Rak podjęzykowy
Etiologia i przyczyny

Rak podjęzykowy, stanowiący około 10% wszystkich złośliwych nowotworów jamy ustnej w populacji europejskiej, rozwija się w tkankach pod językiem i jest w 95% przypadków rakiem płaskonabłonkowym. Patogeneza opiera się na mutacjach DNA komórek nabłonka płaskiego, prowadzących do niekontrolowanego wzrostu i tworzenia guza, który może naciekać tkanki i dawać przerzuty. Najważniejsze czynniki ryzyka to palenie tytoniu (zwiększające ryzyko 3-20-krotnie), nadmierne spożycie alkoholu (około 5-krotnie wyższe ryzyko) oraz synergistyczne działanie obu tych czynników, które może podnieść ryzyko nawet 38-100-krotnie. Infekcja HPV, zwłaszcza typ 16, oraz osłabienie układu odpornościowego (np. po przeszczepach, zakażeniu HIV) również zwiększają podatność na rozwój tego nowotworu. Dodatkowo, czynniki takie jak żucie betelu, niedobory pokarmowe, zła higiena jamy ustnej, przewlekłe stany zapalne i czynniki genetyczne (np. anemia Fanconiego) mają znaczenie w etiologii raka podjęzykowego.

Etiologia raka podjęzykowego (Floor of the mouth cancer) – przyczyny i czynniki rozwoju choroby

Rak podjęzykowy jest jednym z rodzajów nowotworów jamy ustnej, który rozwija się w tkankach znajdujących się pod językiem, w pobliżu żuchwy. Stanowi około jednej dziesiątej wszystkich złośliwych nowotworów jamy ustnej w populacji europejskiej1. Chociaż dokładna przyczyna tego typu raka nie jest w pełni poznana, istnieje wiele czynników ryzyka, które mogą przyczyniać się do jego rozwoju.

Mechanizm rozwoju nowotworu

Rak podjęzykowy rozwija się, gdy komórki pod językiem przechodzą zmiany (mutacje) w swoim DNA. W normalnych komórkach DNA zawiera instrukcje dotyczące wzrostu i podziału komórek z określoną szybkością oraz ich naturalnego obumierania w odpowiednim czasie. W komórkach nowotworowych zmienione DNA zawiera inne instrukcje, które powodują szybkie namnażanie komórek oraz uniemożliwiają ich naturalne obumieranie. Prowadzi to do nadmiernego namnażania się komórek23.

Komórki nowotworowe mogą tworzyć masę zwaną guzem. Guz ten może rozrastać się, naciekając i niszcząc zdrowe tkanki. Z czasem komórki nowotworowe mogą oderwać się i rozprzestrzenić do innych części ciała. Gdy nowotwór się rozprzestrzenia, nazywany jest rakiem przerzutowym4.

Około 95% raków jamy ustnej, w tym raka podjęzykowego, to raki płaskonabłonkowe, rozwijające się z płaskich, cienkich komórek wyściełających jamę ustną56.

Główne czynniki ryzyka

Tytoń i alkohol

Używanie wyrobów tytoniowych i spożywanie alkoholu są najistotniejszymi czynnikami ryzyka rozwoju raka podjęzykowego78:

  • Palenie tytoniu w jakiejkolwiek formie (papierosy, cygara, fajki) lub używanie bezdymnych produktów tytoniowych (tytoń do żucia, snuff) znacząco zwiększa ryzyko raka podjęzykowego. Badania wykazały, że osoby palące mają 3-20 razy większe ryzyko rozwoju tego nowotworu w porównaniu z osobami niepalącymi910.
  • Tytoń zawiera wiele substancji rakotwórczych, szczególnie wielopierścieniowe węglowodory aromatyczne i nitrozoaminy, które uszkadzają DNA komórek11.
  • Regularne i nadmierne spożywanie alkoholu również zwiększa ryzyko raka podjęzykowego. Osoby spożywające duże ilości alkoholu mają około 5-krotnie wyższe ryzyko zachorowania12.
  • Alkohol, mimo że sam w sobie nie jest substancją rakotwórczą, zwiększa przepuszczalność błony śluzowej jamy ustnej, co ułatwia przenikanie innych kancerogenów13.
  • Połączenie palenia tytoniu i spożywania alkoholu działa synergistycznie, drastycznie zwiększając ryzyko raka podjęzykowego – nawet 38-100 razy w porównaniu z osobami, które nie piją ani nie palą1415.
Infekcja HPV

Wirus brodawczaka ludzkiego (HPV), szczególnie typ 16, jest czynnikiem ryzyka raka jamy ustnej, w tym raka podjęzykowego1617:

  • Infekcja HPV jest przekazywana drogą kontaktów seksualnych i wiąże się ze zwiększonym ryzykiem wielu rodzajów nowotworów, w tym raka jamy ustnej18.
  • W jamie ustnej infekcja HPV jest 4 razy częstsza u osób z rakiem płaskonabłonkowym w porównaniu do osób ze zdrową błoną śluzową19.
  • Związek między HPV a rakiem jamy ustnej nie jest tak dobrze udokumentowany jak w przypadku raka gardła, jednak pewne dowody potwierdzają istnienie takiego związku20.
Obniżona odporność

Osłabiony układ odpornościowy zwiększa ryzyko rozwoju raka podjęzykowego2122:

  • Osoby przyjmujące leki immunosupresyjne, np. po przeszczepie narządów, są bardziej narażone na rozwój raka podjęzykowego23.
  • Pewne choroby, takie jak zakażenie HIV/AIDS, również osłabiają układ odpornościowy i zwiększają ryzyko rozwoju tego nowotworu2425.
  • Osoby po przeszczepie komórek macierzystych układu krwiotwórczego mają 4-7 razy większe ryzyko rozwoju raka jamy ustnej w porównaniu z populacją ogólną26.

Dodatkowe czynniki ryzyka

Czynniki związane ze stylem życia

Oprócz głównych czynników ryzyka, takich jak tytoń i alkohol, istnieją inne czynniki związane ze stylem życia, które mogą zwiększać ryzyko raka podjęzykowego27:

  • Żucie betelu i orzechów areki – szczególnie rozpowszechnione w Azji Południowo-Wschodniej2829.
  • Dieta uboga w owoce i warzywa – nieprawidłowe odżywianie i niedobory pokarmowe mogą zwiększać podatność na raka podjęzykowego3031.
  • Zła higiena jamy ustnej – nieodpowiednia higiena może zwiększać ryzyko rozwoju raka podjęzykowego3233.
Predyspozycje genetyczne i historia rodzinna

Czynniki genetyczne mogą również odgrywać rolę w rozwoju raka podjęzykowego34:

  • Historia rodzinna nowotworów jamy ustnej lub innych typów nowotworów może zwiększać ryzyko zachorowania3536.
  • Pewne zespoły genetyczne, takie jak anemia Fanconiego, dyskeratoza wrodzona, mogą predysponować do rozwoju raka podjęzykowego3738.
Przewlekłe stany zapalne jamy ustnej

Chroniczne uszkodzenia i stany zapalne błony śluzowej jamy ustnej mogą przyczyniać się do rozwoju raka podjęzykowego39:

Wpływ wieku i płci

Czynniki demograficzne również odgrywają rolę w ryzyku rozwoju raka podjęzykowego45:

  • Wiek – częstość występowania raka podjęzykowego stopniowo wzrasta u osób w wieku 40-50 lat, z szczytem zachorowań w grupie wiekowej 60-69 lat46. Rak jamy ustnej najczęściej diagnozowany jest po 55 roku życia47.
  • Płeć – rak podjęzykowy występuje prawie dwukrotnie częściej u mężczyzn niż u kobiet, co może być związane z wyższymi wskaźnikami używania tytoniu i alkoholu wśród mężczyzn4849.

Czynniki środowiskowe i zawodowe

Ekspozycja na określone czynniki środowiskowe może zwiększać ryzyko raka podjęzykowego50:

  • Nadmierna ekspozycja na promieniowanie ultrafioletowe (w przypadku raka wargi)5152.
  • Narażenie zawodowe na substancje chemiczne, takie jak azbest, formaldehyd czy kwas siarkowy53.
  • Promieniowanie jonizujące – istnieją dowody na związek między ekspozycją na promieniowanie jonizujące a późniejszym rozwojem nowotworów gruczołów ślinowych54.

Infekcje i choroby współtowarzyszące

Różne infekcje i choroby mogą być powiązane z rozwojem raka podjęzykowego5556:

  • Infekcje grzybicze spowodowane przez gatunki Candida, szczególnie Candida albicans, mogą być zaangażowane w patogenezę zmian przedrakowych jamy ustnej57.
  • Wirus Epsteina-Barr (EBV) – niektóre badania sugerują potencjalny związek między tym wirusem a rakiem jamy ustnej5859.
  • Trzecierzędowa kiła była w przeszłości uznawana za czynnik predysponujący do rozwoju raka jamy ustnej w połączeniu z innymi czynnikami ryzyka60.
  • Choroba przeszczep przeciwko gospodarzowi, zwłaszcza u osób po przeszczepie komórek macierzystych, często poprzedza rozwój raka jamy ustnej6162.

