CANCER OF THE ORAL MUCOSA AND RED BORDER OF THE LIPS

Let’s stop and consider the clinical features of mucosal cancer. The manifestations of cancer vary depending on the nature of the growth stage, as well as the previous diseases against which the cancer developed. On the lower lip, the process is usually painless. Initially, there is a limited compaction. The tumor grows, quickly turns into an ulcerative form. In cancer in the form of a node, which is relatively rare, you can see a rounded rapidly growing tumor, rising above the level of the red border or mucous membrane, along the periphery of which a dense roller is palpated. Sometimes reaching a diameter of several centimeters, the tumor disintegrates in the center. In most cases, the cancer begins to break down very early and looks like an erosion, and then like an ulcer. For the beginning of malignancy, a compaction at the base, determined by palpation, is typical. In the initial stage, the seal is insignificant or not clinically determined at all, then due to the rapid growth of the tumor, it increases, sometimes reaching a stony density. The ulcer usually has raised, inverted, dense edges, covered with a grayish-yellow or gray necrotic plaque; on the red border of the lips, the ulcer is covered with a dense gray coating or with bleeding, bloody-gray crusts. Injuries with sharp edges of teeth, dentures, hot food consumption, smoking, moxibustion accelerate tumor growth. Cauterizing agents can not be used for ulcers, but this is especially dangerous for malignant tumors. Inflammatory phenomena in the tissues surrounding the cancer are expressed or clinically absent. Their degree depends on the previous disease of the mucous membrane, infection of the oral cavity, as well as on the degree of malignant cancer. After cancer metastasizes to the lymph nodes, they are compacted, enlarged, and soldered to the surrounding tissues. Especially early metastasizes cancer of the tongue, which is associated, apparently, with its greater mobility. Cancer of the oral cavity and the red border of the lips refers to a cancer of visual localization, which facilitates its diagnosis, allows for examination and palpation of the lesion without special equipment. With the help of a stomatoscope, you can see earlier morphological changes. The clinical diagnosis should be confirmed by morphological studies of the tumor, i.e. cytological or pathohistological method. Cytological examination allows you to make a correct diagnosis in 90-95 % of cases. The material in such cases is taken by scraping or puncture. “Soft” cancers give abundant scraping, and from “dense” cancers the scraping is scanty, not always sufficient for research. One of the final ways to recognize cancer is pathohistological examination of the biopsy, which allows you to make the correct diagnosis in 99 % of cases. It should not be forgotten that such an injury can stimulate the growth of a tumor and have a fatal effect on the outcome of the disease. Therefore, if cancer is suspected, an express biopsy or an urgent biopsy is performed by an oncologist. It is recommended to do a biopsy under the protection of radiation therapy. If a bone lesion is suspected, X-rays are required. Dentists, as well as doctors of any other profiles, should show oncological caution when examining a patient. Whatever complaints the patient may make, an examination of the entire oral cavity and the red border of the lips is the law for the doctor. Any deviation from the norm should attract his close attention. Early manifestations of cancer can go unnoticed by the patient, and it is the duty of the doctor to detect them in a timely manner, as early as possible. The concept of “oncological alertness” is primarily the sum of specific knowledge of oncology, which allows the doctor to conduct an early, timely diagnosis of cancer.