Lip cancer: the first signs, phases, symptoms,
treatment
oral cancer treatment
oral cancer treatment
signs of mouth cancer | How to Recognize the Signs of Oral Carcinoma
What is lip cancer?
How harmful it is to the body
Causes of lip cancer
Precocative diseases of the lips
Symptoms of lip cancer
Stage of lip cancer
Diagnosis of lip cancer
treatment
perspective
Frequently asked questions about the patient
Any malignant tumor is dangerous due to its secrecy. As a rule, a significant amount of time passes from the beginning of growth to the moment of its identification. The tumor has time to spread throughout the body and affect the lymph nodes. Unlike most cancers, lip cancer is often diagnosed in the early stages. Because of this position, it can be easily detected and start treatment in a timely manner.
It should be noted that in 98% of the tumor affects the lower lip. The development of cancer on the upper lip is a case study - only a few dozen cases have been registered in the world. Given this point, in most cases, it is possible to exclude the presence of an oncological process, with the defeat of the upper lip.
What is lip cancer?
Despite the widespread use of the term "cancer", its essence is not understood by all patients. What does he like? Normally, the whole body is made up of cells and fibers of the connective tissue. A group of identical cells creates tissue (muscle, epithelium, glandular, etc.) that forms the organ (skin, kidney, liver, etc.).
The superficial part of the lip consists of several layers of identical flat cells, arranged in a certain sequence. With the development of the cancerous process, some of them change - acquire a different form, modify their metabolism and their resistance to various physical factors (heat, cold, radiation). However, the most important variation occurs in the genetics of these cells - they start to share uncontrollably.
Lip cancer (squamous cell carcinoma) is a chronic disease in which the normal cell structure and their excessive reproduction
How harmful it is to the body
Cancer cells have changed the metabolism, due to what they produce substances that poison the person. By multiplying them reasonably, they can spread throughout the body, projecting cancer cells into vital organs: the heart, the lungs, the kidneys, the liver and others. Patients with Phase 4 carcinoma often do not die from the presence of excessively multiplied cells, but from the inadequacy of the functions of the previous organs.
Furthermore, the malignant process affects the human lymph nodes and disturbs the functioning of the immune system. Because of this, a patient with lip cancer is more susceptible to the effects of viral and bacterial infections.
Causes of lip cancer
Because lip cancer is not clear nowadays. In most cases, the onset of a tumor is often preceded by a chronic inflammatory process. It can be caused by the following factors: Lip cancer symptomsChronic / normal infections on the lower lip (bacterial or viral cheilitis);
Permanent mechanical loss of the lip - presence of a malocclusion, a sharp edge of the carious tooth, improper dental prostheses, etc;
Regular chemical / thermal damage to the skin of the lips - it is not known with certainty whether lip cancer can result from smoking, alcohol or hot food, but all these factors can contribute to the oncological process;
Professional hazards - regular contact of the face with various heavy metal compounds (bismuth, mercury, antimony, etc.), Arsenic, alkaline / acid vapors;
Some climatic conditions - constant overheating / hypothermia of the skin of the face, changing the insolation regimen (sunburn in the aggressive solar regime) risk factors for lip cancer.
Furthermore, an important role belongs to human inheritance. If close relatives had a tumor process (malignant and benign) or suspected of them, it is considered an important risk factor for cancer.
Precocative diseases of the lips
In the course of numerous clinical studies, doctors have discovered that there are diseases that always go to lip cancer. Precompuctive conditions are called mandatory (also mandatory). This process can be slowed down and even completely stopped, however, only if the patient has been treated properly and taken regularly.
Furthermore, there are diseases that can cause squamous cell carcinoma of the lip, without proper therapy. They are called optional (also - possible) precancer.
Mandatory precursor
The diseases that belong to this group are only three. They differ significantly in the appearance and tactics of the treatment, but they have one thing in common: they all sooner or later go to the initial stage of lip cancer. Below is a brief description of the mandatory precancerous conditions and their characteristic symptoms:
Name of the disease External signs of the disease
Heilit Manganotti
Erosions that constantly emerge on the surface of the lips, pink or pale. These defects persist for several months, after which they heal. The ulcers do not bleed, there is no redness or pain of the lips around them.
The relapse of the disease occurs in 1-3 months.
The limited hyperkeratosis With this pathology on the surface of the lips you can find a small area, covered by a layer of cornea scales. Independently to separate them, as a rule, it is quite difficult. Below the site of keratinization, a hemorrhagic epithelium is found. Stairs can, like climbing over the unchanged skin and being immersed in it.
In the foreground Externally it looks like a small lump (3-9 mm). It is found on the surface of the skin of the lips, has a pink or pale color and is covered by small scales.
