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Where Does Oral Cancer Spread to and What are Its Stages?

Oral cancer develops in the tissues of the throat and the mouth. To be precise, the squamous cells in the mouth, lips and tongue are affected by cancer. 

Most cases of oral cancer are only detected after cancer has spread to the lymph nodes located in the neck. Early diagnosis is key to a higher chance of success when it comes to battling oral cancer. 

Oral cancers can be of many types depending on the affected area. Some types of oral cancers are cancers of the tongue, lips, the inner lining of the mouth, gums, mouth floor and palate. 

Dentists are generally the first people to identify this type of cancer. Simple annual check-ups can help you diagnose oral cancer before it is too late.  

Oral Cancer Symptoms and Risks

Some early signs of oral cancer include a sore in your mouth that does not heal, an unusual lump in your neck, bleeding from the mouth, persistent earaches, a mass or growth anywhere in your oral cavity, weight loss and numbness. 

It is beneficial to be proactive and visit the doctor so that cancer can be diagnosed early and oral cancer treatment can begin from the early stages itself.  

Apart from this, oral cancer can be a result of some unhealthy habits like smoking and consuming alcohol in large quantities. An HPV infection, genetics, returning cancers, weak immune systems and poor nutrition are all factors that could lead to a person contracting oral cancer.  

Diagnosis of Oral Cancer

When a patient visits the top oncologist in India after experiencing symptoms that indicate the possibility of cancer, doctors begin closely examining the roof and floor of the mouth, the lining of the cheeks, tongue and the lymph nodes located in the neck. 

If a lump is found, a brush or tissue biopsy is conducted by collecting cells from the tumour site. After the cancer is confirmed or to collect more data, doctors may also recommend physical tests like X-rays, CT scans, MRI scans or endoscopies to examine the oral cavity in higher detail and diagnose cancer accurately.  


Oral Cancer Staging System

The right treatment strategy can only be decided upon once cancer has been diagnosed correctly. A top oncologist in India will first study the tumour and decide what stage the cancer is on. 

Based on the stage of cancer, a treatment plan is designed to ensure the best results. Most oral cancers are staged using the American Joint Committee’s TNM system. This is a commonly accepted method for cancer staging and revolves around three key data points: 

  • T (Tumour)- This defines the original size of the tumour when it was diagnosed.  
  • N (Node)- This is a simple metric that indicates whether or not cancer has spread to the lymph nodes.  
  • M (Metastasis)- This represents whether cancer has spread to other parts of the body.  

Along with these three measures, a number ranging from 0-4 is attached to each factor. The higher the number, the higher is the severity of that factor. For example, a T1 tumour would be smaller than a T4 tumour. In some cases, the letter ‘X’ is used to indicate that the detail could not be assessed.  

Stages of Oral Cancer

    • Stage 0: At this stage, the cancer is only growing in the epithelium, which is the outermost layer of tissue in the oropharynx. This indirectly indicates that no harmful cells have been found at the neck. Lymph nodes and other nearby cells.  
    • Stage 1: This stage is when the cancer tumour has grown to about 2cm across. At this point, the cancer cells have still not made it to neighbouring sites in the patient’s body.  
    • Stage 2: Any tumour that lies between 2 and 4 cm in size is classified under stage 2. Even at this point it is assumed that no cancer cells are present in places other than the affected site.  
  • Stage 3: In stage 3, there are two possibilities of how the tumour has spread. Either the individual tumour has surpassed the size of 4cm across or that the initial tumour has spread to one lymph node regardless of its size. It is also important that the affected lymph node is on the same side of the head or neck as the primary tumour for it to be called a stage 3 tumour.  
  • Stage 4: Stage 4 cancer is difficult to understand due to its complex nature. It generally means that the cancer cells have spread to both lymph nodes or that the size of the tumour has surpassed 6cm. It also indicates the possibility of cancer having spread to deeper parts of the tissue and/or other nearby organs which is the lungs in most cases.
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