Oral cancer

BSC NURSING III YEAR

1. Oral cancer Mr. Manikandan.T , RN., RM., M.Sc (N)., D.C.A .,( Ph.D ) Assistant Professor, Dept. of Medical Surgical Nursing, VMCON, Puducherry .

2. Oral cancer Cancer arise anywhere within the mouth Head and neck squamous cell carcinoma Cancer includes oral mucosa , lips , tongue , soft/ hard palate ,pharynx , floor of mouth , cheeks

3. Types Basal cell carcinoma : 2 nd most common in oral cancer. Occurs on lips. Caused by excessive exposure to sunlight Squamous cell carcinoma: malignant growth arising from tiny, flat, squamous cells that lines mucous membrane. Mostly affects lower lip, tongue.

4. Causes/predisposing factors Tobacco use (chewing, cigar , cigarette , pipe , snuff) Alcohol Chronic irritation Poor oral hygiene Chronic Inflammation Prolonged exposure to uv rays Human papilloma virus Ingestion of hot foods, spicy foods

5. TNM Staging-T

6. N-node Nx Lymph node cannot be assessed N0 Cancer has not spread to lymph node N1 Cancer has spread to one LN <3cm in diameter& located on same side of the tumor N2a Cancer has spread to one LN >3cm but <6cm & Same side N2b Cancer has spread to more than one LN <6cm & same side N2c Cancer has spread to opposite side <6 cm N3 Tumor ahs spread to more than one LN >6 cm

7. M-metastasis

8. Clinical manifestations Leukoplakia : precancerous yellow- white lesion Erythroplakia : red velvety patch Ulceration Sore that does not heal Lump Sore throat Voice change Difficulty in chewing Dysphagia (late symptoms) Pain in tongue or ear

9. Diagnostics HC/PE Biopsy Oral exfoliative study Toluidine blue test –screening test for oral cancer Toluidine blue is applied topically to stain an area Cancer cells preferentially takes up the dye CT/MRI

10. Management Surgery Radiation therapy Chemotherapy

11. Surgery Excision of tumor Mandibulectomy Hemiglossectomy Radical neck dissection: tissue from jaw down to the clavicle Split thickness skin graft

12. Chemotherapy 5-flurouracil Methotrexate Cisplatin Carboplatin Paclitaxel Bleomycin

13. Nutrition Percutaneous endoscopic gastrostomy Parentral fluids

14. Nursing management Imbalanced nutrition less than body requirement related to dysphagia Chronic pain Anxiety Ineffective coping Ineffective health maintenance

15. Interventions Maintain patent airway Communication Pain management Nutrition Hygiene