What is Oral Cancer?

General Description 

Oral cancer develops in the throat or mouth. It typically starts as a small, painless white or red spot. Oral cancer can affect the gums, lips, tongue, upper palate, inner part of the cheek, or the back of the oesophagus. The common risky aspects of oral cancer include drinking alcohol, tobacco use, and exposure to human papillomavirus (HPV). As researched by the World Health Organization (WHO), oral cancer is the 13^th most common cancer in the world. In 2020, 657,000 new cases of oral cancer were reported. Furthermore, 330,000 deaths occurred due to this disease. Symptoms of oral cancer include persistent mouth sores, swelling in the mouth, difficulty swallowing or chewing, persistent bad breath, and unexplained weight loss. It is significant to see a healthcare professional if any of these symptoms persist for more than two weeks (Oral Health, n.d.).

Oral Cancer: Specific Oncogenic and Tumor Suppressor Mutations

Several oncogenic and tumour suppressor mutations have been associated with the development and progression of oral cancer. Here are a few examples:

1. TP53: The TP53 gene is a “tumour suppressor gene” that supports the regulation of cell growth and division. Mutations in TP53 are common in many types of cancer, including oral cancer. These mutations can cause the protein produced by the gene to lose its ability to control cell growth and division.
2. CDKN2A: The CDKN2A gene is another tumour suppressor gene that helps regulate cell division. Mutations in this gene have been linked with an increased threat of oral cancer, particularly in individuals who smoke or use other tobacco products.
3. HRAS: The HRAS gene is an oncogene that helps regulate cell growth and division. Transformations in HRAS have been found in some cases of oral cancer, particularly in tumours that arise on the lips. (Knopf et al., 2015)

Oral Cancer: Role of Angiogenesis and Metastasis 

Angiogenesis and metastasis are both important processes in the prognosis and development of oral cancer. In oral cancer, angiogenesis is thought to be driven by the release of growth factors and cytokines from tumor cells and other cells in the tumor environment. The creation of new blood vessels facilitates the tumor to develop and spread more effectively by providing them with nutrients and oxygen. In oral cancer, metastasis typically occurs through the lymphatic system. Cancerous cells can enter the lymphatic area and spread to lymph nodes in the neck, which are a common site of metastasis in oral cancer. If oral cancer has spread through lymph nodes, it may require more severe treatment, such as surgery or radiation therapy, to improve the chances of survival of the patient (Sakata et al., 2019).

Current Development in Diagnostics and Therapeutics

There have been several recent advancements in the diagnostics and therapeutics of oral cancer. These advances include Biomarkers, Imaging, Targeted therapies, and Immunotherapy. Researchers are investigating the use of biomarkers, such as circulating tumor cells or specific DNA mutations, to help analyze oral cancer at an earlier stage and observe the treatment response. Biomarkers could potentially allow for more personalized and targeted treatment approaches. Researchers have made advances in Imaging Technology, such as “Positron Emission Tomography (PET)” and “Magnetic Resonance Imaging (MRI)”. PET and MRI scans are improving the ability to detect oral cancer and assess the extent of the disease. Targeted therapies, which are drugs that specifically target certain molecules or pathways involved in cancer growth, are showing promise in the treatment of oral cancer. Immunotherapy stimulates the immune system of the body to attack cancerous cells. Several immunotherapy medicines have been permitted for the treatment of other types of cancerous tumors, and there is growing interest in their potential use in oral cancer. (Mouth Cancer – Symptoms and Causes, n.d.)

References

Knopf, A., Lempart, J., Bas, M., Slotta-Huspenina, J., Mansour, N., & Fritsche, M. K. (2015). Oncogenes and tumor suppressor genes in squamous cell carcinoma of the tongue in young patients. Oncotarget, 6(5), 3443–3451.

Mouth cancer—Symptoms and causes. (n.d.). Mayo Clinic. Retrieved May 6, 2023, from https://www.mayoclinic.org/diseases-conditions/mouth-cancer/symptoms-causes/syc-20350997

Oral health. (n.d.). Retrieved May 6, 2023, from https://www.who.int/news-room/fact-sheets/detail/oral-health

Sakata, J., Hirosue, A., Yoshida, R., Kawahara, K., Matsuoka, Y., Yamamoto, T., Nakamoto, M., Hirayama, M., Takahashi, N., Nakamura, T., Arita, H., Nakashima, H., Nagata, M., Hiraki, A., Shinohara, M., & Nakayama, H. (2019). HMGA2 Contributes to Distant Metastasis and Poor Prognosis by Promoting Angiogenesis in Oral Squamous Cell Carcinoma. International Journal of Molecular Sciences, 20(10), Article 10. https://doi.org/10.3390/ijms20102473