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Thursday, May 27, 2010

Oral Cancer – Statistics, Risk factors, Signs and Symptoms, Diagnosis and Treatment


Oral cancer can be defined as an abnormal, malignant growth of tissue in the lip, mouth and oropharynx. Oral tumors can develop anywhere in the oral cavity and can be benign (non-cancerous), precancerous (potential to become cancerous), and malignant (cancerous).

Statistics for Oral Cancer:

Approximately 35,000 Americans are diagnosed each year with oral cancer that causes about 8000 deaths, killing roughly 1 person per hour. There has been no significant improvement in the statistics over the decades. India has one of the highest incidences of oral cancer in the world. However, if we consider the worldwide statistics, the problem is much greater as there are more than 400,000 new cases found every year.

Cancers involving the head and neck region are found mostly in people above the age of 45. The incidence of Oral cancer is highest of all cancers amongst men (12%) as compared to women (8%). See Oral Cancer Incidence (New Cases) by Age, Race and Gender.

Another alarming fact is that the death rate of oral cancer is higher than that of other cancers like Hodgkin’s Lymphoma, cancer of the larynx, endocrine cancers, skin cancer or cancer of the testes. The most probable cause for the high death rate could be the fact that oral cancers are mostly detected in their later stages when the cancer cells have already migrated to other sites through the lymph nodes thereby making it more difficult to treat. However, oral cancer can be detected early if the patient comes to the dentist in time and the dentist is able to diagnose the condition correctly. Oral cancers can be of several different types, but it is found that about 90% of them are squamous cell carcinomas.

Risk factors:

There are several risk factors that can be associated with oral cancers. Understanding these factors can help in preventing its onset.

Ø One of the prominent factors to be considered is the age. (above 40)
Ø Most oral cancers can be related to the excessive use of tobacco and or alcohol. In India, oral cancer has been linked to the use of betel nut chewing, cigarette or bidi smoking and the use of tobacco in products like Gutka etc.
Ø Biological factors include viral and fungal infections: Most commonly the human papilloma virus, particularly HPV16 has been found to be associated with oral cancers that occur in the back of the mouth.
Ø Other than lifestyle factors there are also physical factors like exposure to ultraviolet radiation and exposure to x-rays.
Ø Nutritional factors like diet that is deficient in fruits and vegetables could become a risk factor.

Signs And Symptoms Of Oral Cancer:

In majority of cases oral cancers remain unnoticed in their early stages due to the fact that it is painless and the patient may ignore other symptoms like color changes of the mucosa or small lumps. But, if the patient does land up at the dentists office in time then the dentist or even a doctor can detect the minor tissue changes while it is still very small.

Oral cancer may appear as red or white patches of tissue in the mouth or sometimes even as a small indurated ulcer that appears like a canker sore. Most of these signs and symptoms may appear like any other benign tissue changes that occur commonly in the mouth, like a cheek bite, and therefore it is very important to have any such discolorations or ulcers that do not heal within 14 days to be examined by a professional.

Oral Cancer 
Lesion 
Oral Cancer Lesion

There may be other symptoms like small lumps or masses in the oral cavity or neck with pain and difficulty in swallowing, speaking, chewing and or hoarseness which may last for a long time. There may also be numbness in the oral or facial region or a unilateral persistent earache that may serve as adequate warning signs to visit a doctor.

Establishing a Diagnosis:

The dentist or doctor can quickly establish a firm diagnosis of the oral cancer by doing a biopsy of the tissues involved. The procedure is inexpensive, painless, doesn’t take much time and generally can be done under local anesthesia.

There may be many other factors that also need to be established before any treatment can be initiated. The doctor may advise various other investigations like dental x-rays, chest x-rays, CT Scan and MRI to rule out any other underlying conditions.

Apart from the age and the general health of the patient, the extent of treatment for oral cancer will also depend upon the location, size, type, extent of the tumor and the stage of the disease.
Determination of the stage of cancer in the lip or oral cavity is important in order to plan the best course of treatment.

