Oral Cancer

About Oral Cancer

Oral cancer arises within the mouth, including the tongue, gums, lips, cheek lining, palate and floor of the mouth. It often presents as a non-healing ulcer, growth or thickened patch. Tobacco in any form and excessive alcohol are the strongest risk factors. Because untreated tumours can spread aggressively, early evaluation by a specialist team is essential.

Most cases occur after the age of fifty, but younger adults are increasingly affected. Men carry a higher risk than women, and a diet low in fresh fruit and vegetables adds to vulnerability. Importantly, more than a quarter of oral cancers occur in non-smokers and only occasional drinkers, so any persistent oral lesion deserves a careful look regardless of habits.

Self-examination is recommended yearly, and every three months for tobacco users. Any swelling, ulcer or lesion lasting more than two weeks should be evaluated. At our Lucknow clinic, suspicious areas are biopsied and, if cancer is confirmed, staged with a contrast-enhanced CT of face and neck and FNAC of any enlarged neck node before final treatment planning.

Treatment generally combines surgery to remove the tumour with selective use of radiotherapy or chemotherapy. Pre-operative steps include imaging, photographs, blood arrangement, and a detailed discussion of tracheostomy, ICU care and possible microvascular re-exploration. Dr. Agarwal, FRCS Edinburgh, ensures each patient and family understands the plan, the recovery and the importance of follow-up.

Surgery is performed under general anaesthesia and may include tracheostomy, nasogastric tube placement, neck node dissection, wide local excision of the tumour and reconstruction with bone, muscle or skin transfer using microsurgical vessel anastomosis. The aim is to restore appearance and function as close to normal as possible while clearing the cancer with safe margins.

What to expect

• Biopsy, CT and FNAC for accurate staging
• Multidisciplinary planning with oncology support
• Wide local excision with safe surgical margins
• Selective neck lymph node dissection
• Microvascular reconstruction using bone, muscle or skin
• Tracheostomy and ICU care when indicated
• Coordinated radiotherapy or chemotherapy where required

Recovery

• ICU monitoring for the first few days
• Ryle's tube feeds while the mouth heals
• Head elevation and gentle Betadine mouth rinses
• Dressing changes and drain removal as advised
• Gradual return to oral feeds and mouth-opening exercises
• Radiotherapy started six to eight weeks after surgery if needed