Czynniki o potencjalnym wpływie na rozwój raka podjęzykowego

Badania epidemiologiczne wykazały, że około 75% przypadków raka jamy ustnej, w tym raka podjęzykowego, jest związanych z modyfikowalnymi czynnikami behawioralnymi6364. Jednak około 25% pacjentów rozwija raka podjęzykowego bez oczywistych czynników ryzyka, co sugeruje istnienie nieznanych jeszcze mechanizmów patogenetycznych6566.

Warto podkreślić, że rak podjęzykowy jest w dużej mierze chorobą możliwą do zapobiegania, ponieważ większość czynników ryzyka można wyeliminować poprzez modyfikację stylu życia67. Szczególnie ważne jest unikanie używania tytoniu i nadmiernego spożycia alkoholu, dbanie o odpowiednią higienę jamy ustnej oraz regularne badania stomatologiczne, które mogą przyczynić się do wczesnego wykrycia i skutecznego leczenia tego nowotworu68.

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

  1. 09.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Floor of the mouth cancer: Symptoms, treatment and prognosis | CURAPROX
    https://curaprox.co.nz/blog/post/interesting-facts-about-floor-of-the-mouth-cancer?srsltid=AfmBOooVAnKMr6IqXha97TB_6fdAdlXso1QNkZH-K3BRsf8s_qKQhPW0
    Roughly one tenth of all malignant tumours in German oral cavity cancer patients are located in the floor of the mouth. […] Floor of the mouth cancer occurs when cells with altered genetic information multiply and are not recognised by the immune system. These altered cancer cells gradually displace healthy cells and form a tumour, which grows either quickly or slowly depending on the type of tumour. […] The main risk factors for floor of the mouth cancer are: Drinking and smoking (also the use of „smokeless” tobacco products), Betel chewing (use of betel nuts; especially in Southeast Asia), Chronic inflammation due to poorly fitting dentures or sharp-edged teeth, Virus infections (especially HPV), Untreated preliminary stages (e.g. leukoplakia), Poor oral hygiene.
  • #2 Mayo Clinic Health Library – Floor of the mouth cancer | Swiss Medical Network
    https://www.swissmedical.net/en/healtcare-library/con-20198288
    Floor of the mouth cancer happens when cells under the tongue develop changes in their DNA. A cell’s DNA holds the instructions that tell a cell what to do. In healthy cells, the DNA gives instructions to grow and multiply at a set rate. The instructions also tell the cells to die at a set time. In cancer cells, the DNA changes give different instructions. The changes tell the cancer cells to make many more cells quickly. Cancer cells can keep living when healthy cells would die. This causes too many cells. […] The cancer cells might form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. In time, cancer cells can break away and spread to other parts of the body. When cancer spreads, it’s called metastatic cancer.
  • #3 Floor of the mouth cancer // Middlesex Health
    https://middlesexhealth.org/learning-center/diseases-and-conditions/floor-of-the-mouth-cancer
    Floor of the mouth cancer happens when cells under the tongue develop changes in their DNA. […] The cancer cells might form a mass called a tumor. […] The changes tell the cancer cells to make many more cells quickly. Cancer cells can keep living when healthy cells would die. This causes too many cells.
  • #4 Mayo Clinic Health Library – Floor of the mouth cancer | Swiss Medical Network
    https://www.swissmedical.net/en/healtcare-library/con-20198288
    Floor of the mouth cancer happens when cells under the tongue develop changes in their DNA. A cell’s DNA holds the instructions that tell a cell what to do. In healthy cells, the DNA gives instructions to grow and multiply at a set rate. The instructions also tell the cells to die at a set time. In cancer cells, the DNA changes give different instructions. The changes tell the cancer cells to make many more cells quickly. Cancer cells can keep living when healthy cells would die. This causes too many cells. […] The cancer cells might form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. In time, cancer cells can break away and spread to other parts of the body. When cancer spreads, it’s called metastatic cancer.
  • #5 Mouth cancer – Symptoms and causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/mouth-cancer/symptoms-causes/syc-20350997
    It’s not always clear what causes mouth cancer. This cancer starts as a growth of cells in the mouth. It most often starts in cells called squamous cells. These are flat, thin cells that line the lips and the inside of the mouth. Most oral cancers are squamous cell carcinomas. […] Mouth cancer happens when cells on the lips or in the mouth develop changes in their DNA. A cell’s DNA holds the instructions that tell the cell what to do. In healthy cells, the DNA tells the cells to grow and multiply at a set rate. The DNA also tells the cells to die at a set time. […] In cancer cells, the DNA changes give different instructions. The changes tell the cancer cells to grow and multiply quickly. Cancer cells can keep living when healthy cells would die. This causes too many cells. […] The cancer cells might form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. In time, the cancer cells can break away and spread to other parts of the body. When cancer spreads, it’s called metastatic cancer.
  • #6 Oral squamous cell carcinoma: Symptoms, causes, and more
    https://www.medicalnewstoday.com/articles/oral-squamous-cell-carcinoma
    Oral squamous cell carcinoma begins in the squamous cells, which are the cells that line the lips and the inside of the mouth. […] Medical professionals do not fully understand what causes oral squamous cell carcinoma. […] However, they do know that cancer typically happens as a result of genetic mutations. The body usually requires changes in a number of different genes for oral squamous cell carcinoma to develop. […] The main risk factor for this type of cancer is smoking tobacco, particularly if a person smokes more than two packs of cigarettes per day. This is because of the cancer-causing chemicals found in tobacco smoke. […] The risk of developing oral cancer is three times higher in people who smoke compared to people who do not smoke. […] Alcohol consumption also increases a persons risk of developing oral cancers. According to the American Cancer Society, a person who combines smoking and drinking alcohol is around 30 times more likely to develop oral cancer than people who do not smoke or drink.
  • #7 Oral Squamous Cell Carcinoma – Ear, Nose, and Throat Disorders – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/ear-nose-and-throat-disorders/tumors-of-the-head-and-neck/oral-squamous-cell-carcinoma
    Over 95% of people with oral squamous cell carcinoma smoke tobacco, drink alcohol, or both. […] The chief risk factors for oral squamous cell carcinoma are Smoking (especially 2 packs/day) and Alcohol use. […] Risk increases dramatically when alcohol use exceeds 177 mL (6 oz) of distilled liquor, 148 mL (5 oz) of wine, or 1065 mL (36 oz) of beer/day. […] The combination of heavy smoking and heavy alcohol consumption is estimated to raise the risk 100-fold in females and 38-fold in males. […] Squamous cell carcinoma of the tongue may also result from any chronic irritation, such as dental caries, overuse of mouthwash, chewing tobacco, or the use of betel quid. […] Oral human papillomavirus (HPV), typically acquired via oral-genital contact, may have a role in the etiology of some oral cancers; however, HPV is identified in oral cancer much less often than it is in oropharyngeal cancer, and its presence in resected tissue does not necessarily imply causation. […] Intraoral squamous cell carcinomas may begin on the floor of the mouth or on the lateral and ventral surfaces of the tongue.
  • #8 CANCER OF THE ORAL CAVITY
    https://pmc.ncbi.nlm.nih.gov/articles/PMC5018209/
    Cancer of the oral cavity is one of the most common malignancies, especially in developing countries, but also in the developed world. Squamous cell carcinoma (SCC) is the most common histology and the main etiological factors are tobacco and alcohol use. […] Tobacco smoking and alcohol are the main etiological factors in SCC of the oral cavity (SCCOC). Other habits such as betel nut and tobacco chewing have been implicated in the Asian population. […] Tobacco contains many carcinogenic molecules, especially polycyclic hydrocarbons and nitrosamines. A directly proportional effect exists between the pack years of tobacco used and the risk of SCCOC. This risk can be reduced after tobacco cessation, but it does not fully abate. […] Alcohol and tobacco seem to have a synergistic effect in the etiology of oral and oropharyngeal SCC. However, alcohol is linked to an increased risk of cancer even in non-smokers. Other factors such as poor oral hygiene, wood dust exposure, dietary deficiencies, red meat and salted meat consumption have been reported as etiologic factors.
  • #9 Cancer of the Oral Mucosa – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK565867/
    Smoking tobacco is the greatest risk factor for developing oral cancer due to carcinogenic chemicals, including nitrosamines, benzopyrenes, and aromatic amines. The risk of developing oral cancer is 3 times higher in smokers compared with non-smokers. Individuals are also at risk from secondary passive smoking environments, particularly with chronic second-hand exposure. The results of studies demonstrate a synergistic relationship with alcohol consumption, resulting in a higher risk of malignancy. […] Alcohol consumption, especially when combined with smoking, elevates the risk of oral cancer. Although ethanol is not a carcinogenic substance, it enhances the permeability of the oral mucosa, making it more susceptible to damage from other carcinogens. […] HPVs, mainly types 16 and 18, are associated with malignancies, notably cervical cancer and oropharyngeal cancer, especially tonsillar and base of tongue tumors. Although the association with oral cancers is not as well-established, some evidence supports such a connection. In the oral cavity, HPV infection is 4 times more likely in individuals with squamous cell carcinomas compared to those with healthy mucous membranes. […] Individuals who have undergone hematopoietic stem cell transplants face a significantly increased risk of developing oral cancer, ranging from 4 to 7 times higher than that of the general population. The development of graft-versus-host disease in the oral cavity often precedes the onset of cancer.