Treatment of Oral Cancer:

Cancer that involves the lip or oral cavity can be treated best if detected in the early stages, like most cancers that involve the other parts of the body.

The treatment of oral cancer may involve surgery, radiation therapy or a combination of both, and or chemotherapy. It is recommended that the patient should get a complete dental examination before any treatment is carried out. Cancer treatment makes the mouth sensitive to infection and so it is advisable to get all the fillings, extractions and prosthesis work done prior to any surgical or radiation therapy. A thorough prophylaxis, or cleaning should be done as well. Taking care of the oral health before any other procedure ensures minimal post-therapeutic complications.

The treatment of oral cancers involves the efforts of surgeons, radiation oncologists, chemotherapy oncologists, dental practitioners, nutritionists, rehabilitation and restorative specialists.

Surgery:

surgery is the usual treatment undertaken to remove tumors from the mouth in patients with oral cancer. The different surgical techniques that are used to remove specific oral tumors includes- Primary tumor resection, mandible resection, maxillectomy, Moh’s micrographic surgery, laryngectomy and neck dissection in cases of extensive involvement of the lymph nodes in the neck.

Radiation Therapy:

Radiotherapy is a treatment that involves high-energy rays that damages the cancer cells and stops their further growth. The therapy is localized to the area where cancer cells are found just like the surgical therapy. The radiation may be given externally or internally with the help of machines or radioactive materials. Some patients may require a combination of both surgical and radiation therapy.

Chemotherapy:

Chemotherapy involves the use of medications that kill the cancer cells by their ability to interfere with it’s replication. Researchers are still looking for effective drugs or combination of drugs to treat Oral cancers and are also exploring ways to combine chemotherapy with other treatment modalities to destroy the cancer cells and prevent it from spreading. Chemotherapy is also used in combination with surgery and radiation therapy in severe cases.

After Effects of Oral Cancer Treatment:

Side effects of oral cancer treatment will vary depending upon the type and extent of treatment and area being treated, which can be temporary or permanent. There may be swelling, sore mouth, difficulty in chewing or talking or swallowing, changes to appearance, fatigue, lowered immunity and a lack of appetite due to nausea, vomiting and others. Therefore such patients need to be rehabilitated.
Rehabilitation varies from person to person depending upon the extent of oral cancer treatment and it involves – dietary counseling, reconstructive surgery, prosthesis, speech therapy and other adjunctive therapy to assist in chewing of foods and the problems associated with the lack of salivary function.

Extremely detailed overview of oral cancer in all respects.

Original article posted on Xomba

Trying To Get Some Sleep On A Saturday Afternoon?

Now, I have the habit of taking a small nap every afternoon, every single day. If I don't get that nap then I get very irritable by the end of the day. But, trying to get some sleep on a Saturday afternoon.......

Yes, it's Saturday again. The weekend is here, hooray! The whole long week is over. My husband has a five day week and so his weekend starts on a Saturday. Well, at last I can have a peaceful sleep in the afternoon, since my husband too likes to relax, you would think, No?

Come Saturday and we finish all our morning chores on time including having lunch and then with much anticipation of a good long nap we both hit the bed. Ahhh....All set for some good sleep.

Triiing...Trrrrriiing, rings the phone shrilly, shattering all the peace. Wrong number! Groaan, Curse loudly. Slip into the covers again. My eyes have just closed and am preparing to slip into a trance, when another shrill Trriiing...Trring wakes me up cruelly! My husband's cell phone. Turns out to be a poor salesman of some company working on a Saturday afternoon! My husband warns him of the consequences if he received any other call from him ever in the future and specially on a F****G Saturday afternoon.

I tell my husband to switch off his phone and go to sleep, for C***sakes! OK, finally we are all settled in and ready to visit dreamland. Oh no..Not so fast mister. Squaaak..Squaak goes the doorbell. (Yes, we have a funny sounding doorbell)! I get to the door and find someone who's come to meet my husband regarding some office work....

