Beware! Oral ulcers that do not heal for more than 2 weeks may be a "signal" of this cancer

Aunt Zhang discovered a blister-like bump on her left gum six months ago, accompanied by local pain. At first, she thought it was a mouth ulcer and did not pay attention to it. But six months later, the symptoms did not improve, and the gum pain worsened, seriously affecting her quality of life.

Finally, the pain was unbearable, so Aunt Zhang went to the hospital with her family for relevant examinations. After the expert diagnosis, the results surprised Aunt Zhang and her family. What Aunt Zhang thought was "oral ulcer" turned out to be "oral cancer". In fact, Aunt Zhang who mistook oral cancer for oral ulcer is not an isolated case, because for most people, oral ulcers are common. However, experts remind that if oral ulcers do not heal for more than two weeks, you should be alert to whether it is a sign of cancer.

What are the types of oral cancer?

Who is prone to oral cancer?

What symptoms should you be alert to?

What are the treatments for oral cancer?

What should we pay attention to in postoperative care?

And how to prevent oral cancer?

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Who is prone to oral cancer?

Oral cancer mostly occurs in adults aged 40 to 60, and more men than women. With the aging of the population in my country, we have found in clinical work that the proportion of oral cancer patients among the elderly is on the rise, and most of them are elderly men.

Most middle-aged and elderly people with oral cancer have the following problems:

Have a history of smoking and drinking. Some patients smoke and drink for a long time.

Elderly people often have dental problems, such as sharp residual crowns and roots in the mouth, repeated biting and abrasion of the tongue and cheek mucosa;

Some patients have bad restorations in their mouths, such as dentures from street stalls or informal dental clinics, which can cause adverse stimulation to the gums and buccal mucosa.

Some patients have a history of oral mucosal diseases, such as leukoplakia, erythema, and lichen planus. These oral mucosal diseases have the potential for malignant transformation, and some of them can develop into oral cancer;

In my country's Hunan, Guangdong, Guangxi, Hainan and other areas where people like to chew betel nut, there is a saying that "betel nut plus cigarettes have infinite power." From this, we can see that betel nut plays a vital role in inducing oral cancer.

Common oral cancers in clinical practice are divided into the following types according to the different sites of occurrence. They include tongue cancer, gum cancer, buccal mucosa cancer, palate cancer, and mouth floor cancer. Among them, tongue cancer mostly occurs on the side edge of the tongue, but can also occur on the tip and back of the tongue, and most of them are ulcerous. This is why many patients do not pay much attention to it, thinking it is just a common oral ulcer, and use some ulcer treatment drugs, such as some lozenges, which delays the disease.

Gingival cancer and buccal mucosal cancer also mostly present as ulcerative type. If the location of the cancer is relatively posterior, there may be progressive restriction of mouth opening, or even complete inability to open the mouth. When palate cancer progresses to a certain extent, the mouth and nose may be connected, and the patient may feel hollow when speaking. Squamous cell carcinoma is also common in floor of mouth cancer, and most of them still present as ulcerative type. Most of them will experience pain, increased saliva, and limited tongue movement. Some patients will experience difficulty swallowing and speech disorders.

What symptoms should you be alert to?

One point that almost all oral specialists or head and neck tumor specialists will mention is: If you find an ulcer in your mouth and it does not improve for more than 2 weeks, you must be vigilant and see a doctor.

Doctors will give advice and treatment plans based on their rich clinical experience.

First, if it is suspected to be a common oral ulcer (medically known as aphthous ulcer, which recurs repeatedly and has self-healing properties, generally can heal itself in about a week), it is recommended to treat the symptoms, avoid spicy and irritating foods, and recheck after 1 to 2 weeks;

Second, when traumatic ulcers are considered based on medical history, it is recommended to remove the cause, such as temporarily not wearing poorly repaired removable dentures (removable dentures), etc. Most ulcers can heal on their own;

Third, if a cancerous ulcer is suspected, the patient will generally be advised to undergo an oral biopsy, and the next treatment plan will be determined based on the biopsy pathological diagnosis.

In addition to an ulcer that has not healed in 2 weeks, what other symptoms should patients be alert to?