  • #10 Oral cancer – Wikipedia
    https://en.wikipedia.org/wiki/Oral_cancer
    Risk factors include tobacco and alcohol use. Those who use both alcohol and tobacco have a 15 times greater risk of oral cancer than those who use neither. Other risk factors include betel nut chewing and sun exposure on the lip. HPV infection may play a limited role in some oral cavity cancers. […] The main causes of oral cancer are alcohol and tobacco (smoked or chewed). The risk is especially high when a person regularly uses both. The more is consumed of either the higher the risk of developing oral cancer. Like all environmental factors, the rate at which cancer will develop is dependent on the dose, frequency and method of application of the carcinogen (the substance that is causing the cancer). […] Tobacco is the greatest single cause of oral and pharyngeal cancer. Using tobacco increases the risk of oral cancer by 3 to 6 times and is responsible for around 40% of all oral cancers. Smokeless tobacco (including chewing tobacco, snuff, snus) also causes oral cancer.
  • #11
    https://journals.lww.com/cancerjournal/fulltext/2016/12020/oral_cancer__etiology_and_risk_factors__a_review.4.aspx
    The most important carcinogens in tobacco smoke are the aromatic hydrocarbon benz-pyrene and the tobacco-specific nitrosamines (TSNs) namely 4-(nitrosomethylamino)-1-(3-pyridyl)-1-butanone (NNK) and N’-nitrosonornicotine (NNN). […] Animal studies have shown that NNK and NNN in the tobacco products cause tumors of the oral cavity, lung, esophagus, and pancreas. […] Studies have shown the association of these products with oral cancer development. […] Studies have shown the association of tobacco chewing with oral cancer and precancer namely leukoplakia, erythroplakia, and oral submucous fibrosis. […] Alcohol has been implicated in the development of oral cancer. […] Alcohol consumption has been shown to act synergistically with tobacco in the increased risk of development of oral cancer.
  • #12 Cancers of the Oral Mucosa: Background, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/1075729-overview
    Tobacco and alcohol use are independent risk factors for mouth cancer and tongue cancer. Heavy tobacco smokers have a 20-fold greater risk; heavy alcohol drinkers a 5-fold greater risk; those who do both have a 50-fold greater risk. Betel-quid chewing and oral snuff are important risk factors in people from specific geographic areas (eg, betel chewing in Southeast Asia). Finally, a diet low in fresh vegetables and fruits has also been implicated in causing oral SCC, and HPVs have been implicated in oropharyngeal cancers. At present, there is not enough evidence to link the use of marijuana (cannabis) with oral cancer, other than the fact that patients who use marijuana tend to have higher rates of infection with HPV. The following factors are associated with the etiology of oral cancers: […] Tobacco is a potent risk factor for oral cancer. An interaction occurs between redox-active metals in saliva and the low-reactive free radicals in cigarette smoke. The result may be that saliva loses its antioxidant capacity and instead becomes a potent pro-oxidant milieu. […] An immune deficiency state may predispose one to a higher risk of developing oral SCC, especially lip cancer.
  • #13 Cancer of the Oral Mucosa – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK565867/
    Smoking tobacco is the greatest risk factor for developing oral cancer due to carcinogenic chemicals, including nitrosamines, benzopyrenes, and aromatic amines. The risk of developing oral cancer is 3 times higher in smokers compared with non-smokers. Individuals are also at risk from secondary passive smoking environments, particularly with chronic second-hand exposure. The results of studies demonstrate a synergistic relationship with alcohol consumption, resulting in a higher risk of malignancy. […] Alcohol consumption, especially when combined with smoking, elevates the risk of oral cancer. Although ethanol is not a carcinogenic substance, it enhances the permeability of the oral mucosa, making it more susceptible to damage from other carcinogens. […] HPVs, mainly types 16 and 18, are associated with malignancies, notably cervical cancer and oropharyngeal cancer, especially tonsillar and base of tongue tumors. Although the association with oral cancers is not as well-established, some evidence supports such a connection. In the oral cavity, HPV infection is 4 times more likely in individuals with squamous cell carcinomas compared to those with healthy mucous membranes. […] Individuals who have undergone hematopoietic stem cell transplants face a significantly increased risk of developing oral cancer, ranging from 4 to 7 times higher than that of the general population. The development of graft-versus-host disease in the oral cavity often precedes the onset of cancer.
  • #14 Oral Squamous Cell Carcinoma – Ear, Nose, and Throat Disorders – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/ear-nose-and-throat-disorders/tumors-of-the-head-and-neck/oral-squamous-cell-carcinoma
    Over 95% of people with oral squamous cell carcinoma smoke tobacco, drink alcohol, or both. […] The chief risk factors for oral squamous cell carcinoma are Smoking (especially 2 packs/day) and Alcohol use. […] Risk increases dramatically when alcohol use exceeds 177 mL (6 oz) of distilled liquor, 148 mL (5 oz) of wine, or 1065 mL (36 oz) of beer/day. […] The combination of heavy smoking and heavy alcohol consumption is estimated to raise the risk 100-fold in females and 38-fold in males. […] Squamous cell carcinoma of the tongue may also result from any chronic irritation, such as dental caries, overuse of mouthwash, chewing tobacco, or the use of betel quid. […] Oral human papillomavirus (HPV), typically acquired via oral-genital contact, may have a role in the etiology of some oral cancers; however, HPV is identified in oral cancer much less often than it is in oropharyngeal cancer, and its presence in resected tissue does not necessarily imply causation. […] Intraoral squamous cell carcinomas may begin on the floor of the mouth or on the lateral and ventral surfaces of the tongue.
  • #15 Cancers of the Oral Mucosa: Background, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/1075729-overview
    Tobacco and alcohol use are independent risk factors for mouth cancer and tongue cancer. Heavy tobacco smokers have a 20-fold greater risk; heavy alcohol drinkers a 5-fold greater risk; those who do both have a 50-fold greater risk. Betel-quid chewing and oral snuff are important risk factors in people from specific geographic areas (eg, betel chewing in Southeast Asia). Finally, a diet low in fresh vegetables and fruits has also been implicated in causing oral SCC, and HPVs have been implicated in oropharyngeal cancers. At present, there is not enough evidence to link the use of marijuana (cannabis) with oral cancer, other than the fact that patients who use marijuana tend to have higher rates of infection with HPV. The following factors are associated with the etiology of oral cancers: […] Tobacco is a potent risk factor for oral cancer. An interaction occurs between redox-active metals in saliva and the low-reactive free radicals in cigarette smoke. The result may be that saliva loses its antioxidant capacity and instead becomes a potent pro-oxidant milieu. […] An immune deficiency state may predispose one to a higher risk of developing oral SCC, especially lip cancer.
  • #16 Floor of Mouth Cancer: Symptoms, Risk Factors, Diagnosis, Treatment
    https://www.healthline.com/health/floor-of-mouth-cancer
    Floor of the mouth cancer is a type of oral cancer that forms under the tongue. Smoking, tobacco use, and drinking alcohol are some of the main risk factors for this form of cancer. […] Researchers aren’t sure what causes the specific changes that lead to floor of the mouth cancer. However, all oral cancers have been linked to tobacco use. This includes cigarettes, chewing tobacco, cigars, and pipes. […] In addition to tobacco, risk factors for floor of the mouth cancer include: Heavy alcohol use: Alcohol use is linked to an increased risk of many types of cancer, including floor of the mouth cancer. A weakened immune system: There’s a link between a weakened immune system and a higher risk of floor of the mouth cancer. This includes conditions that weaken the immune system and immunosuppressant medications. Human papillomavirus (HPV): HPV is a virus that’s passed through sexual contact. It’s associated with a higher risk of multiple cancer types, including floor of the mouth cancer.
  • #17 Cancer of the Oral Mucosa – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK565867/
    Smoking tobacco is the greatest risk factor for developing oral cancer due to carcinogenic chemicals, including nitrosamines, benzopyrenes, and aromatic amines. The risk of developing oral cancer is 3 times higher in smokers compared with non-smokers. Individuals are also at risk from secondary passive smoking environments, particularly with chronic second-hand exposure. The results of studies demonstrate a synergistic relationship with alcohol consumption, resulting in a higher risk of malignancy. […] Alcohol consumption, especially when combined with smoking, elevates the risk of oral cancer. Although ethanol is not a carcinogenic substance, it enhances the permeability of the oral mucosa, making it more susceptible to damage from other carcinogens. […] HPVs, mainly types 16 and 18, are associated with malignancies, notably cervical cancer and oropharyngeal cancer, especially tonsillar and base of tongue tumors. Although the association with oral cancers is not as well-established, some evidence supports such a connection. In the oral cavity, HPV infection is 4 times more likely in individuals with squamous cell carcinomas compared to those with healthy mucous membranes. […] Individuals who have undergone hematopoietic stem cell transplants face a significantly increased risk of developing oral cancer, ranging from 4 to 7 times higher than that of the general population. The development of graft-versus-host disease in the oral cavity often precedes the onset of cancer.
