[Click! Health] Oral Cancer Caused by Lifestyle Habits... Why Early Treatment Is Important

If you smoke more than one pack of cigarettes a day, your risk of developing oral cancer is about 10 times higher compared to the general population. If smoking is accompanied by alcohol consumption, the incidence rate increases even further. This is why it is important to check whether your daily habits might be causing oral cancer.

Persistent leukoplakia suspected of oral cancer
[Photo by Seoul National University Hospital]

Oral cancer is a malignant tumor that can occur anywhere inside the mouth, including the palate, gums, buccal mucosa, tongue, floor of the mouth, area behind the molars, jawbone, lips, oropharynx (the back part of the tongue), and the area connecting to the throat. Among these, it most commonly occurs on the tongue, gums including the maxilla and mandible, and buccal mucosa. According to the national cancer registration statistics, oral cancer accounted for 4,064 cases in 2020, representing 1.6% of all cancer cases.

Oral cancer typically forms in a specific area and continues to grow without disappearing. Environmental factors play a much larger role than genetic factors. Smoking, chewing tobacco, alcohol consumption, dietary habits, and nutritional deficiencies all influence its development. When alcohol and smoking are combined, the incidence rate increases by about 15 times. Poor oral hygiene or continuous irritation from dentures are among the main causes. Human papillomavirus (HPV), syphilis, and oral submucous fibrosis are also known major causes of oral cancer. Recently, the male-to-female ratio of oral cancer incidence has shifted to 2.7:1, with an increase in female cases, which is presumed to be due to the rise in smoking and drinking among women.

Professor Eun-Jae Jeong of the Department of Otorhinolaryngology at Seoul National University Hospital advised, "Early detection and treatment of oral cancer are crucial, so knowing the suspicious symptoms is helpful. If white patches (leukoplakia) or red spots, or inflammatory ulcers such as stomatitis persist for more than three weeks, or if the lesion is extensive, or if bleeding and pain continue, a biopsy and detailed examination should be performed."

Professor Jeong Eun-jae, Department of Otorhinolaryngology, Seoul National University Hospital
[Photo by Seoul National University Hospital]

As oral cancer progresses, it mainly metastasizes to the lymph nodes under the jaw, so a lump may be felt in the neck. Therefore, if you feel a mass in the neck area or experience a foreign body sensation or pain when swallowing, you should see a specialist. Oral cancer can be mistaken for stomatitis or periodontal disease, so early detection may be overlooked. Since it is a dangerous cancer that easily metastasizes to lymph nodes in the neck, regular check-ups are necessary.

If oral cancer is visible to the naked eye, it can be confirmed without an otorhinolaryngology endoscopic examination. If the lesion progresses to the tonsils or the base of the tongue, the lesion is confirmed by comprehensively evaluating the results of otorhinolaryngology endoscopy and imaging tests.

To diagnose oral cancer, a biopsy is performed by removing a small part of the suspected lesion inside the mouth under local anesthesia for microscopic examination. Oral lesions that do not heal for more than three weeks, especially those that are large or accompanied by pain and bleeding, must be confirmed by biopsy. Additionally, to determine the exact infiltration range of the lesion and to check for systemic metastasis to lymph nodes or lungs, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) are used.

Among patients diagnosed with oral cancer, especially those caused by smoking, metastasis or multiple cancers may occur in other organs such as the esophagus and lungs, so gastroscopy and additional imaging tests are also necessary.

A precise reconstruction of the jawbone after extensive oral cancer surgery using digital programs and 3D printing technology.
[Photo by Seoul National University Hospital]

Treatment of oral cancer varies depending on the stage, age, overall health, and extent of tissue loss, but surgical treatment is generally considered first. Early-stage oral cancer has a high cure rate of about 80%. However, in advanced stages, the cure rate is known to drop to around 30%.

Early oral cancer can often be treated easily within the oral cavity, and the defect area is usually small enough that additional reconstructive surgery is not required. However, advanced oral cancer requires more considerations. Usually, treatment involves surgery followed by radiation therapy or chemoradiation therapy rather than surgery alone. As oral cancer progresses, it may invade other parts of the oral cavity or surrounding structures, resulting in a more extensive surgical removal.

Since the oral structures play an important role in eating and speaking, minimizing secondary functional loss due to surgery is crucial. If facial bones such as the jawbone must be removed, appropriate reconstruction is essential as it directly affects facial appearance. Reconstruction after oral cancer surgery involves transplanting necessary skin, muscle, and bone tissue from various parts of the body such as the arms, legs, back, or abdomen to the required area inside the mouth. Recently, digital programs and 3D printing technology have been combined to replicate the patient’s removed jawbone, facial bones, and teeth exactly, helping improve the patient’s quality of life after surgery.

Professor Jeong emphasized, "Research showing a strong link between lifestyle habits and oral cancer suggests that oral cancer prevention is somewhat possible through personal lifestyle improvements." To prevent oral cancer, quitting smoking, controlling alcohol consumption, and protecting against radiation or ultraviolet rays are necessary. Many studies also indicate that intake of fruits, green and yellow vegetables, and vitamins A, C, and E can help prevent oral cancer. Hot or hard foods can irritate the oral cavity, and continuous damage from ill-fitting dentures or worn, sharp dental prostheses, as well as wounds in the oral mucosa, have been reported to potentially transform into oral cancer, so regular check-ups and improvements are needed.

Professor Jeong advised, "As with most cancers, the treatment methods and outcomes for early-stage oral cancer and advanced oral cancer differ greatly. Early cancer treatment is simple, has a high cure rate, and leaves no sequelae, but advanced cancer treatment is complex, has a low cure rate, and is accompanied by various functional declines, which significantly lowers quality of life." He added, "Therefore, for early detection and prevention of oral cancer, it is important to maintain oral cleanliness, avoid smoking, excessive drinking, and chronic irritation in the mouth, and promptly consult a specialist if suspicious lesions appear. Even in advanced cancer cases, medical professionals are doing their best to maintain quality of life and achieve a cure through rapidly advancing medical technology, so please do not lose hope and let us overcome this together."

This content was produced with the assistance of AI translation services.