Now, finally I manage to calm myself and try to sleep. Okay, I am almost there...drifting, drifting, drifting. Suddenly, I feel as if I am falling down and get up with a jerk. Oh, just a dream. Try the whole process again. I must have just closed my eyes for a minute, (I feel) when my son comes and wakes me up to tell me it's five O'clock. Time for him to go out and play. Can I make his milk?

Oh, no, I grooan...Five already???

Well, that's how it is every Saturday afternoon! I must be the only "crackpot" who waits eagerly for a Monday!

Original post on Xomba

Bulimia Nervosa an Eating disorder - Statistics, Signs, Symptoms and Treatment

Overview:

Bulimia is a serious psychological eating disorder also known as bulimia nervosa. It is characterized by frequent episodes of binging-eating and is then followed by inappropriate methods of weight control or purging. A person suffering from this disorder may use inappropriate methods like vomiting, fasting, excessive use of laxatives and diuretics, or even compulsive exercising to lose weight.

People who suffer from bulimia are generally very conscious about their personal appearance related to the shape and size of their bodies. They may be of normal weight or even slightly over weight at times but suffer from self–esteem issues that may lead to depression and stress. They feel the need to lose weight constantly and as a result indulge in inappropriate methods to lose the weight as mentioned above.




bulimia Pictures, Images and Photos

Binge eating is not in response to hunger usually and the person eats large amounts of food in a short period of time. Binging and purging becomes an obsession and a vicious cycle for these people who cannot control their urges and give in to feelings of guilt for their behavior. The individual experiences a short-lived sense of calmness soon after losing control and this calmness is followed by self-loathing.
It is very important to differentiate between bulimia and another eating disorder called “anorexia nervosa”. Anorexia nervosa is a disorder where people tend to “fast” and starve themselves in order to remain thin. They suffer from extreme weight loss and look very skinny. In spite of their skinny look, they somehow seem to believe that they are still overweight. They try to lose weight by any of these methods like, excessive exercise, intake of laxatives and not eating. Whereas, in bulimia the person generally looks normal and will eat or binge on large amounts of food followed by purging that is usually done in secret. This is the reason why their condition may go undiagnosed for any lengths of time until a serious complication from the physical self-abuse occurs.

Eating disorders are typically found to be associated with certain professions that are more concerned with physical appearances, weight issues and thinness of the body. They are modeling, gymnastics, film industry, dancing, wrestling and athletics or sports.

Statistics of Bulimia

Bulimia was diagnosed independently as an eating disorder in the early 1980’s and is most commonly seen in adolescent and young adult women. Men are also equally affected by this disorder. According to statistical reports, bulimia is estimated to affect between 3% of all women in the U.S. at some point in their lifetime. About 6% of teen girls and 5% of college-aged females are believed to suffer from bulimia. Approximately 10% of identified bulimic patients are men. Bulimics are also susceptible to other compulsions, affective disorders, or addictions. 20-40% of women with bulimia also have a history of problems related to drug or alcohol use, suggesting that many affected women may have difficulties with control of behavioral impulses.

Signs and Symptoms of Bulimia

If you suspect any of your friends or family members to be suffering from bulimia then look out for warning signs that may include any of the following:

Ø Trying to lose weight using extreme measures
Ø Always looking to use the bathroom after eating (to purge) or showing signs of throwing up
Ø Using diet pills or any other drugs to urinate or have bowel movements
Ø Exercise heavily even in bad weather, injury, fatigue or sickness
Ø There may be swelling in the jaw or cheek area
Ø Their teeth may appear “clear”
Ø They suffer from depression
Ø They may act differently and spend less time with family and friends often isolating themselves and becoming more withdrawn and secretive.
Ø They may also have cuts and calluses on the back of their hands or knuckles.

Look at the picture below to find out how bulimia harms your health.