  • #18 Floor of Mouth Cancer: Symptoms, Risk Factors, Diagnosis, Treatment
    https://www.healthline.com/health/floor-of-mouth-cancer
    Floor of the mouth cancer is a type of oral cancer that forms under the tongue. Smoking, tobacco use, and drinking alcohol are some of the main risk factors for this form of cancer. […] Researchers aren’t sure what causes the specific changes that lead to floor of the mouth cancer. However, all oral cancers have been linked to tobacco use. This includes cigarettes, chewing tobacco, cigars, and pipes. […] In addition to tobacco, risk factors for floor of the mouth cancer include: Heavy alcohol use: Alcohol use is linked to an increased risk of many types of cancer, including floor of the mouth cancer. A weakened immune system: There’s a link between a weakened immune system and a higher risk of floor of the mouth cancer. This includes conditions that weaken the immune system and immunosuppressant medications. Human papillomavirus (HPV): HPV is a virus that’s passed through sexual contact. It’s associated with a higher risk of multiple cancer types, including floor of the mouth cancer.
  • #19 Cancer of the Oral Mucosa – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK565867/
    Smoking tobacco is the greatest risk factor for developing oral cancer due to carcinogenic chemicals, including nitrosamines, benzopyrenes, and aromatic amines. The risk of developing oral cancer is 3 times higher in smokers compared with non-smokers. Individuals are also at risk from secondary passive smoking environments, particularly with chronic second-hand exposure. The results of studies demonstrate a synergistic relationship with alcohol consumption, resulting in a higher risk of malignancy. […] Alcohol consumption, especially when combined with smoking, elevates the risk of oral cancer. Although ethanol is not a carcinogenic substance, it enhances the permeability of the oral mucosa, making it more susceptible to damage from other carcinogens. […] HPVs, mainly types 16 and 18, are associated with malignancies, notably cervical cancer and oropharyngeal cancer, especially tonsillar and base of tongue tumors. Although the association with oral cancers is not as well-established, some evidence supports such a connection. In the oral cavity, HPV infection is 4 times more likely in individuals with squamous cell carcinomas compared to those with healthy mucous membranes. […] Individuals who have undergone hematopoietic stem cell transplants face a significantly increased risk of developing oral cancer, ranging from 4 to 7 times higher than that of the general population. The development of graft-versus-host disease in the oral cavity often precedes the onset of cancer.
  • #20 Cancer of the Oral Mucosa – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK565867/
    Smoking tobacco is the greatest risk factor for developing oral cancer due to carcinogenic chemicals, including nitrosamines, benzopyrenes, and aromatic amines. The risk of developing oral cancer is 3 times higher in smokers compared with non-smokers. Individuals are also at risk from secondary passive smoking environments, particularly with chronic second-hand exposure. The results of studies demonstrate a synergistic relationship with alcohol consumption, resulting in a higher risk of malignancy. […] Alcohol consumption, especially when combined with smoking, elevates the risk of oral cancer. Although ethanol is not a carcinogenic substance, it enhances the permeability of the oral mucosa, making it more susceptible to damage from other carcinogens. […] HPVs, mainly types 16 and 18, are associated with malignancies, notably cervical cancer and oropharyngeal cancer, especially tonsillar and base of tongue tumors. Although the association with oral cancers is not as well-established, some evidence supports such a connection. In the oral cavity, HPV infection is 4 times more likely in individuals with squamous cell carcinomas compared to those with healthy mucous membranes. […] Individuals who have undergone hematopoietic stem cell transplants face a significantly increased risk of developing oral cancer, ranging from 4 to 7 times higher than that of the general population. The development of graft-versus-host disease in the oral cavity often precedes the onset of cancer.
  • #21 Floor of Mouth Cancer: Symptoms, Risk Factors, Diagnosis, Treatment
    https://www.healthline.com/health/floor-of-mouth-cancer
    Floor of the mouth cancer is a type of oral cancer that forms under the tongue. Smoking, tobacco use, and drinking alcohol are some of the main risk factors for this form of cancer. […] Researchers aren’t sure what causes the specific changes that lead to floor of the mouth cancer. However, all oral cancers have been linked to tobacco use. This includes cigarettes, chewing tobacco, cigars, and pipes. […] In addition to tobacco, risk factors for floor of the mouth cancer include: Heavy alcohol use: Alcohol use is linked to an increased risk of many types of cancer, including floor of the mouth cancer. A weakened immune system: There’s a link between a weakened immune system and a higher risk of floor of the mouth cancer. This includes conditions that weaken the immune system and immunosuppressant medications. Human papillomavirus (HPV): HPV is a virus that’s passed through sexual contact. It’s associated with a higher risk of multiple cancer types, including floor of the mouth cancer.
  • #22
    https://content.irisoncology.com/library/floor-of-the-mouth-cancer
    Having a weak immune system. If the body’s germ-fighting immune system is weakened by medicines or illness, there might be a higher risk of floor of the mouth cancer. People with a weakened immune system include those taking medicines to control the immune system, such as after an organ transplant. Certain medical conditions, such as infection with HIV, also can weaken the immune system.
  • #23 Oral Cancer Causes and Risk Factors
    https://www.cancercenter.com/cancer-types/oral-cancer/risk-factors
    About 70 percent of people diagnosed with oral cancer are heavy drinkers. […] Chewing gutka, a combination of betel quid and tobacco, is also common. Both of these substances are associated with an increased oral cancer risk. […] Taking drugs that suppress the immune system, such as those used to prevent rejection of a transplant organ or to treat certain immune diseases, may increase the risk of oral cancer. […] People with a severe case of this illness, which usually causes an itchy rash but sometimes appears as white lines or spots in the mouth and throat, may have a higher risk of oral cancer. […] GVHD increases the likelihood of oral cancer, which may develop as soon as two years later.
  • #24 Floor Of The Mouth Cancer: Causes, Symptoms And Treatment
    https://www.netmeds.com/health-library/post/floor-of-the-mouth-cancer-causes-symptoms-and-treatment?srsltid=AfmBOoorju0SCsc_-YAb0dG26wdfNtzYJHbneU7MDwXC8yL5mQQUJlGM
    A family history of oral cancer or other types of cancer aggravates the risk of floor of the mouth cancer. […] Genetic syndromes or diseases increases the chances of getting diagnosed with this form of cancer. […] Getting diagnosed with HPV (i.e. Human papillomavirus) strain increases the risk. […] Having a compromised immunity from birth or suffering from diseases like HIV or AIDS increases the risk of this type of cancer. […] A poor nutrition or dietary insufficiency makes an individual more prone to floor of the mouth carcinoma.
  • #25 Risks And Causes Of Mouth And Oropharyngeal Cancer | Cancer Research UK
    https://www.cancerresearchuk.org/about-cancer/mouth-cancer/risks-causes
    The link to HPV is much stronger for oropharyngeal cancers than it is for mouth cancers. HPV causes around 50 out of every 100 (around 50%) of oropharyngeal cancers in the UK. […] Research shows an increased risk of mouth and oropharyngeal cancer in people with HIV/AIDS – there are higher rates of Human papillomavirus (HPV) infection in people with HIV. […] Changes can happen in the cells in the lining of the mouth. […] Head and neck cancer risk is higher in people with a brother or sister (sibling) who had head and neck cancer. […] People who have the following cancers are also at increased risk of mouth cancer: a type of cervical cancer called squamous cell cancer, cancer of the food pipe (oesophageal squamous cell cancer), lung cancer.
  • #26 Cancer of the Oral Mucosa – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK565867/
    Smoking tobacco is the greatest risk factor for developing oral cancer due to carcinogenic chemicals, including nitrosamines, benzopyrenes, and aromatic amines. The risk of developing oral cancer is 3 times higher in smokers compared with non-smokers. Individuals are also at risk from secondary passive smoking environments, particularly with chronic second-hand exposure. The results of studies demonstrate a synergistic relationship with alcohol consumption, resulting in a higher risk of malignancy. […] Alcohol consumption, especially when combined with smoking, elevates the risk of oral cancer. Although ethanol is not a carcinogenic substance, it enhances the permeability of the oral mucosa, making it more susceptible to damage from other carcinogens. […] HPVs, mainly types 16 and 18, are associated with malignancies, notably cervical cancer and oropharyngeal cancer, especially tonsillar and base of tongue tumors. Although the association with oral cancers is not as well-established, some evidence supports such a connection. In the oral cavity, HPV infection is 4 times more likely in individuals with squamous cell carcinomas compared to those with healthy mucous membranes. […] Individuals who have undergone hematopoietic stem cell transplants face a significantly increased risk of developing oral cancer, ranging from 4 to 7 times higher than that of the general population. The development of graft-versus-host disease in the oral cavity often precedes the onset of cancer.
  • #27 Floor of the mouth cancer: Symptoms, treatment and prognosis | CURAPROX
    https://curaprox.us/blog/post/interesting-facts-about-floor-of-the-mouth-cancer?srsltid=AfmBOopAV4pQA_0HBi6V8lJvNNQuk6K695DMVzGK3UAI7UsBGh_Y-Ajb
