Oral Cancer and Medical Malpractice

Oral cancer is the uncontrollable growth of cells that invade and inflict damage in areas involving the lips, tongue, cheek lining, floor of the mouth, gingiva, and palate. Men are twice as likely to have oral cancer, specifically men over the age of 40. Risk factors include smoking/tobacco use; heavy alcohol use; chronic irritation from rough teeth, dentures, or fillings; human papilloma virus infection; family history; excessive sun exposure; taking immunosuppressants that weaken the immune system; and poor oral hygiene. Oral cancer can present with a sore, lump, or ulcer in the mouth that initially is painless; however, as the cancer progresses it may evolve into a burning sensation or pain. The area may appear pale colored or it can be dark and discolored. Other symptoms include dysphagia (difficulty swallowing), odynophagia (painful swallowing), chewing problems, speech difficulties, lymphadenopathy (swollen lymph nodes), and weight loss.

iStock_000018882292XSmall.jpgTo diagnose oral cancer, your physician or dentist will examine your oral cavity and if a suspicious lesion is identified then an oral brush biopsy may be performed. The test is painless and involves isolating and analyzing a small sample of tissue for abnormal cells. However, if the lesion is more concerning then a scapel biopsy is recommended to determine whether the area is malignant or benign. X-rays and CT scans may be utilized to determine if the cancer has metastasized. Other tests that may be conducted include endoscopy, barium swallow, or PET scan. 90% of oral cancers are squamous cell carcinomas. Squamous cells are thin, flat cells that line the lips and oral cavity. Squamous cell carcinoma often develops in areas of leukoplakia, white patches of cells that do not rub off. Other types of oral cancer include adenocarcinoma, lymphoma, melanoma, or teratoma.

If oral cancer is not diagnosed early, it can be life threatening. Treatment is dependent on the stage of the cancer which is determines by tumor size, lymph node involvement, and metastatsis. Surgery is recommended if the tumor is small enough and has not spread to the lymph nodes. Complications of surgery include disfigurement of the face, head, and neck. Often surgery is combined with radiation. Complications of radiation include dry mouth and dysphagia. When dealing with larger tumors, chemotherapy is recommended. Speech therapy is also essential to improve and retain movement, chewing, swallowing, and speech.

Depending on the presentation of the oral cancer, approximately 50% of individuals with oral cancer may survive greater than 5 years following diagnosis and treatment. If the cancer is identified early before significant metastasis, then the cure rate may be almost 90%; nevertheless, the majority of oral cancers have metastasized prior to diagnosis. One in four individuals with oral cancer will die due to delayed diagnosis and treatment. To prevent oral cancer, individuals should avoid smoking/tobacco, moderate or avoid alcohol use, and practice good oral hygiene