Oral Cancer Treatment in Mumbai, India

Oral and mouth cancer are serious conditions originating in the tissues of the oral cavity, including the lips, tongue, gums, floor and roof of the mouth, and salivary glands. These cancers are among the most prevalent in India, with over 1,00,000 cases recorded annually, disproportionately affecting men. Early detection and timely treatment are critical in improving survival rates and minimizing the need for aggressive interventions.

Alternate Names

• Cancer of the oral cavity and pharynx

• Mouth cancer

• Head and neck cancer

Associated Anatomy

Bones, teeth, muscles, nerves, blood vessels, salivary glands, and mucosa

Types of Oral (Mouth) Cancer

Oral and mouth cancers are classified by cell type and location:

• Squamous Cell Carcinoma (SCC): Most common, develops in the squamous cells lining the mouth and throat.

• Verrucous Carcinoma: A slow-growing SCC subtype that rarely spreads but invades surrounding tissues.

• Basal Cell Carcinoma (BCC): Develops in areas exposed to sunlight, such as the lips.

• Minor Salivary Gland Carcinomas: Includes mucoepidermoid carcinoma and adenoid cystic carcinoma.

• Lymphoma: Affects lymphatic tissues in the tongue and tonsils.

• Mucosal Melanoma: Develops in the moist membranes of the oral cavity.

• Sarcomas: Sarcomas are rare oral cancers that originate in the connective tissues such as bones, cartilage, muscles, and blood vessels.

By Location:

• Lip Cancer: Common among men, often related to UV exposure.

• Tongue Cancer: Can occur in the visible part or at the base near the throat.

• Jaw and Gum Cancer: May affect the upper or lower gums and jaw.

• Cheek and Palate Cancer: Rare, but may develop in the buccal mucosa or roof of the mouth.

Oral Cancer Symptoms

Common symptoms include:

• Non-healing sores or ulcers in the mouth or lips.

• White, red, or speckled patches (leukoplakia, erythroplakia).

• Unexplained bleeding, lumps, or crusty areas in the mouth.

• Difficulty in chewing, swallowing, or speaking.

• Persistent ear pain, hoarseness, or sore throat.

• Changes in bite alignment or loose teeth.

• Weight loss and bad breath.

If symptoms persist for over two weeks, consult a doctor or dentist promptly.

Oral Cancer Causes

The primary causes of oral and mouth cancer include:

1. Tobacco Use: Smoking cigarettes, cigars, or pipes, as well as chewing tobacco, is the leading cause of oral cancer.

2. Excessive Alcohol Consumption: Prolonged and heavy drinking irritates oral tissues, increasing cancer risk.

3. Human Papillomavirus (HPV): Certain strains, especially HPV type 16, are linked to oral cancers.

4. Prolonged Sun Exposure: Increases the risk of lip cancer.

5. Poor Oral Hygiene and Chronic Infections: Gum disease and untreated dental problems can lead to cellular changes in the oral cavity.

Risk Factors for Oral Cancer

Several factors increase the likelihood of developing oral cancer:

1. Betelnut and Paan Masala Chewing: Common in South Asia, this habit significantly raises the risk.

2. Family History of Cancer: Genetic predisposition plays a role.

3. Immune System Compromise: Conditions like HIV/AIDS or immunosuppressive therapy may elevate risk.

4. Dietary Deficiencies: Low intake of fruits, vegetables, and essential nutrients like vitamin A and C.

5. Previous Cancer History: A personal or family history of cancer can increase susceptibility.

6. Exposure to Chemicals: Occupational exposure to asbestos, formaldehyde, and sulfuric acid may contribute to risk.

7. Gender: Men are at a higher risk of developing oral cancer compared to women.

Complications of Oral Cancer

Oral cancer and its treatment can result in:

• Surgery Complications: Pain, bleeding, infection, and difficulty eating.

• Dysphagia (Difficulty Swallowing): Caused by surgery or radiation therapy.

• Dental Problems: Tooth loss or decay due to jaw shape changes.

• Speech Difficulties: Alterations in lips or tongue affecting articulation.

• Mental Health Issues: Anxiety, depression, and frustration during or after treatment.

• Carotid Artery Narrowing: Due to radiation therapy, leading to cardiovascular problems.

Diagnosis of Oral Cancer

Diagnosis involves a combination of:

• Physical Examination: Inspection of oral tissues for abnormalities.

• Biopsy: Tissue samples taken for pathological analysis.

• Imaging Tests: X-rays, CT scans, MRIs, and PET scans to determine cancer spread.

• Exfoliative Cytology: Scraping of cells for microscopic examination.

Stages of Oral Cancer

• Stage 0: Early stage, confined to the surface.
• Stage I: Tumor ≤2 cm, no metastasis.

• Stage II: Tumor 2–4 cm, limited spread.

• Stage III: Larger tumors with regional spread.

• Stage IV: Advanced stage, spread to distant organs.

Oral Cancer Treatment Options

Mouth cancer treatment depends on many factors, including the location of the cancer and the cancer stage. It also depends on the overall health of the patient and their personal preferences. Mouth cancer treatment can either include a single type of treatment or the person may have to undergo a combination of treatments.