    Floor of the mouth cancer occurs when cells with altered genetic information multiply and are not recognised by the immune system. These altered cancer cells gradually displace healthy cells and form a tumour, which grows either quickly or slowly depending on the type of tumour. […] It is not yet known why this type of cell mutation occurs. However, there are a number of risk factors that increase the likelihood of developing floor of the mouth cancer. […] The main risk factors for floor of the mouth cancer are: […] – Drinking and smoking (also the use of „smokeless” tobacco products) […] – Betel chewing (use of betel nuts; especially in Southeast Asia) […] – Chronic inflammation due to poorly fitting dentures or sharp-edged teeth […] – Virus infections (especially HPV) […] – Untreated preliminary stages (e.g. leukoplakia) […] – Poor oral hygiene.
  • #28 Floor of the mouth cancer: Symptoms, treatment and prognosis | CURAPROX
    https://curaprox.us/blog/post/interesting-facts-about-floor-of-the-mouth-cancer?srsltid=AfmBOopAV4pQA_0HBi6V8lJvNNQuk6K695DMVzGK3UAI7UsBGh_Y-Ajb
    Floor of the mouth cancer occurs when cells with altered genetic information multiply and are not recognised by the immune system. These altered cancer cells gradually displace healthy cells and form a tumour, which grows either quickly or slowly depending on the type of tumour. […] It is not yet known why this type of cell mutation occurs. However, there are a number of risk factors that increase the likelihood of developing floor of the mouth cancer. […] The main risk factors for floor of the mouth cancer are: […] – Drinking and smoking (also the use of „smokeless” tobacco products) […] – Betel chewing (use of betel nuts; especially in Southeast Asia) […] – Chronic inflammation due to poorly fitting dentures or sharp-edged teeth […] – Virus infections (especially HPV) […] – Untreated preliminary stages (e.g. leukoplakia) […] – Poor oral hygiene.
  • #29 Oral cancer – Wikipedia
    https://en.wikipedia.org/wiki/Oral_cancer
    Drinking alcohol is a major cause of oral cancer. It is responsible for about 20% of global oral cancer cases. The more alcohol is consumed regularly the higher the risk, but light to moderate drinking still somewhat increases the chances of getting oral cancer. The risk is especially high when both alcohol and tobacco are used. […] Infection with human papillomavirus (HPV), particularly type 16, is a cause of oropharyngeal cancer (tonsils, base of tongue). However, its role in the genesis of oral cavity cancers is a matter of debate. […] Chewing betel quid (paan) and Areca nut-based products is known to be a strong risk factor for developing oral cancer even in the absence of tobacco. It doubles the risk of oral cancer 2.1 times and when chewed with additional tobacco in its preparation (like in gutka), there is an even higher risk.
  • #30 Floor Of The Mouth Cancer: Causes, Symptoms And Treatment
    https://www.netmeds.com/health-library/post/floor-of-the-mouth-cancer-causes-symptoms-and-treatment?srsltid=AfmBOoorju0SCsc_-YAb0dG26wdfNtzYJHbneU7MDwXC8yL5mQQUJlGM
    A family history of oral cancer or other types of cancer aggravates the risk of floor of the mouth cancer. […] Genetic syndromes or diseases increases the chances of getting diagnosed with this form of cancer. […] Getting diagnosed with HPV (i.e. Human papillomavirus) strain increases the risk. […] Having a compromised immunity from birth or suffering from diseases like HIV or AIDS increases the risk of this type of cancer. […] A poor nutrition or dietary insufficiency makes an individual more prone to floor of the mouth carcinoma.
  • #31
    https://journals.lww.com/cancerjournal/fulltext/2016/12020/oral_cancer__etiology_and_risk_factors__a_review.4.aspx
    The role of alcohol as an independent factor in oral carcinogenesis is still unclear albeit epidemiological evidence establishes the synergistic role played by alcohol with tobacco. […] The relationship between diet and nutrition to the risk of cancer development has been established by several epidemiological and laboratory studies. […] Cultural risk factors and dietary factors seem to interplay in the development of oral cancer and precancer. […] The use of mouthwash has also been implicated to cause oral cancer. […] Mat, which is a tea-like beverage consumed in South America and in parts of Europe has been shown to be an independent cause for development of oral and pharyngeal cancers. […] Viruses have been strongly implicated in the development of malignant tumors of the squamous epithelia including the oral squamous epithelium.
  • #32 Floor of the mouth cancer: Symptoms, treatment and prognosis | CURAPROX
    https://curaprox.us/blog/post/interesting-facts-about-floor-of-the-mouth-cancer?srsltid=AfmBOopAV4pQA_0HBi6V8lJvNNQuk6K695DMVzGK3UAI7UsBGh_Y-Ajb
    Floor of the mouth cancer occurs when cells with altered genetic information multiply and are not recognised by the immune system. These altered cancer cells gradually displace healthy cells and form a tumour, which grows either quickly or slowly depending on the type of tumour. […] It is not yet known why this type of cell mutation occurs. However, there are a number of risk factors that increase the likelihood of developing floor of the mouth cancer. […] The main risk factors for floor of the mouth cancer are: […] – Drinking and smoking (also the use of „smokeless” tobacco products) […] – Betel chewing (use of betel nuts; especially in Southeast Asia) […] – Chronic inflammation due to poorly fitting dentures or sharp-edged teeth […] – Virus infections (especially HPV) […] – Untreated preliminary stages (e.g. leukoplakia) […] – Poor oral hygiene.
  • #33 Mouth Cancer/Oral Cancer: Symptoms, Causes & Treatment
    https://www.careinsurance.com/blog/health-insurance-articles/mouth-cancer-causes-symptoms-and-treatment
    Oral cancer is a malignant disease affecting the oral cavity; i.e., the lips, cheeks, tongue, base of the mouth, hard and soft palates, sinuses, and throat. Smoking cigarettes, chewing tobacco, or drinking alcohol are the primary causes of the oral cancer. […] The most probable mouth cancer causes include: Chewing tobacco, Smoking cigarettes, Drinking alcohol, Excessive exposure to the sun, Human papillomavirus (HPV), Family history of cancer, Epstein Barr virus, Swollen or bleeding gums, Poor oral hygiene. […] Oral cancer is a type of cancer that can arise from poor oral hygiene and exposure of the oral cavity to harmful substances. Here are some of the key risk factors associated with oral cancer discussed below: Tobacco Consumption: Both smoking and the use of smokeless tobacco are major risk factors that contribute to the majority of oral cancers. Excessive Alcohol Consumption: Heavy alcohol use, especially when combined with tobacco, significantly increases the risk of developing oral cancer. HPV Infection: Certain strains of the human papillomavirus (HPV) are linked to oropharyngeal cancers. Direct Sun Exposure: Prolonged exposure to direct sunlight can heighten the risk of developing lip cancer. Poor Oral Hygiene: Inadequate oral hygiene practices, such as not brushing teeth properly or having oral issues like pyorrhea and gingivitis, may raise the risk of oral cancers. Age and Gender: Oral cancer is more prevalent among older individuals and men, meaning that elderly people who consume harmful substances like tobacco and alcohol are particularly vulnerable to this disease.
  • #34 Floor Of The Mouth Cancer: Causes, Symptoms And Treatment
    https://www.netmeds.com/health-library/post/floor-of-the-mouth-cancer-causes-symptoms-and-treatment?srsltid=AfmBOoorju0SCsc_-YAb0dG26wdfNtzYJHbneU7MDwXC8yL5mQQUJlGM
    A family history of oral cancer or other types of cancer aggravates the risk of floor of the mouth cancer. […] Genetic syndromes or diseases increases the chances of getting diagnosed with this form of cancer. […] Getting diagnosed with HPV (i.e. Human papillomavirus) strain increases the risk. […] Having a compromised immunity from birth or suffering from diseases like HIV or AIDS increases the risk of this type of cancer. […] A poor nutrition or dietary insufficiency makes an individual more prone to floor of the mouth carcinoma.
  • #35 Floor Of The Mouth Cancer: Causes, Symptoms And Treatment
    https://www.netmeds.com/health-library/post/floor-of-the-mouth-cancer-causes-symptoms-and-treatment?srsltid=AfmBOoorju0SCsc_-YAb0dG26wdfNtzYJHbneU7MDwXC8yL5mQQUJlGM
    A family history of oral cancer or other types of cancer aggravates the risk of floor of the mouth cancer. […] Genetic syndromes or diseases increases the chances of getting diagnosed with this form of cancer. […] Getting diagnosed with HPV (i.e. Human papillomavirus) strain increases the risk. […] Having a compromised immunity from birth or suffering from diseases like HIV or AIDS increases the risk of this type of cancer. […] A poor nutrition or dietary insufficiency makes an individual more prone to floor of the mouth carcinoma.
  • #36 Oral Cavity Cancer
    https://www.health.ny.gov/statistics/cancer/registry/abouts/oral.htm
    Personal history of cancer. People who have had one cancer of the oral cavity have a greater risk of developing another oral cavity cancer. People who have had other smoking-related cancers, such as lung cancer, are also at increased risk of developing oral cavity cancer. […] Family history. People with close relatives (parents, brothers/sisters, children) who have had oral cavity cancer are at increased risk of getting cancer of the oral cavity. […] Some studies have suggested that various sources of irritation to the mouth, such as broken or poorly fitting dentures, may increase the risk of oral cavity cancer. Some studies have also shown an increased risk of oral cavity cancer in people who use mouthwashes containing alcohol. Other studies have not confirmed this association. Scientists are also studying the risk of other viruses, including the Epstein-Barr virus (a very common virus that causes infectious mononucleosis, also called „mono”) and herpes simplex virus. Additional research is needed to determine the role, if any, these factors may have in the development of cancer of the oral cavity.
  • #37 Mouth Cancers: Gum, Palate, Inner Cheek & Floor of Mouth
    https://www.cancercenter.com/cancer-types/oral-cancer/types/mouth-cancer
