A malignant neoplasm of any structure or tissue within the oral cavity. Most oral cancers are squamous cell carcinomas which commonly involve the lips, lateral border of the tongue, floor of the mouth, and retromolar area (posterior to the third molars). The clinical features of oral cancer can include long-standing asymptomatic ulceration, firmness or hardness on palpation, and, in advanced cases, hard cervical lymph nodes with loss of weight and pale complexion. Some cancers may appear as velvety red patches (erythroplakia) or may arise from pre-existing raised white patches (leukoplakia). Causative agents include carcinogens in tobacco (smoking and smokeless tobacco including paan), and sunlight on the lips. Alcohol itself is not carcinogenic but it potentiates the effects of carcinogens by increasing the permeability of the oral mucosa. Oral squamous cell carcinoma infiltrates local tissues and spreads via the lymphatics to the cervical lymph nodes, where it may escape into the tissues of the neck. Oral cancer screening is an important part of routine dental examinations. Early diagnosis by biopsy is essential for a good outcome prognosis. Treatment is by surgical excision which may be accompanied by radiotherapy. The prognosis tends to be generally worse when tumours arise in the more posterior parts of the oral cavity and oropharynx, when they are large, or have spread to the cervical lymph nodes and tissues of the neck. The incidence of oral cancer is rising particularly in the young and this may be related to an increase in alcohol consumption.
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