancer is approximately 80 percent.

What do you mean by a 5-year survival rate?

The 5-year survival rate is one of the most important statistics when it comes to cancer diagnosis and treatment. It shows the percentage of patients who live at least 5 years after their cancer has been diagnosed.