What is Jaw Cancer?
Jaw cancer is the growth of malignant cells on the jaw bones mainly osteosarcomas. The jaw is the most common site for cyst growth, which are usually benign. The jaw is composed of the maxilla and the mandible. The maxilla is the upper portion of the jaw while the mandible supports the floor of the mouth.
The Jaw Bones
Other types of malignant cells that arise in the jaw bone are Ewing’s sarcomas or giant cell tumors. Cancer that arises from the jaw bone is termed primary jaw cancer. However, malignant cells can also spread to the jaw from other cancers in the neck and head, termed as secondary jaw cancer. Jaw cancer results in pain in the area with difficulty in opening the mouth. Malignant cells in the jaw tend to spread quickly to adjacent organs.
A tumor that Has Grown on the Mandible
Signs & Symptoms
Signs and symptoms of jaw cancer are related to the growth of tumor on the area which restricts movement and circulation to the area. These include:
Acute pain while eating or drinking
This is the most common symptom of jaw cancer due to the compression of the tumor on the surrounding nerves. The tumor also creates disruption on the temporo-mandibular joint. The jaw pain may be characterized as slowly progressing, radiating to the face and neck and increasing in intensity while the jaw is moved. There is also tenderness around the area.
Paresthesia in the jaw
Compression of the nerves in the jaw results in tingling sensation and numbness in the area.
Swelling in the jaw
The tumor does not only compress nerves, but also obstruct the blood flow in the area causing swelling.
Mass in the jaw area
Oral examination can reveal an abnormal growth around the jaw. The patient may also feel an uneven alignment over the maxilla and mandible as a result of the mass or tumor. Tumors may grow inside leading to oral masses or outside the jaw leading to facial masses.
Jaw tumors affect the sockets of the teeth that lead to loosening. Sometimes, dentists are the ones who initially diagnose jaw tumors because of affectations of the teeth during dental check-ups. Jaw cancer pain may also be mistaken as a toothache by a patient that’s why the first consult is made from dentists. Other symptoms include sore throat, sores around the jaw and difficulty of swallowing or chewing
Causes & Risk Factors
The development of jaw cancer is associated with mutations in the oncogenes. The risk factors for jaw cancer are similar to those of oral cancer. The following outlines the risk factors of malignancy in the jaw:
Smoking and tobacco use
Smoking and tobacco use have been one of the most common risk factor for oral and jaw cancers. The carcinogens contained in cigarettes are potent reasons for the development of malignant cells.
Constant irritation of the oral mucosa from alcoholic drinks may lead to secondary jaw cancers.
Betel nut chewing
People fond of chewing betel nut are also at risk for secondary jaw cancers as a result of oral cancers.
Conditions that may cause constant irritation of the mandibular joint may also cause malignancies in the area.
Human papilloma virus specifically type 16 of the virus is a definite causative factor for jaw and oral cancers. The virus travels from the mouth into the tonsils, pharynx and the bones on the jaws which cause cellular changes on the area.
The staging of jaw cancer follows the general staging of malignancies.
Stage 0 or Carcinoma in Situ
The initial stage involves the growth of the cancer cells within cell membranes of the jaw tissues.
Stage I or Localized Growth
This stage involves the growth of malignant cells in the tissues in the joint. The cells may not be present on the subcutaneous and muscle tissues.
Stage II or Locally Advanced Growth
Stage II involves growth of the tumor in the jaw bone including the subcutaneous, muscle tissues, ligaments and tendons.
Stage III or Regional Spread
Regional spread involves the spread of malignant cells on adjacent tissues such as the oral cavity and surrounding lymph areas.
This sub stage involves the occurrence of gross tumor with microscopic seeding on adjacent tissues with no lymph spread.
This involves gross tumor spread on surrounding tissues with seeding of less than 2 cm in size.
This involves gross tumor spread on surrounding areas with seeding of more than 2 cm in size. The lymph nodes on the neck and upper chest may be affected.
Stage IV or Metastatic Cancer
The last stage of jaw cancer involves the spread of the malignant cells throughout the rest of the body due to lymphatic spread. Patients who are diagnosed in this stage usually have poor prognosis and lesser survival rate.
Diagnosis of jaw cancer involves physical examination, radiographic studies and biopsy.
Examination of the mouth and head may show masses on the oral cavity or on the face. The teeth are also examined to determine any loosening that is associated with lump growth on tooth sockets.
X-ray results often reveal lumps located on the maxillo-mandibualr joint. However, radiographic studies are not definitive of malignant cells because benign cysts on the area may also be identified.
Biopsy is the sole definitive test for jaw cancer. A sample of the tissues and bones in the jaw is taken and subjected to histologic examinations to assess the cellular patterns and check any aberrations. Osteosarcomas are usually identified.
The most preferred management for osteosarcoma of the jaws is surgery although chemotherapy and radiation may also be performed as adjunct therapies.
Surgery is performed for jaw cancers that have not yet spread to other areas of the body. Surgery removes the malignant tumors that grew in a particular site. This treatment is more effective for localized growth rather than in cells that have metastasized because there is already extensive cancer in the body. Removing the main tumor may not help in treating the diseases for advanced stages.
Chemotherapy is usually given as an adjunct to surgery to completely eradicate the cancer cells that may have spread to the adjacent organs. Patients undergoing chemotherapy are immunocompromised because of myelosuppression. In this regard, patients should be placed in reverse isolation to prevent infections from occurring.
Radioactive materials may be placed within the patient to destroy malignant cells. Radioactive rays may also be directly aimed at the cancerous cells. Radiation therapy prevents the spread of cancer cells as well as reducing the size of the tumors.
The outcome of treatment for jaw osteosarcoma depends on the grade and stage of the diseases. Generally, osteosarcomas in the bone have better prognosis than other forms of malignancies especially when the cancer cells are still confined inside the jaw bone.
Prompt treatment of jaw cancer in its early stages provides a successful result. The survival rate of jaw cancer is 40% for men and 50% for women at the time diagnosis and treatment is made regardless of the stage. Osteosarcomas are very responsive to chemotherapy and radiation which contributes to a high survival rate.
Jaw Cancer Pictures
A Jaw Tumor Seen at the floor of the Mouth
A Locally Advanced growth of the Jaw Cancer
Jaw Cancer spreading to other Areas in the Mouth
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