One of the most prevalent forms of oral cancer is oral squamous cell carcinoma (OSCC), a major cause of morbidity and mortality worldwide. Following a definite oral cancer diagnosis, OSCC is typically treated with a multidisciplinary approach including surgery, chemotherapy, and radiation. In contrast, conventional chemotherapy medicines may be ineffective and have a range of side effects. Many techniques have been proved and authorized for treatment and diagnostics of different types of oral cancer, while others are currently being investigated in clinical trials. This book chapter is aimed to explain the current preclinical status of nano-based techniques to successfully diagnose and treat OSCC. This book chapter would also emphasize recent theranostics approaches utilized to cure OSCC. Nanotechnology also improved cancer biomarker detection, making them faster and more sensitive. To overcome these constraints and improve in situ drug delivery, various nanoparticles have been employed as innovation drivers.
Oral cancers form one of the most common malignancies seen worldwide, with a steady increase in number over time. Surgery with the addition of adjuvant therapy forms the cornerstone of therapeutic management for these cancers. Despite excellent surgical management, loco-regional recurrences have always been of concern. This has expanded the role of radiotherapy, with concomitant therapies, allowing to establish an effective management protocol. Over the last two decades, there have been huge strides taken towards understanding these specific aspects and providing insight into the most fruitful application of radiotherapy in these patients. In this chapter, we have presented the oncologists perspective to dealing with the non-surgical aspects of oral cancer management. We have elaborated on the chronological order with which radiotherapy has evolved and provided the contemporary aspects of decision making, essential for current practice. The evidence-based approach will address all components of radiotherapy workflow from basic understanding of patient’s anatomy, planning & evaluation during therapy to the outcomes & toxicity profiles to be expected in day-to-day clinics. Established guidelines have been incorporated into the graphical representations to ensure scenario-based understanding. Future perspectives, essential for identifying the possible direction of therapy & potential improvements in outcomes, have also been addressed.
One of the most common types of cancer is head and neck cancer. Head and neck cancers are the sixth most common cancer worldwide and the most common cancer in developing countries. Oral cancer, which is a subset of head and neck cancers, refers to any cancerous growth in the oral cavity. Risk factors for oral cancer include age, malnutrition, genetic factors, family history, X-rays, papilloma virus, alcohol, smoking, tobacco, which three last are the strongest risk factors. The destructive link between tobacco products and human cancers stems from a powerful combination of two factors - nicotine and carcinogens. The highest incidence of tobacco related oral cancer is seen in low and middle income countries. The chance of curing oral cancers increases if they are diagnosed and treated early. At least three-quarters of all oral cancers can be prevented by quitting smoking and drinking alcohol. Screening programs can be valuable in patients from high-risk groups (smokers and alcoholics) or in patients with a previous diagnosis of cancer outside the head and neck.
Fine needle aspiration cytology is an important diagnostic tool in cytopathology. There are many challenges and pitfalls encountered in intraoral salivary gland cytopathology as tumours of these glands show morphological diversity and overlapping features. There are often variable solid-cystic components, metaplastic or necrotic changes, fibrosis, hyalinisation and haemorrhage accounting for heterogeneity of these tumours. The tumour profile of intraoral salivary gland is quite different from the major salivary glands and needs special attention. A low-grade malignant tumour may sometimes mimic a benign neoplasm or a non-neoplastic lesion resulting in a false negative diagnosis. Moreover, misinterpretation and failure to recognize subtle morphological and architectural patterns of cells also pose diagnostic challenges. In this chapter, we intend to highlight the key cytopathological features of intraoral salivary gland tumours and tumour-like lesions with emphasis to overcome diagnostic challenges and pitfalls to avoid misdiagnosis which will aid in planning further management and treatment.
Early stage oral cavity squamous cell carcinoma (OCSCC) has a significant risk of subclinical nodal metastases, which is the strongest independent prognostic factor for regional recurrence and survival. However current preoperative imaging modalities are unable to identify patients with micrometastases, and an observation strategy has been associated with inferior outcomes when compared to an elective neck dissection. Sentinel lymph node biopsy provides a safe and accurate staging procedure to select the patients who benefit from an elective neck dissection, while avoiding unnecessary surgery in the patients who are node negative. There is recent Level II evidence demonstrating equivalent oncological outcomes when compared with elective neck dissection. However, a multidisciplinary approach is required including reliable mapping of the sentinel lymph node, precise surgical technique and comprehensive histopathological analysis to ensure accurate results are obtained.
