Epidermoid cancers of mucous membranes
Epidermoid cancers of mucous membranes, primarily consisting of squamous cell carcinomas, arise in tissues lined by mucous membranes, which serve protective and functional roles within the body. These cancers can occur in various sites, including the mouth, larynx, and respiratory, gastrointestinal, and genitourinary tracts. Risk factors for developing these malignancies include nicotine and alcohol consumption, exposure to certain carcinogens like asbestos, and dietary habits involving high salt and preservatives. The mutation of the p53 gene is often implicated in the cancer's development, leading to abnormal cell growth and the formation of lesions such as erythroplakia and leukoplakia.
Symptoms may include persistent sores, lumps, difficulty swallowing, and altered sensory functions, prompting the need for medical evaluation. Diagnosis typically involves tissue sampling and imaging techniques, with oncologists employing a staging system to assess the extent of disease spread. Treatment options include surgery, radiation, chemotherapy, and emerging therapies like immunotherapy. Early detection significantly improves prognosis, with a survival rate of approximately 90% if identified early; however, many cases remain undiagnosed until advanced stages, leading to poorer outcomes.
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Epidermoid cancers of mucous membranes
RELATED CONDITIONS: Squamous cell carcinoma, skin cancers, head and neck cancers, nasopharyngeal cancer, laryngeal cancer, nasal cavity and paranasal sinus cancers, oral and oropharyngeal cancers, gastrointestinal cancers, urinary system cancers
DEFINITION: Epidermoid cancers of mucous membranes are squamous cell malignancies in tissues in which glands produce mucosal fluids to protect epithelial cells and assist various physiological functions. These membranes line the interiors of body cavities, organs, and structures that connect directly or indirectly to external skin openings. Some references to epidermoid cancers of mucous membranes limit them to head and neck cancers. Since the mid-nineteenth century, medical literature has mentioned epidermoid cancers in other mucous membranes, which are extensive throughout the torso, including respiratory, gastrointestinal, and genitourinary tracts.
Risk factors: Nicotine exposure increases people’s risk for developing epidermoid malignancies in mucous membranes in the mouth, larynx, and pharynx. Alcohol consumption exacerbates epidermoid cancer risks. Oncology experts have associated epidermoid cancers of mucous membranes with such carcinogens as asbestos and industrial by-products, including sawdust.
Medical professionals have connected these cancers to diets containing large amounts of salt and preservatives, which can damage mucous membranes. They have also tied these cancers to periodontitis, the Epstein-Barr virus, and the human papillomavirus (HPV), which causes epidermoid cancer in mucous membranes. Researchers have studied how pemphigoid, an autoimmune condition causing blistering of mucous membranes, possibly affects patients’ vulnerability to cancer.
Etiology and the disease process: Epidermoid carcinomas result from a mutation of the p53 gene, which usually occurs because of sun exposure. They form in squamous cells in external skin tissues and internal membrane tissues in organs and cavities. Squamous cell carcinomas develop in the outer epithelial layer of membranes when routine cell division and replacement and sometimes epithelial cell production of keratin proteins deviate, and extra abnormal cells and keratin accumulate. Malignant squamous cells typically first appear as lesions known as erythroplakia if red or brown and leukoplakia if white. Tumors grow and spread into other epithelial layers. For example, epidermoid tumors in the lungs begin in respiratory passage membranes and then extend to adjacent organs or lymph nodes.
Incidence: Squamous cell carcinomas associated with external skin cancers, with an estimated one million diagnoses in the United States yearly, occur more frequently than they develop in mucous membranes. Statistics for each type of mucous membrane affected by epidermoid cancers vary. Over 90 percent of various head and neck cancers consist of squamous cell carcinomas. Some 25 to 35 percent of non-small-cell lung cancer cases diagnosed involve squamous cell carcinomas. Men are more susceptible than women to developing epidermoid cancers in mucous membranes. These malignancies tend to occur after the age of sixty-five.
Symptoms: Many patients locate lumps in their necks or detect lesions on their lips or mouths. These oral sores and others in mucous membrane tissues do not undergo the normal healing processes. Epidermoid cancers in mucous membranes may cause sore throats and affect how people chew, swallow, and speak. Other symptoms include swollen or numb sinus, jaw, or neck areas, impaired hearing, respiration difficulties, and altered sensory abilities. Some patients experience problems with how dentures fit.
Screening and diagnosis: Health professionals, including dentists, screen patients for potential membrane cancers and collect tissue or fluid samples for laboratory testing. Diagnostic procedures include computerized imaging and scanning, endoscopic ultrasound, and other tests. Physicians differentiate epidermoid carcinomas in mucous membranes from keratin cysts and mucosal melanomas.
Oncologists stage most epidermoid cancers of mucous membranes with the TNM (tumor/lymph node/metastasis) system, devising designations that expand the four basic stages to describe lymph node impact more precisely in terms of tumor size, extent of metastasis, and location relative to nodes. Various types of mucous membrane epidermoid cancers have specific staging criteria, such as which vocal cord is affected.
Treatment and therapy: Many physicians use radiation, chemotherapy, and surgical treatment to remove tumors, lymph nodes, or affected organs. Radiation and chemotherapy without surgery enable patients to continue normal activities and capabilities by retaining body parts, such as their larynx, essential for speech. Some oncologists deliver chemoradiation intravenously to tumors. Researchers have tested the potential for using herpes simplex virus type 1 to treat tumors in mucous membranes. Cryosurgery, photodynamic therapy, and Mohs surgery are commonly used surgeries, but the choice will depend on the location and stage of the cancer. Topical medications like cream imiquimod or 5-fluorouracil are often used on the skin. Immunotherapy treatments include Cemiplimab-rwlc (Libtayo) and Pembrolizumab (Keytruda).
Speech and physical therapists, nutritionists, prosthodontists, plastic surgeons, and other specialists enhance the treatment of epidermoid cancers in mucous membranes. Psychologists offer emotional support because many mucous membrane cancer patients suffer intense depression.
Prognosis, prevention, and outcomes: Patients with epidermoid cancers in mucous membranes are most likely to survive if their malignancies are detected early, with an estimated 90 percent survival rate. Medical professionals estimate that more than 50 percent of cases, however, remain undiagnosed until tumor growth has expanded to later stages, increasing fatalities within five years of diagnosis compared with other cancers.
Bibliography
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