    Human papillomavirus (HPV) infection: HPV infection is associated with a small number of oral cavity cancers; it’s much more likely to cause oropharyngeal cancers (carcinomas of the tonsils, throat and base of the tongue). […] Gender: Oral cavity cancer occurs twice as frequently in men than in women, according to the ACS, possibly due to alcohol and tobacco use. […] Age: Young people are far less likely to have oral cavity cancers because these take many years to develop. Most often, these cancers occur in people older than age 55, according to the ACS. […] Ultraviolet (UV) light exposure: Too much UV light exposure from the sun is linked to an increased incidence of lip cancers. […] Suboptimal nutrition: A diet low in fruits and vegetables is associated with an increased risk of mouth cancers. […] Genetic syndromes: People born with the inherited genetic syndromes Fanconi anemia and dyskeratosis congenita have an increased risk of developing mouth cancers.
  • #38 Childhood Oral Cavity Cancer – NCI
    https://www.cancer.gov/types/head-and-neck/patient/child/oral-cavity-treatment-pdq
    Oral cavity cancer is caused by certain changes to the way the cells in the oral cavity function, especially how they grow and divide into new cells. Often, the exact cause of these cell changes is unknown. […] Risk factors for oral cavity cancer in children and adolescents include: HPV infection, having certain genetic conditions, such as: Fanconi anemia, dyskeratosis congenita, connexin gene mutations, epidermolysis bullosa, xeroderma pigmentosum, having chronic graft-versus-host disease. […] Getting the HPV vaccine can protect against HPV infection and lower the risk of this and many other types of cancer.
  • #39 Floor of the mouth cancer: Symptoms, treatment and prognosis | CURAPROX
    https://curaprox.us/blog/post/interesting-facts-about-floor-of-the-mouth-cancer?srsltid=AfmBOopAV4pQA_0HBi6V8lJvNNQuk6K695DMVzGK3UAI7UsBGh_Y-Ajb
    Floor of the mouth cancer occurs when cells with altered genetic information multiply and are not recognised by the immune system. These altered cancer cells gradually displace healthy cells and form a tumour, which grows either quickly or slowly depending on the type of tumour. […] It is not yet known why this type of cell mutation occurs. However, there are a number of risk factors that increase the likelihood of developing floor of the mouth cancer. […] The main risk factors for floor of the mouth cancer are: […] – Drinking and smoking (also the use of „smokeless” tobacco products) […] – Betel chewing (use of betel nuts; especially in Southeast Asia) […] – Chronic inflammation due to poorly fitting dentures or sharp-edged teeth […] – Virus infections (especially HPV) […] – Untreated preliminary stages (e.g. leukoplakia) […] – Poor oral hygiene.
  • #40 Floor of the mouth cancer: Symptoms, treatment and prognosis | CURAPROX
    https://curaprox.us/blog/post/interesting-facts-about-floor-of-the-mouth-cancer?srsltid=AfmBOopAV4pQA_0HBi6V8lJvNNQuk6K695DMVzGK3UAI7UsBGh_Y-Ajb
    Floor of the mouth cancer occurs when cells with altered genetic information multiply and are not recognised by the immune system. These altered cancer cells gradually displace healthy cells and form a tumour, which grows either quickly or slowly depending on the type of tumour. […] It is not yet known why this type of cell mutation occurs. However, there are a number of risk factors that increase the likelihood of developing floor of the mouth cancer. […] The main risk factors for floor of the mouth cancer are: […] – Drinking and smoking (also the use of „smokeless” tobacco products) […] – Betel chewing (use of betel nuts; especially in Southeast Asia) […] – Chronic inflammation due to poorly fitting dentures or sharp-edged teeth […] – Virus infections (especially HPV) […] – Untreated preliminary stages (e.g. leukoplakia) […] – Poor oral hygiene.
  • #41 Cancers of the Oral Mucosa: Background, Pathophysiology, Etiology
    https://emedicine.medscape.com/article/1075729-overview
    Tobacco and alcohol use are independent risk factors for mouth cancer and tongue cancer. Heavy tobacco smokers have a 20-fold greater risk; heavy alcohol drinkers a 5-fold greater risk; those who do both have a 50-fold greater risk. Betel-quid chewing and oral snuff are important risk factors in people from specific geographic areas (eg, betel chewing in Southeast Asia). Finally, a diet low in fresh vegetables and fruits has also been implicated in causing oral SCC, and HPVs have been implicated in oropharyngeal cancers. At present, there is not enough evidence to link the use of marijuana (cannabis) with oral cancer, other than the fact that patients who use marijuana tend to have higher rates of infection with HPV. The following factors are associated with the etiology of oral cancers: […] Tobacco is a potent risk factor for oral cancer. An interaction occurs between redox-active metals in saliva and the low-reactive free radicals in cigarette smoke. The result may be that saliva loses its antioxidant capacity and instead becomes a potent pro-oxidant milieu. […] An immune deficiency state may predispose one to a higher risk of developing oral SCC, especially lip cancer.
  • #42 Floor of the mouth cancer: Symptoms, treatment and prognosis | CURAPROX
    https://curaprox.us/blog/post/interesting-facts-about-floor-of-the-mouth-cancer?srsltid=AfmBOopAV4pQA_0HBi6V8lJvNNQuk6K695DMVzGK3UAI7UsBGh_Y-Ajb
    Floor of the mouth cancer occurs when cells with altered genetic information multiply and are not recognised by the immune system. These altered cancer cells gradually displace healthy cells and form a tumour, which grows either quickly or slowly depending on the type of tumour. […] It is not yet known why this type of cell mutation occurs. However, there are a number of risk factors that increase the likelihood of developing floor of the mouth cancer. […] The main risk factors for floor of the mouth cancer are: […] – Drinking and smoking (also the use of „smokeless” tobacco products) […] – Betel chewing (use of betel nuts; especially in Southeast Asia) […] – Chronic inflammation due to poorly fitting dentures or sharp-edged teeth […] – Virus infections (especially HPV) […] – Untreated preliminary stages (e.g. leukoplakia) […] – Poor oral hygiene.
  • #43 Oral cancer – Wikipedia
    https://en.wikipedia.org/wiki/Oral_cancer
    People after hematopoietic stem cell transplantation (HSCT) are at a higher risk for oral cancer. Post-HSCT oral cancer may have more aggressive behavior with poorer prognosis, when compared to oral cancer in people not treated with HSCT. […] A premalignant (or precancerous) lesion is defined as „a benign, morphologically altered tissue that has a greater than normal risk of malignant transformation.” There are several different types of premalignant lesion that occur in the mouth. Some oral cancers begin as white patches (leukoplakia), red patches (erythroplakia) or mixed red and white patches (erythroleukoplakia or „speckled leukoplakia”). Other common premalignant lesions include oral submucous fibrosis and actinic cheilitis.
  • #44 Common benign and malignant oral mucosal disease
    https://www1.racgp.org.au/ajgp/2020/september/common-benign-and-malignant-oral-mucosal-disease
    Oral squamous cell carcinoma (SCC) most commonly presents as a non-healing ulcer, which can be indurated/firm and have irregular margins and raised, rolled edges. […] The major risk factors for oral cavity SCC are smoking, alcohol consumption of 3 standard drinks per day and betel quid (paan) consumption. […] If an ulcer is suspected to have any suspicious malignant features, then immediate referral to an oral and maxillofacial surgeon or specialist unit in a tertiary hospital is indicated. […] The primary curative management of oral cavity SCC is surgery, with radiotherapy and chemotherapy used as adjunctive therapy to reduce the risk of recurrence. […] Oral submucous fibrosis (OSMF) is a potentially malignant disorder characterised by fibroelastic change and epithelial atrophy of the oral mucosa, which results in stiffness of the oral mucosa and trismus (inability to open the mouth).
  • #45 Floor of Mouth Cancer: Symptoms and Causes | Clinique MFML
    https://cliniquemaxillo.com/en/blogue/floor-of-mouth-cancer-symptoms-causes/
    Floor of mouth cancer risk factors are well known, the main ones being smoking and excessive drinking, and both combined present a major risk. […] The incidence of floor of mouth cancer is gradually increasing in people between the ages of 40 and 50, and there is a peak in the 60-69 age group. […] Additionally, more and more cases are being reported among adults under the age of 40, who now account for about 4-6% of all reported cases. The increasing use of cannabis may be the cause.
  • #46 Floor of Mouth Cancer: Symptoms and Causes | Clinique MFML
    https://cliniquemaxillo.com/en/blogue/floor-of-mouth-cancer-symptoms-causes/
    Floor of mouth cancer risk factors are well known, the main ones being smoking and excessive drinking, and both combined present a major risk. […] The incidence of floor of mouth cancer is gradually increasing in people between the ages of 40 and 50, and there is a peak in the 60-69 age group. […] Additionally, more and more cases are being reported among adults under the age of 40, who now account for about 4-6% of all reported cases. The increasing use of cannabis may be the cause.
  • #47 Oral Cancer Causes and Risk Factors
    https://www.cancercenter.com/cancer-types/oral-cancer/risk-factors
    While the exact cause of oral cancer isn’t known, several factors are known to increase risk, including human papillomavirus (HPV) infection, tobacco use and alcohol consumption. […] The risk of developing oral cancer increases with age; however, people younger than age 55 may develop the disease, as well. […] Oral cancer is twice as common in men as in women. This difference may be related to the use of alcohol and tobacco, which are major oral cancer risk factors seen more commonly in men than in women. […] HPV is a risk factor for oral cancer. […] The average age at diagnosis for oral cancer is 63, and more than two-thirds of individuals with this disease are over age 55, although it may occur in younger people, as well. […] About 85 percent of patients with oral cancers use tobacco in the form of cigarettes, chewing tobacco or snuff.