If there are symptoms such as slurred speech, limited mouth opening, painful swallowing, fixed tongue, painful and loose teeth, and some relatively fixed swollen lymph nodes felt in the neck, once these symptoms occur, the patient must be vigilant, seek medical attention as soon as possible, get a clear diagnosis, and evaluate the condition. Never rely on luck.

What are the treatments for oral cancer?

For patients with early oral cancer, after completing relevant examinations upon admission and evaluating systemic and local conditions, if they can tolerate general anesthesia, surgery is the first choice for extended resection of the primary lesion and neck lymph node dissection (because most oral cancer patients may have cervical lymph node metastasis). Patients with mid-to-late stage oral cancer should adopt a comprehensive treatment plan, advocating induction chemotherapy first, followed by extended resection of the lesion, and postoperative adjuvant radiotherapy to reduce the risk of recurrence and metastasis. For larger defects after extended resection, repair and reconstruction should generally be considered, and appropriate tissue flap repair should be selected according to the type of defect. For example, defects after tongue cancer and buccal mucosal cancer can be repaired with soft tissue flaps such as forearm flaps, and mandibular defects after mandibular gingival cancer and floor of mouth cancer can be repaired with bone tissue flaps such as fibula flaps, in order to restore the patient's morphology and function, such as swallowing and speech, to the greatest extent.

It should be pointed out that patients should do oral-related treatment before radiotherapy. It is recommended to remove some residual crowns and roots. Teeth with persistent pain should be treated by an oral medicine specialist, because it is generally not recommended for patients to have their teeth extracted within 3 to 5 years after radiotherapy, otherwise extraction wounds may occur.

Serious consequences such as non-healing and radiation osteonecrosis seriously affect the patient's quality of life.

For patients with terminal oral cancer who are in poor general condition and have distant metastases such as the lungs, palliative treatments such as immunotherapy, targeted therapy, and traditional Chinese medicine are recommended. If the patient is unable to undergo relevant treatment for personal reasons, symptomatic treatments such as analgesia and nutritional support are required to improve the patient's quality of life to a certain extent.

Oral cancer postoperative care

What should I pay attention to?

After oral cancer surgery, a gastric tube is usually placed for 2 weeks, and nasogastric feeding is recommended (small amounts and multiple times are recommended), and oral care is provided (caregivers clean and disinfect the oral cavity about 2 times a day). For patients who have undergone free flap repair, it is generally recommended to stay in bed for about 5 days and closely observe the condition of the flap, such as the color, texture, and elasticity of the flap. If the flap is pale or cyanotic, it is recommended to undergo surgical exploration in a timely manner to reduce the risk of flap necrosis.

Patients are advised to sleep on air mattresses when they are bedridden, and limb air pressure therapy is performed after evaluation by the Department of Traditional Chinese Medicine to reduce the incidence of bedsores. After patients can get out of bed, it is recommended to get out of bed and move around appropriately to prevent deep vein thrombosis in the lower extremities. For some oral cancer patients who have undergone tracheotomy, attention should be paid to nebulizing and diluting sputum, suctioning sputum regularly, etc., to reduce the incidence of pneumonia.

At the same time, closely observe the changes in the patient's body temperature, respiration, oxygen saturation and other basic vital signs, promptly review blood routine and other infection indicators, pay attention to the healing of the incision, etc. If there is a possibility of infection, timely antibiotic anti-infection treatment. For patients with buccal mucosal cancer, mouth opening training should be strengthened after surgery to avoid severe mouth opening restriction in the long term, which affects life treatment. The company and encouragement of family members play a pivotal role in the patient's prognosis.

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How to prevent oral cancer?

According to the common risk factors of oral cancer, effective means of preventing oral cancer include the following:

Avoid smoking, drinking, spicy food, etc.

Timely handle residual crowns and roots in the mouth. For overly sharp tooth tips, it is recommended that the oral department or prosthodontist department make appropriate adjustments.

It is recommended to have oral denture restoration performed in regular medical institutions such as dental hospitals;

Timely treatment of oral mucosal diseases such as oral leukoplakia, erythema, and lichen planus;

Maintaining a healthy physical and mental state, avoiding mental stress and depression, and maintaining an optimistic spirit are of positive significance in preventing the occurrence of tumors;

Appropriate intake of vitamins A, B, E and trace elements such as selenium can reduce the incidence of oral cancer.

Source: Chongqing University Cancer Hospital

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