Bulimia FAQBulimia FAQ

The person who suffers from this disorder will be overly concerned with their weight and body shape. They may complain of generalized weakness, fatigue, loss of menstrual cycles and abdominal pain. There may even be complains of vomiting and diarrhea without the person revealing that it is self induced.

BulimiaBulimia

A physical examination by the doctor may reveal signs of chronic binging and purging. An oral examination may show dental cavities, loss of tooth enamel, enlarged salivary glands, and scars on the knuckles may be present as a result of chronic self-induced vomiting. The person may present with signs of dehydration, dry skin, malnutrition, swelling of the lower legs and feet, changes in hair and nails or even a loss of sensation in the hands or feet. There may also be other medical complications and long-term effects of bulimia.

A family member who suffers from such an eating disorder needs a lot of your support. You need to suggest the family member to see an eating disorder expert, although you may be faced with denial, resistance and or even anger. A doctor and or a counselor can help them to overcome the disorder.

Treatment of Bulimia:

A person suffering from bulimia presents many medical and psychological complications that are mostly considered reversible through a multidisciplinary treatment approach. The treatment usually involves counseling and behavioral therapy. It is important to carry out the treatment in the early stages of this disorder because over time the behavior patterns become more deeply ingrained and thus are harder to change. People who get early treatment have a better chance of full recovery from the disorder.

It goes without saying that support and encouragement at home from family members is very important for the successful treatment of bulimia. The person’s behavior can be monitored closely and can be helped to maintain a reasonable eating pattern. Family members can also ensure that the person continues to stay in treatment and keeps the appointments with the doctors and other therapists.

Medical treatment for bulimia can be managed by either a physician, a psychiatrist or a clinical psychologist depending upon the extent of the medical complications. Any serious medical problem that is related to the eating disorder may require the person to be hospitalized . The person may require IV fluids to correct an electrolyte imbalance or even for nutrition.

Antidepressant medications prove to be beneficial in the treatment of bulimia. Fluoxetine (Prozac) is a drug that has been approved by the US Food and Drug Administration as a treatment of choice for bulimia due to their relative safety and low incidence of side effects. Other antidepressants like MAOIs (monoamine oxidase inhibitors), tricyclic antidepressants, and buspirone (Buspar) have also shown to decrease bingeing and vomiting in people suffering from bulimia.

An appropriate treatment module will address the underlying issues of control, self-perception, and family dynamics. In addition, the person can also be provided nutritional education and behavior management as a healthy alternative to weight management.

Group counseling or support groups can assist the patient in the recovery process along with individual therapy and family therapy. In group therapy, people suffering with the same disorder get together and share their stories and experiences. This therapy seems to work well for people with bulimia.

The ultimate goal for the person suffering from bulimia is to accept himself/herself and to be able to lead a healthy emotional and physical life. This may take some time, and so a positive outlook along with much effort on the part of the person affected is essential for a successful recovery.

Read here how clinical research is contributing to advances in the understanding and treatment of bulimia:
http://bulimia.emedtv.com/bulimia/bulimia-clinical-research.html

For more informationYou can find out more about bulimia from
http://www.womenshealth.gov/faq/bulimia-nervosa.cfm at 1-800-994-9662 or from one of the following organizations.

National Institute of Mental Health (NIMH), NIH, HHS
Phone: (866) 615-NIMH (6464)
Internet Address: http://www.nimh.nih.gov

National Mental Health Information Center, SAMHSA, HHS
Phone: (800) 789-2647
Internet Address: http://www.mentalhealth.org

Academy for Eating Disorders
Phone: (847) 498-4274
Internet Address: http://www.aedweb.org

National Association of Anorexia Nervosa and Associated Disorders
Phone: (847) 831-3438
Internet Address: http://www.anad.org

National Eating Disorders Association
Phone: (800) 931-2237
Internet Address: http://www.nationaleatingdisorders.org

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Original Article Posted on Xomba