Surgical Interventions

• Excision of tumours: Surgery types and techniques
  • The onco surgeon may remove the tumour by cutting it along with some healthy tissue surrounding the tumour to make sure that all cancer cells are removed.
  • Neck dissection: If the tumour has spread to the lymph nodes in the neck or if there is a high risk of this occurrence based on the depth and size of the tumour, then the surgeon may recommend neck dissection or removal of the lymph nodes along with some of the neck tissue.
• Reconstructive surgery post-treatment
  • After the treatment or surgery for mouth cancer, the doctor may recommend reconstructive surgery to rebuild the mouth so that the patient can talk and eat. The reconstruction surgery may involve the transplant of skin, bone or muscle grafts from other areas of the body. The surgeon may also use dental implants to replace the patient’s natural teeth.

Radiation Therapy

Radiation therapy is one of the common mouth cancer treatments. The technique uses beams of high energy (x-rays or protons) to destroy the cancer cells. When the radiation is delivered outside the body, this is known as external beam radiation. Brachytherapy is another technique that involves delivering radiation by placing radioactive seeds, capsules or wires near or inside the cancer.

Often, radiation is used after surgery to eliminate the cancer. If the cancer is in the early stages, radiation therapy may be used alone; however, it may also be used along with chemotherapy to increase its effectiveness. However, this can increase side effects such as dry mouth, jawbone damage and tooth decay. If oral cancer is in the advanced stages, radiation therapy may be used to relieve and manage the symptoms and side effects of the disease, such as pain.

Chemotherapy

Chemotherapy involves systemic treatment with chemotherapy drugs to kill the cancer cells. The drugs may be given alone or along with other drugs. Chemotherapy may be used by itself for mouth cancer treatment or it may be used with other treatments, such as surgery or radiation therapy to increase the effectiveness of the treatment.

Depending on the drugs used in chemotherapy, the patient can experience side effects, including nausea, hair loss, fatigue and vomiting. The side effects of chemotherapy can be reduced or managed by the following strategies:

• Get rest and take short naps
• Stay well hydrated
• Eat only when it’s possible
• Exercise a bit to fight fatigue
• Have medications for nausea or have some gum, mints or popsicles
• Cut your hair or shave it off in case of hair loss or start wearing scarves, hats or a wig

Targeted Therapy

• Mouth cancer can be treated by targeted drug therapy which alters some of the things that encourage the growth of cancer cells. Targeted therapy can be used by itself or in combination with other therapies like radiation therapy or chemotherapy.

• Targeted therapy uses Cetuximab (Erbitux), a synthetic immune system protein. The drug works by targeting and blocking the EGFR (epidermal growth factor receptor) protein in the cells and helps to stop or slow down the growth of the cancer cells.
• Some of the side effects of targeted drug therapy include skin rash, sun sensitivity, itching, tiredness, headache, diarrhoea, infections and fever.

Immunotherapy

• Cancer cells produce proteins that prevent the immune system from identifying them as harmful and stopping them. Immunotherapy interferes with this process and makes use of the body’s immune system to fight mouth cancer.
• Checkpoint inhibitors are drugs that block the checkpoint proteins and restore the immune system’s capability to attack harmful cancer cells and prevent them from growing. It has been seen that checkpoint inhibitors are quite effective in lung and skin cancer.
• Currently, immunotherapy is mainly used to treat advanced mouth cancer patients who are not responding to other regular treatments.

Importance of Regular Dental Check-Ups

Regular dental check-ups, at least once every six months, can help detect early signs of oral cancer. Dentists can identify abnormal growths, patches, or sores during routine exams, enabling timely diagnosis and treatment. Good oral hygiene practices also play a crucial role in preventing complications.

Oral Cancer Preventions and Awareness

Adopting healthy habits can reduce the risk:

• Quit smoking and alcohol consumption.

• Avoid betelnut chewing and excessive sun exposure.

• Maintain good oral hygiene and get regular dental check-ups.

• Vaccinate against HPV.

Mumbai hosts several awareness campaigns conducted by organizations like the Indian Cancer Society and Oral Cancer Foundation to educate the public on early detection and risk reduction.

Frequently Asked Questions

1. Which is The Best Hospital for Oral Cancer Treatment in Mumbai?

Nanavati Max Hospital is renowned for advanced treatments, multidisciplinary care, and experienced oncologists.

2. Is Mouth Cancer Treatment Covered by Health Insurance?

Yes, most health insurance policies cover surgery, radiation therapy, and chemotherapy costs.

3. Can I Lead a Normal Life During Treatment?

Depending on the treatment, you may require rest and adjustments to your routine.

4. What are The Long-Term Effects of Treatment?

Possible effects include dry mouth, tooth decay, nerve damage, and speech challenges.

5. How Can I Support a Loved One Undergoing Treatment?

Provide emotional and practical support, assist with appointments and medications, and encourage good oral care.

6. How Do I Find The Best Oncologist for Mouth Cancer Treatment?

Some ways to find the best oncologist for mouth cancer treatment include:

• Ask your doctor, friends or family members for references for the best oncologist for mouth cancer treatment.

• Do an online search for the best hospitals or oncologists who specialise in treating oral cancer and check out reviews, testimonies

• Speak to mouth cancer patients about their experience.

• Find cancer support groups in your city and get references for the best oncologists.

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