  • #48 Mouth Cancer Causes, Risk Factors & Prevention | Memorial Sloan Kettering Cancer Center
    https://www.mskcc.org/cancer-care/types/mouth/mouth-cancer-risk-factors-prevention
    People who chew betel quid or gutka which is more common in parts of Asia have an increased risk of cancer of the mouth. […] Mouth cancer is nearly twice as common in men as in women. This might be because men have higher rates of tobacco and alcohol use. […] Cancers of the mouth usually take many years to develop, so they are not common in young people. Most people are over 40 when cancer is first found in the mouth. The average age of diagnosis is around 60. […] Cancers of the lip are more common in people who spend time in the sun. Tanning beds use can also increase the risk for lip cancer. […] Other less common risk factors for mouth cancer include: a diet low in fruits and vegetables, a weakened immune system, graft-versus-host disease, a condition that sometimes occurs after a stem cell transplant, lichen planus, a disease that often affects the skin, certain genetic syndromes, such as Fanconi anemia and dyskeratosis congenital.
  • #49 Oral Cancer Causes and Risk Factors
    https://www.cancercenter.com/cancer-types/oral-cancer/risk-factors
    While the exact cause of oral cancer isn’t known, several factors are known to increase risk, including human papillomavirus (HPV) infection, tobacco use and alcohol consumption. […] The risk of developing oral cancer increases with age; however, people younger than age 55 may develop the disease, as well. […] Oral cancer is twice as common in men as in women. This difference may be related to the use of alcohol and tobacco, which are major oral cancer risk factors seen more commonly in men than in women. […] HPV is a risk factor for oral cancer. […] The average age at diagnosis for oral cancer is 63, and more than two-thirds of individuals with this disease are over age 55, although it may occur in younger people, as well. […] About 85 percent of patients with oral cancers use tobacco in the form of cigarettes, chewing tobacco or snuff.
  • #50
    https://journals.lww.com/cancerjournal/fulltext/2016/12020/oral_cancer__etiology_and_risk_factors__a_review.4.aspx
    Certain viral genes are proto-oncogenes which become oncogenes when inserted into the host’s DNA and ultimately resulting in malignant transformation. […] Fungal infections caused by Candida species, in particular, Candida albicans has been implicated in the pathogenesis of oral premalignant lesions. […] Immunosuppressed individuals are more prone to develop oral cancers. […] Occupational risks, namely exposure to excessive solar radiation/ultraviolet (UV) light is known to cause lip cancers. […] Poor oral hygiene, poor dental status (sharp/fractured teeth due to caries/trauma), and chronic ulceration from an ill-fitting denture has been suggested to promote neoplasm in the presence of other risk factors. […] Tertiary syphilis had been known to predispose to the development of oral cancer along with other risk factors such as tobacco and alcohol.
  • #51 Oral cancer – UF Health
    https://ufhealth.org/conditions-and-treatments/oral-cancer
    Oral cancer most commonly involves the lips or the tongue. It may also occur on the: […] Smoking and other tobacco use are linked to most cases of oral cancer. Heavy alcohol use also increases the risk for oral cancer. […] Human papillomavirus (HPV) infection (the same virus that causes genital warts) account for a larger number of oral cancers than in the past. One type of HPV, type 16 or HPV-16, is much more commonly associated with almost all oral cancers. […] Other factors that may increase the risk for oral cancer include: Long-term (chronic) rubbing, such as from rough teeth, dentures, or fillings; Taking medicines (immunosuppressants) that weaken the immune system; Poor dental and oral hygiene. […] Oral cancers can recur if tobacco or alcohol use is not stopped.
  • #52 Mouth Cancer Causes, Risk Factors & Prevention | Memorial Sloan Kettering Cancer Center
    https://www.mskcc.org/cancer-care/types/mouth/mouth-cancer-risk-factors-prevention
    People who chew betel quid or gutka which is more common in parts of Asia have an increased risk of cancer of the mouth. […] Mouth cancer is nearly twice as common in men as in women. This might be because men have higher rates of tobacco and alcohol use. […] Cancers of the mouth usually take many years to develop, so they are not common in young people. Most people are over 40 when cancer is first found in the mouth. The average age of diagnosis is around 60. […] Cancers of the lip are more common in people who spend time in the sun. Tanning beds use can also increase the risk for lip cancer. […] Other less common risk factors for mouth cancer include: a diet low in fruits and vegetables, a weakened immune system, graft-versus-host disease, a condition that sometimes occurs after a stem cell transplant, lichen planus, a disease that often affects the skin, certain genetic syndromes, such as Fanconi anemia and dyskeratosis congenital.
  • #53 Oral Cancer Causes, Diagnosis, and Treatment in Turkey
    https://bi-maristan.com/en/otorhinolaryngology/head-and-neck/oral-cancer/
    It is important to note that more than 25% of oral cancers occur in people who do not smoke and who only drink alcohol occasionally. […] Other factors that may increase the risk of oral cancer include: Gastroesophageal reflux disease (GERD) Previous radiation therapy to the head, neck, or both Exposure to certain chemicals, especially asbestos, sulphuric acid, and formaldehyde Having a long-term injury or chronic trauma, such as from rough teeth Drinking very hot mate tea, which is common in South America.
  • #54
    https://journals.lww.com/cancerjournal/fulltext/2016/12020/oral_cancer__etiology_and_risk_factors__a_review.4.aspx
    Substantial evidence exists for a relationship between exposure to ionizing radiation and the later development of salivary gland tumors. […] Genetic predisposition has been shown to be an important risk factor in the development of OSCC. […] It is clear from the above review that several risk factors are implicated in the development of oral cancer, of which the most common and established are tobacco smoking and betel quid chewing.
  • #55
    https://journals.lww.com/cancerjournal/fulltext/2016/12020/oral_cancer__etiology_and_risk_factors__a_review.4.aspx
    The role of alcohol as an independent factor in oral carcinogenesis is still unclear albeit epidemiological evidence establishes the synergistic role played by alcohol with tobacco. […] The relationship between diet and nutrition to the risk of cancer development has been established by several epidemiological and laboratory studies. […] Cultural risk factors and dietary factors seem to interplay in the development of oral cancer and precancer. […] The use of mouthwash has also been implicated to cause oral cancer. […] Mat, which is a tea-like beverage consumed in South America and in parts of Europe has been shown to be an independent cause for development of oral and pharyngeal cancers. […] Viruses have been strongly implicated in the development of malignant tumors of the squamous epithelia including the oral squamous epithelium.
  • #56
    https://journals.lww.com/cancerjournal/fulltext/2016/12020/oral_cancer__etiology_and_risk_factors__a_review.4.aspx
    Certain viral genes are proto-oncogenes which become oncogenes when inserted into the host’s DNA and ultimately resulting in malignant transformation. […] Fungal infections caused by Candida species, in particular, Candida albicans has been implicated in the pathogenesis of oral premalignant lesions. […] Immunosuppressed individuals are more prone to develop oral cancers. […] Occupational risks, namely exposure to excessive solar radiation/ultraviolet (UV) light is known to cause lip cancers. […] Poor oral hygiene, poor dental status (sharp/fractured teeth due to caries/trauma), and chronic ulceration from an ill-fitting denture has been suggested to promote neoplasm in the presence of other risk factors. […] Tertiary syphilis had been known to predispose to the development of oral cancer along with other risk factors such as tobacco and alcohol.
  • #57
    https://journals.lww.com/cancerjournal/fulltext/2016/12020/oral_cancer__etiology_and_risk_factors__a_review.4.aspx
    Certain viral genes are proto-oncogenes which become oncogenes when inserted into the host’s DNA and ultimately resulting in malignant transformation. […] Fungal infections caused by Candida species, in particular, Candida albicans has been implicated in the pathogenesis of oral premalignant lesions. […] Immunosuppressed individuals are more prone to develop oral cancers. […] Occupational risks, namely exposure to excessive solar radiation/ultraviolet (UV) light is known to cause lip cancers. […] Poor oral hygiene, poor dental status (sharp/fractured teeth due to caries/trauma), and chronic ulceration from an ill-fitting denture has been suggested to promote neoplasm in the presence of other risk factors. […] Tertiary syphilis had been known to predispose to the development of oral cancer along with other risk factors such as tobacco and alcohol.
  • #58 Mouth cancer – who’s at risk, symptoms and treatments | healthdirect
    https://www.healthdirect.gov.au/mouth-cancer
    Mouth cancer is an aggressive cancer that can affect your lips, tongue or the inside of your mouth. […] Risk factors include smoking, drinking alcohol and poor oral hygiene. […] The two main causes of mouth cancer are smoking cigarettes, cigars or pipes or using smokeless tobacco and drinking alcohol. […] Other factors that can increase your risk include: drinking alcohol and smoking at the same time, sun exposure (especially to the lips), poor diet, poor oral hygiene or gum disease, a family history of mouth cancer, chewing betel nut (the seed of the areca palm tree). […] Certain viruses also increase your risk of mouth cancer, such as human papillomavirus (HPV), which can be caught through oral sex, and Epstein-Barr virus (EBV), which causes glandular fever.
  • #59 Oral Cavity Cancer
    https://www.health.ny.gov/statistics/cancer/registry/abouts/oral.htm
