oral cancer, a malignant neoplasm on the lip or in the mouth that occurs at an average age of 60, with a frequency eight times higher in men than in women. Predisposing factors are alcoholism; heavy use of tobacco; poor oral hygiene; ill-fitting dentures; syphilis; Plummer-Vinson syndrome; betel nut chewing; and, in lip cancer, pipe smoking and overexposure to sun and wind. Premalignant leukoplakia or erythroplasia or a painless nonhealing ulcer may be the first sign of oral cancer; localized pain usually occurs later, but lymph nodes may be involved early in the course. Diagnostic measures include digital examination, biopsy, exfoliative cytology, x-ray film of the mandible, and chest films to detect metastatic lung lesions. Almost all oral tumors are epidermoid carcinomas. Adenocarcinomas occur occasionally, whereas sarcomas and metastatic lesions from other sites are rare. Small primary lesions may be treated by excision or irradiation, and more extensive oral tumors may be treated by surgery, with removal of involved lymph nodes and preoperative or postoperative radiotherapy. Among chemotherapeutic agents administered are cisplatin, methotrexate, 5-fluorouracil, bleomycin, and Adriamycin. Postoperative nursing care involves maintenance of airway patency, relieving pain, promoting adequate nutrition, and health teaching regarding follow-up care and psychosocial adjustment if body image has been affected.