Each of these diseases is easy to detect due to the characteristic external signals. At the slightest suspicion of obligatory precautions of the lip, it is advisable to immediately consult a doctor.Optional precancer
It is a larger group, represented by the following diseases:
Chronic cheilitis - inflammation of the mucous membrane and of the skin of the lips, which lasts more than two months. The causes may be different: allergy, bacterial or viral contamination, fungal infection, etc;
Radiant stomatitis is the most severe form of inflammation of the oral mucosa (in particular, alveolar processes). More often, it occurs after radiotherapy or work with radioactive isotopes;
Leukoplakia - keratinization of all oral mucosa, accompanied by inflammatory symptoms (pain with chewing, redness of the mucous membranes, swelling, bleeding gums);
Papilloma is a benign tumor from the skin of the lips. On the outside it seems the formation of a rounded shape, a little protruding from the front. Color does not differ from surrounding tissues;
Keratoacanthoma - another tumor of the lip, round or oval form with a slight occidentalization / ulcer in the center. Disappear by itself for several months (up to 6).
These diseases do not always lead to cancer of the lower lip, but their presence is an unfavorable prognostic sign. Timely therapy can prevent the development of a malignant process, which is much harder to treat than the precancer.
Symptoms of lip cancer
The first signs of cancer
As a rule, external changes on the lip occur shortly after signs of tumor intoxication. Patients may complain of persistent weakness, which persists throughout the day. There is a decrease in appetite and a slight loss of body weight (within 2-3 kg). The patient is often worried about a headache and a small fever for a fairly long time (up to 37.8 ° C).
These signs of lip cancer can be the only manifestations of the disease. As a rule, the external signs of the tumor begin to appear after several weeks or even months after the development of intoxication.
What does lip cancer look like?
In the region of the lower lip a small area is formed, covered by a gray crust. As a rule, it rises rather above the surrounding skin. In the initial stages of the disease, it is painless during palpation and is much denser than the invisible tissue of the lips.
If you remove the crust, then under it you can find red tubercles of various sizes, firmly fused with the underlying skin.
Progression of lip cancer
If the first signs of lip cancer have not been found treatment - the tumor will continue to develop. It will increase considerably in size, take the form of a large knot and will affect the surrounding tissues. The patient will have new symptoms, such as:
Pain in the lower area of the lip may be of varying intensity, from mild discomfort to unbearable painful irritation. As a rule, it increases with palpation;
Itching of the skin of the lips;
Difficulty during the meal - due to the pain, the patient saves the lower lip.
In some patients, part of the tumor tissue can necrotise (dead). What will the lip cancer look like in this case? It will take the form of an ulcer. In the center will be defined groove with irregular edges, painless when probing. At the edge appears a significant compaction of the skin, which can spread to the chin or cheeks.
With a prolonged course of the process, lip cancer begins to affect the surrounding lymph nodes (chin, occipital, cervical, etc.) and spreads the metastases - parts of the cancer cells. When they reach different organs, they continue to multiply, which leads to the breakdown of vital functions.
Stage of lip cancer
In the diagnosis of the patient, it must indicate the stage of the cancer of the lip, for example - Squamous cell carcinoma of the lower lip of phase III (T 2 N 1 M 0). What do these TNM letters mean, the numbers and the stage connected to them? All signs indicated in the diagnosis are necessary for a purpose - to determine the prevalence of cancer throughout the body.
The TNM classification is an abbreviation of three words that characterize a malignant tumor:The tumor size (Tumor) - can take values from 1 to 4. If the cancer is assigned a value of T 1 -T 3, this means that only the tissues of the lip are affected. T 4 is, in principle, inoperable tumors that develop in the surrounding organs (jaw, tongue, throat, etc.);
Lymph node disease (Nodus)
N 0 - no damage to the lymph nodes.
N 1 - a small increase in a near lymph node (up to 3 cm);
N 2 - if in a lymph node there is a great focus of cancerous growth (node greater than 6 cm) or in several small knot foci (up to 6 cm);
N 3 - different lymph nodes are significantly enlarged (more than 6 cm).
The presence of metastases (metastases) - the absence of metastases is indicated by M 0. Availability - M
Given these three points, the cancer phase is exposed:
Stage T N M
I 1 0 0
II 2 0 0
III 3 0 0
1-3 1 0
IV 4 0 0
Any value 2/3 0
Any value Any value 1
Why do you need to know the stage of lip cancer? From this will depend on the tactics of the doctors, the choice of treatment and the prognosis for the patient. This question needs to be approached very carefully and use all the diagnostic methods necessary to determine the prevalence of the tumor.
