What & Where is the Buccal Region?
The word “buccal” refers to the inside of the cheeks in the mouth. Buccal cancers start out as a lump or ulcer inside the cheek that doesn’t go away after a few weeks. Excessive tobacco and alcohol use are both known to contribute to the development of buccal cancer. Cancerous growths in this area tend to be painful and may bleed easily. Remember that not all lumps in the cheeks are cancer, but if a patient feels a growth in this area, it is a good idea for them to see a doctor to get it checked out.
A biopsy may be necessary to determine if the growth is a cancer, and further evaluation with an MRI or a CT scan may be required. The treatment for buccal cancers is usually surgery, sometimes followed by radiation treatment and occasionally chemotherapy.
Buccal Region Anatomy
In order to begin to understand buccal cancer, it is important to gain some background knowledge on the surrounding anatomy. The buccal region refers to the inner cheek, with the buccal mucosa being the lining of the inside of the cheek. The buccal mucosa extends from the anterior tonsillar pillar at the back of the mouth, to the lining of the lips at the front of the mouth. A branch of the fifth cranial nerve, called the trigeminal nerve, provides feeling to this entire region of the mouth.
Causes, Signs & Symptoms
Common Causes of Buccal Cancer
- Tobacco
- Alcohol
- Betel nut
In some cases, the first sign of buccal cancer could be a lump in the neck. This means that the tumor has spread to lymph nodes in the neck. However, in buccal cancers, the primary cancer in the mouth is usually noticed before it reaches these lymph nodes.
Common Symptoms
- Painful sores or ulcers in the mouth.
- A patch in the mouth.
- Recurrent bleeding from the mouth.
- Bad breath.
Other Possible Symptoms
- Loose teeth or dentures that don’t fit correctly.
- Difficulty opening the mouth (trismus).
- Numbness (i.e. in the lower teeth or lower lip/chin area).
- Pain or difficulty with swallowing.
Learn more about the causes, signs & symptoms of buccal cancer
Diagnosis
The diagnosis phase can be difficult and overwhelming. During this phase, further testing will be necessary to confirm a diagnosis and determine the best course of treatment. Patients can expect their doctor to have a discussion with them about the risks, benefits, and alternatives to having a physical examination, a biopsy and having imaging scans performed.
Type, Grade & Stage
After diagnosing a patient with buccal cancer, a doctor will need to determine what type of cancer it is, the grade of the tumor (i.e. the risk level), and the stage of the cancer based on a biopsy or pathology after surgery.
It is important to note that oral cancers can be difficult to diagnose. If a doctor is having a hard time determining what type of cancer it is, they might ask for a second opinion and send some pieces of the tumor off to a specialist in head and neck pathology who deals more frequently with these types of tumors.
Treatment Plan
After determining a diagnosis and completing a full pre-treatment evaluation, doctors will recommend a course of treatment for their patients.
In general, there are three different options for the treatment of buccal cancer that can be used alone or in combination: surgery, radiation and chemotherapy.
Prognosis
A prognosis is a prediction of the outcome of one’s disease. How likely is survival? Will the cancer come back? These are the big questions on most people’s minds after receiving a diagnosis of buccal cancer.
In general, there are 5 tumor characteristics that can inform a patient about their chances of being cured: the stage, the site, the type & grade, the spread to lymph nodes, the tumor margins and the spread into local structures.
What to Expect After Treatment
After treatment, patients should follow-up with their doctors on a regular basis.
Patients should visit their head and neck specialist on a regular schedule (or earlier if they have any concerning symptoms). This allows doctors to monitor the patient for any sign that the cancer has returned. The best timeline for follow-up will be determined by the doctor.