    Personal history of cancer. People who have had one cancer of the oral cavity have a greater risk of developing another oral cavity cancer. People who have had other smoking-related cancers, such as lung cancer, are also at increased risk of developing oral cavity cancer. […] Family history. People with close relatives (parents, brothers/sisters, children) who have had oral cavity cancer are at increased risk of getting cancer of the oral cavity. […] Some studies have suggested that various sources of irritation to the mouth, such as broken or poorly fitting dentures, may increase the risk of oral cavity cancer. Some studies have also shown an increased risk of oral cavity cancer in people who use mouthwashes containing alcohol. Other studies have not confirmed this association. Scientists are also studying the risk of other viruses, including the Epstein-Barr virus (a very common virus that causes infectious mononucleosis, also called „mono”) and herpes simplex virus. Additional research is needed to determine the role, if any, these factors may have in the development of cancer of the oral cavity.
  • #60
    https://journals.lww.com/cancerjournal/fulltext/2016/12020/oral_cancer__etiology_and_risk_factors__a_review.4.aspx
    Certain viral genes are proto-oncogenes which become oncogenes when inserted into the host’s DNA and ultimately resulting in malignant transformation. […] Fungal infections caused by Candida species, in particular, Candida albicans has been implicated in the pathogenesis of oral premalignant lesions. […] Immunosuppressed individuals are more prone to develop oral cancers. […] Occupational risks, namely exposure to excessive solar radiation/ultraviolet (UV) light is known to cause lip cancers. […] Poor oral hygiene, poor dental status (sharp/fractured teeth due to caries/trauma), and chronic ulceration from an ill-fitting denture has been suggested to promote neoplasm in the presence of other risk factors. […] Tertiary syphilis had been known to predispose to the development of oral cancer along with other risk factors such as tobacco and alcohol.
  • #61 Cancer of the Oral Mucosa – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK565867/
    Smoking tobacco is the greatest risk factor for developing oral cancer due to carcinogenic chemicals, including nitrosamines, benzopyrenes, and aromatic amines. The risk of developing oral cancer is 3 times higher in smokers compared with non-smokers. Individuals are also at risk from secondary passive smoking environments, particularly with chronic second-hand exposure. The results of studies demonstrate a synergistic relationship with alcohol consumption, resulting in a higher risk of malignancy. […] Alcohol consumption, especially when combined with smoking, elevates the risk of oral cancer. Although ethanol is not a carcinogenic substance, it enhances the permeability of the oral mucosa, making it more susceptible to damage from other carcinogens. […] HPVs, mainly types 16 and 18, are associated with malignancies, notably cervical cancer and oropharyngeal cancer, especially tonsillar and base of tongue tumors. Although the association with oral cancers is not as well-established, some evidence supports such a connection. In the oral cavity, HPV infection is 4 times more likely in individuals with squamous cell carcinomas compared to those with healthy mucous membranes. […] Individuals who have undergone hematopoietic stem cell transplants face a significantly increased risk of developing oral cancer, ranging from 4 to 7 times higher than that of the general population. The development of graft-versus-host disease in the oral cavity often precedes the onset of cancer.
  • #62 Oral Cancer Causes and Risk Factors
    https://www.cancercenter.com/cancer-types/oral-cancer/risk-factors
    About 70 percent of people diagnosed with oral cancer are heavy drinkers. […] Chewing gutka, a combination of betel quid and tobacco, is also common. Both of these substances are associated with an increased oral cancer risk. […] Taking drugs that suppress the immune system, such as those used to prevent rejection of a transplant organ or to treat certain immune diseases, may increase the risk of oral cancer. […] People with a severe case of this illness, which usually causes an itchy rash but sometimes appears as white lines or spots in the mouth and throat, may have a higher risk of oral cancer. […] GVHD increases the likelihood of oral cancer, which may develop as soon as two years later.
  • #63 Oral Cancer: Causes, Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/11184-oral-cancer
    Oral cancer starts in the squamous cells in your oral cavity. Squamous cells are flat and, when viewed under a microscope, look like a fish scale. […] Normal squamous cells become cancerous when their DNA changes and cells begin growing and multiplying. Over time, these cancerous cells can spread to other areas inside of your mouth and then to other areas of your head and neck or other areas of your body. […] About 75% of people who develop oral cancer have the following habits: Smoke cigarettes, cigars or pipes. Use smokeless tobacco products such as chewing tobacco, dip, snuff or water pipes (hookah or shush). Regularly drink excessive amounts of alcohol. Spend a lot of time in the sun without protecting their lips with sunblock. Have human papillomavirus (HPV). Have a family history of oral cancer. […] Its important to note that 25% of people who develop oral cancer dont smoke or have other known risk factors.
  • #64 Understanding What Causes Oral Cancer: Key Factors and Insights – Belmont Dental
    https://www.belmontdental.com/blog/what-causes-oral-cancer/
    Around 75% of oral cancer cases are linked to modifiable behaviors, highlighting the importance of lifestyle changes in prevention. […] Tobacco use is one of the most significant risk factors for developing oral cancer. […] Alcohol, another major risk factor, exacerbates the dangers posed by tobacco. […] The human papillomavirus (HPV), particularly HPV-16, is a significant contributor to the development of oral cancers. […] While tobacco, alcohol, and HPV are primary causes, other risk factors also contribute to the development of oral cancer. […] Genetic predisposition and family history play crucial roles in determining the risk of developing oral cancer. […] Although most cases of oral cancer are not directly linked to inherited factors, a family history remains an important risk factor.
  • #65 Oral Cancer: Causes, Symptoms & Treatment
    https://my.clevelandclinic.org/health/diseases/11184-oral-cancer
    Oral cancer starts in the squamous cells in your oral cavity. Squamous cells are flat and, when viewed under a microscope, look like a fish scale. […] Normal squamous cells become cancerous when their DNA changes and cells begin growing and multiplying. Over time, these cancerous cells can spread to other areas inside of your mouth and then to other areas of your head and neck or other areas of your body. […] About 75% of people who develop oral cancer have the following habits: Smoke cigarettes, cigars or pipes. Use smokeless tobacco products such as chewing tobacco, dip, snuff or water pipes (hookah or shush). Regularly drink excessive amounts of alcohol. Spend a lot of time in the sun without protecting their lips with sunblock. Have human papillomavirus (HPV). Have a family history of oral cancer. […] Its important to note that 25% of people who develop oral cancer dont smoke or have other known risk factors.
  • #66 Oral Cancer: Symptoms, Causes, And Treatment | Oral Cancer Institute
    https://oralcancer.com/oral-cancer/
    Oral cancer can result from a variety of causes, many of which are preventable. Some key risk factors include: […] Tobacco Use: Smoking cigarettes, cigars, or pipes and using smokeless tobacco significantly increases the risk for oral cancer. […] Alcohol Consumption: Heavy alcohol use, especially hard liquor, is linked to a higher likelihood of oral cancer. […] HPV Infection: The human papillomavirus (HPV), particularly HPV-16, is a major risk factor for oro-pharyngeal cancers or cancers in the back of the throat. 70% of all throat cancers are HPV related. […] Prolonged Sun Exposure: Sun exposure increases the risk of skin cancers as well as lip cancer. […] Age and Gender: Oral cancer is more common in men and typically occurs in individuals over 40. […] Smoking and drinking alcohol together greatly increases the incidence of oral cancers. […] The frequency of oral cancers in people without recognized risk factors is growing. About 30% of oral cancer patients present with no underlying risk factors. Thus screening is important regardless of whether one smokes or not.
  • #67
    http://waocp.com/journal/index.php/apjcb/article/view/1221
    Historically, clinicians have noted a connection between iron deficiency and oral squamous cell carcinoma (OSCC), and subsequent research has consistently supported this association. […] Edentulous patients and poor oral hygiene are known risk factors for cancer of the oral cavity. […] The oral microbiome, mucosal inflammation, and oral mucosal trauma caused by teeth and prosthetic devices have been gaining attention as potential contributors to the development of oral cancer. […] Oral cancer can be considered a largely preventable disease, given that most risk factors can be eliminated.
  • #68 Floor of Mouth Cancer | Memorial Sloan Kettering Cancer Center
    https://www.mskcc.org/cancer-care/types/mouth/types-mouth/floor-mouth
    Floor of mouth cancer is a type of head and neck cancer that begins when the cells that make up the floor of the mouth (the horseshoe-shaped area under the tongue) grow out of control and form lesions or tumors. […] Using tobacco products, particularly chewing tobacco, and regularly drinking too much alcohol can increase your chances of developing cancer in the floor of your mouth. […] The most common symptom of floor of mouth cancer is a sore in your mouth that keeps growing larger. Other signs of cancer in the floor of the mouth include: […] Floor of mouth cancer is highly curable when diagnosed early. […] The goals in the treatment of floor of mouth cancer are to: […] If the cancer is more advanced, radiation, chemotherapy, or both may be used to shrink the tumor before or after surgery to reduce the risk of the cancer coming back.