Marcus is 73 years old. He retired from his position as CEO of a financial investment firm five years ago. He described the job as stressful and demanding but also exhilarating. His day was filled with crises, and he thrived on the adrenaline rushes. Over time, stress, poor eating habits, and chain-smoking all took their toll on his health. He was diagnosed with oral cancer five years ago.
Against medical advice, Marcus continued to drink alcohol and smoke. He recently underwent major surgery to remove half of his lower jaw, a portion of his upper jaw on the right side, and lymph nodes in his neck. He is undecided about whether he wants to have reconstructive surgery in the future. Right now, he is most concerned with recovering from the surgery and “getting back to life.”
To further complicate matters, Marcus has type 2 insulin-dependent diabetes. His doctors have told him that he has the potential to get off insulin if he develops healthier eating habits.
What is oral cancer?
Oral cancer falls under the category of head and neck cancers. Cancers are abnormal cells that divide uncontrollably. Oral cancers develop on the lining of the cheeks, gums, roof of the mouth, tongue, or lip.
What are the symptoms of oral cancer?
According to the American Cancer Society, the most common symptoms of oral cancer include:
- A sore that will not heal
- Mouth pain
- A lump or thickening in the lips, mouth, or cheek
- A red or white patch on the tongue, gums, tonsils, or lining of the mouth
- Trouble chewing or swallowing
- Persistent sore throat
- Trouble moving the jaw or tongue
- Swelling or pain in the jaw
- Changes in how dentures fit
- Loosening or pain around teeth
- A lump in the neck or back of the throat
- Weight loss
- Ear pain
What causes oral cancer?
The three major risk factors for oral cancer are smoking, excess alcohol consumption, and infections with human papillomavirus (HPV).
Smoking
Tobacco use is one of the strongest risk factors for oral cancer. Whether you use snuff, dip, chew, or dissolvable forms of oral tobacco products, they all increase the risk of developing cancers of the cheek, gums, or inner surface of the lips.
Smoking cigarettes, pipes, and cigars all increase your risk of developing oral cancer. And the more you smoke, the higher the risk.
There is also the potential that long-term exposure to second-hand smoke can increase your risk. However, more research is needed to determine whether this is the case.
Alcohol use
The combination of smoking and drinking is an especially dangerous combination. Alcohol irritates the inner lining of the mouth, which makes it easier for carcinogens found in tobacco products to enter your cells. Those who consume alcohol and smoke are 35 times more likely to get oral cancer than those who do neither.
HPV infections
Cancers caused by HPV are more commonly found in the oropharynx (throat region) than in the mouth. However, when they occur in the mouth, they are usually found in young adults with no history of tobacco or alcohol use.
Ultraviolet light
Ultraviolet light exposure increases the risk of developing cancer on the lip.
Most cancers in the mouth are squamous cell cancers. Squamous cells are thin, flat cells that line the inside and outside of the body.
Tobacco use and smoking, excessive alcohol consumption, HPV, and ultraviolet light exposure are modifiable or preventable risk factors for developing oral cancer. Having a genetic predisposition and aging are other risk factors that cannot be changed.
How common is oral cancer?
In 2021, approximately 54,010 Americans are expected to be diagnosed with oral cancer. This accounts for about 2.8% of all cancers.
Approximately 10,850 people in the U.S. are expected to die from oral cancer in 2021, accounting for about 1.8% of all cancer deaths.
What are the stages of oral cancer?
Staging is a way to consistently convey information about where a cancer is located and whether it has spread.
Stage 1
A stage 1 oral cancer meets the following criteria:
- 2 cm or smaller in size
- 5 mm or less in depth
- Has not spread to the lymph nodes or other organs
Stage 2
A stage 2 oral cancer is either larger or deeper than a stage 1 cancer, but it has not spread to the lymph nodes or other organs. It meets one of these two criteria.
- 2 cm or smaller in size and 5mm-10mm in depth
- Between 2 and 4 cm in size, 10 mm or less in depth
Stage 3
In stage 3 oral cancer, either the tumor is larger or deeper than a stage 2 cancer, or it has spread to a single lymph node. It meets one of these two criteria.
- Larger than 4 cm in size or 10 mm or more in depth, but has not spread to lymph nodes or body organs
- The cancer is any size and has not invaded any mouth structures, but it has invaded one lymph node, and the lymph node is 3 cm in size or less.
Stage 4
In stage 4, the tumor has invaded structures in the mouth or spread to other parts of the body.
Marcus has stage four cancer as it has invaded both his upper and lower jaw, the skin overlying the jaw, and several lymph nodes on the right side. Marcus had a feeding tube placed after surgery. He is scheduled to have radiation therapy and then be evaluated for reconstructive surgery.
What is the life expectancy of someone with oral cancer?
The average age of diagnosis for someone with oral cancer is 62 years old. Approximately one-fourth of cases are diagnosed in people under the age of fifty-five.
The five-year life expectancy for someone with oral cancer is 66.9% when compared to someone who does not have cancer. This means that 66.9% of people who would have been alive if they did not have oral cancer will still be alive at the five-year mark. It excludes those who die from other causes.
It is important to keep in mind that these numbers are estimates based on large groups of people, and each person’s situation is different.
Factors that affect life expectancy
The following factors may also impact how long someone with oral cancer might live.
- How early the cancer was caught
- How aggressively the cancer is treated
- Lifestyle factors such as tobacco and alcohol consumption
- Whether there is a genetic predisposition
- The presence of other chronic medical conditions
The survival rates are higher in people whose cancer is associated with HPV infections than in those who develop cancer secondary to alcohol and tobacco use.
There is a strong association between smoking and tobacco use and developing oral cancers. People who cannot quit smoking after they are diagnosed with oral cancer will have more problems with wound healing, a higher incidence of side effects associated with cancer treatment, and a higher risk of infections. All these factors combined worsen their prognosis.
Survival based on cancer stage
Survival can also be broken down by the oral cancer stage at diagnosis.
- Localized cancer: 85.2% five-year survival rate
- Regional spread of cancer: 67.9% five-year survival rate
- Cancer has metastasized or distant spread: 40.2% five-year survival rate
- Unknown stage: 55.6% five-year survival rate
How can home healthcare help you recover from oral cancer surgery?
Marcus needed help with managing his feeding tube after surgery. A Sunland Home Care and Medical nurse was scheduled to come to Marcus’ home twice daily to administer his tube feedings and medications and check his blood sugar. His diabetes has been well controlled while he has been using tube feeding.
Marcus expects to need help for the next three to four weeks. He has also requested in-home services from Sunland Home Care and Medical caregivers. He needs assistance with personal care and housekeeping chores. If all goes well, he will undergo reconstructive surgery and eventually have his feeding tube removed.
Sunland Home Care & Medical can:
- Prepare and administer tube feedings.
- Provide the care your family would if they were able.
- Allow you to conserve your energy for more enjoyable tasks.
- Help with personal care tasks.
- Do light housekeeping and meal preparation.
- Review and prepare medications.
- Check post-op wounds.