Diagnosis of lip cancer
It is possible to detect a tumor on the lower lip with the naked eye, but in order for the diagnosis to become reliable, it must be confirmed by laboratory methods of investigation. To study the spread of the tumor, the presence of metastases and lesions of the lymph nodes can be performed using instrumental diagnostics.
Laboratory diagnostics
Cytological examination
Until now, this method is the "gold standard" in the diagnosis of any cancer. The principle is simple - it is necessary to take a sample of cells from a suspicious area, stain and look under a microscope. If it differs from normal ones or one observes their excessive division, this is a reliable confirmation of the nature of cancer of the disease.
There are several methods of cell collection: scraping, puncture (drilling and suction), thin cutting with scalpels or drums, etc. The preferred method is determined individually by an oncologist.
Biomarker study
Cancer cells release special chemicals that can be found in the patient's blood. This method is used much less often than the cytological method, as it is expensive and not quite accurate (the probability of error is 15-24%). In general, biomarkers are examined in cases where it is impossible to examine the cells under a microscope or if the doctor remains in doubt about the correctness of the diagnosis.
For lip cancer, the P53 and KI-67 markers are specific.
Instrumental diagnostics
Roentgen of the lower jaw
The most accessible method that allows to evaluate the presence / absence of the germination of cancer in the bone. Its accuracy is much lower than the CT, however, because of its low price, it has become widespread. At T 4 on the sighting image you can see the darkness focus, irregularly shaped. As a rule, it is distinguished in a fan-like fashion in different directions - this is a characteristic sign of cancer growth.CT, MRI of the face and neck area
These research methods allow to accurately assess the spread of cancer in this area. With the help of MRI, assess soft tissue damage (tongue, pharynx, lymph nodes, etc.). On a computer tomogram, bone changes are better defined.
Fluorescent diagnosis
A modern way to evaluate tumor growth. With the help of a special device that emits waves of a certain frequency, suspicious tissues are studied. The method is absolutely safe, human irradiation does not occur. Exactly, it is related to MRI or CT. The disadvantage is a small prevalence in the Russian Federation.
treatment
What is the basis for lip cancer treatment? Cancer cells are less resistant to various external factors, such as cold, radiation, ultraviolet light, etc. All destroy altered tissues, leaving health almost intact.
The treatment method is selected according to the stage of cancer spread of the lower lip throughout the body. It is recommended to use local methods if:
if it was limited to the lower lip and the underlying tissues;
do not separate in the lymph nodes;
there are no metastases in other organs.
In other words, they are used for T 1-4 N 0 M 0 tumors. In other cases, with the involvement of the lymph nodes or the appearance of metastases, chemotherapy is used.
Local treatment methods
Cryosurgical method
This new technology can greatly improve the patient's prognosis after treatment and reduce the risk of re-emergence of the disease. The principle of the method is as follows: first the cancer of the lip and the area around it are treated with cold, after which the affected tissues are excited with a scalpel or coagulated (argon-plasma, electrical or other scalpel changes). The cold destroys the tumor cells and creates a delimitation tree, which allows the surgeon to perform the operation with great precision.
Radial + surgical method
The combination of surgical removal of lip cancer and irradiation of the affected area has become widespread in Russia. After the excision of the tumor, it is likely that a part of the pathological cells will persist. To permanently destroy these remains, while preserving healthy tissues, they use targeted radiation.
Photodynamic therapy
The most modern method, which has shown its high efficiency and safety. Three components are needed to lead it:
Photosensitizer - a drug that increases the sensitivity of cancer cells to ultraviolet;
An ultraviolet light source;
Access of oxygen to the affected area.
The patient is given a special drug-photosensitizer, after which they act on lip cancer with ultraviolet light. With photodynamic therapy, there are practically no adverse reactions, and there is an insignificant number of relapses. Unfortunately in Russia this method is very limited, due to the high costs.
Principles of chemotherapy
If the tumor has already spread through the body, it is practically ineffective to affect only the cancer of the lower lip. This will not stop the progression of cancer, but in some cases it can improve the condition of the patient. In the presence of metastases in the organs and lymph nodes, chemotherapy is the preferred method of treatment.Currently, there are a large number of drugs that reduce cancer growth and destroy altered cells. Choosing an optimal combination of drugs and making an appropriate appointment can only be an oncologist.
perspective
With a timely treatment of the initial stages of lip cancer (up to the third), the prognosis is favorable. The use of modern methods has allowed us to provide a 5-year survival rate of almost 90% of patients. The recurrence of tumors occurs in 30-34% of cases.
If lip cancer is detected at stage 4, it is often impossible to treat the disease. Since it is extremely difficult to eliminate all sites of tumor growth (metastasis, lesions of the lymph nodes, tissues of the head). Remission can be achieved in 20-30% of patients. In other cases, palliative treatment methods are used to alleviate the symptoms of the disease.
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