How is a biopsy performed in lip tumors?
Usually, a piece containing both the abnormal-looking area and healthy tissue is removed with the help of a scalpel or other instruments and placed in a container containing special liquids to prevent deterioration and sent to the pathology laboratory.
This procedure is usually performed under local anesthesia without hurting the patient. Sometimes it may be possible to remove the entire lesion. This will be decided by the physician.
After the biopsy, the patient can continue his daily life, but is advised to eat only soft and cold foods for a while.
Biopsy is mainly performed by ear, nose and throat specialists. In addition, dermatologists and sometimes general practitioners and dentists can also perform biopsies. However, it is always the pathologist who will examine the tissue.
Is a biopsy necessary for the diagnosis of lip cancer and does taking a biopsy increase the spread of the tumor?
Taking a biopsy is a risk that causes the tumor to spread and harms the patient. It is not a transaction. On the contrary, in order to apply the most accurate treatment as soon as possible, it is possible to first name the disease by biopsy.
For this reason, biopsy is essential for correct diagnosis. We can only talk about the suspicion of cancer before biopsy.
How is staging (TNM Classification) done in lip cancer?
Clinicians use this system, known in medicine as TNM classification, to indicate the stage of the disease and prognosis (course of the disease, They are used to predict the course of the disease and ultimately plan the most appropriate treatment for the patient.
T; the size of the tumor where it originates,
N; For tumors in the head and neck region, the size and status of the tumor that has metastasized (spread) to the neck lymph nodes,
M; It indicates the presence of metastasis in distant organs beyond the neck, often through blood.
For example, T1 N0 M0 lip tumor means a tumor on the lip that is less than 2cm in widest dimension, has not spread to the lymph nodes in the neck, and has not spread to distant organs. In another classification, 'stage' means 1, that is, the earliest stage tumor.
In this classification;
T: from 1 to 4
N: From 0 to 3
M: Expressed as 0 or 1.
Of these three letters, the most determining one regarding the course of the disease is M (spread of the disease through blood or to distant areas). In the presence of metastasis to distant organs, it becomes M1, which means the other classification, 'stage' 4C, that is, the last stage disease.
How is staging done in lip and oral cavity cancers?
The valid classification used by physicians all over the world to report the extent of cancer in the body, that is, its stage, is the TNM classification and the related 'staging'.
Accordingly;
T; the size and spread of the tumor where it originates,
N; Presence of metastasis (spread) in the neck lymph nodes for tumors in the head and neck region, and if metastasized, the number and size of the metastasized lymph nodes,
M; It indicates whether there is metastasis beyond the neck, in distant organs (lung, bone, brain and liver), most often through blood.
T Category
Tis :Cancer in situ. In other words, the cancer is very superficial in the lining layer called the epithelium and has not reached the lymph and blood vessels required for its spread.
T1: The largest dimension of the tumor is less than 2cm.
T2: Tumor size is between 2cm and 4cm.
T3: Tumor size is greater than 4cm.
T4:The tumor has extended to the structures adjacent to the oral cavity.
T4a:It has extended to the lower jawbone (mandible), upper jawbone (maxilla), face and neck skin,
T4b: The tumor has spread to the bones in the area called 'skull base' at the bottom of the skull or to the jugular vein called the carotid or carotid artery and has surrounded it.
N Category
N0: No detectable metastasis in neck lymph nodes.
N1: Neck, mouth There is a single metastasized lymph node, smaller than 3cm, on the same side (right or left) as the tumor within it.
N2a: In the neck, larger than 3cm on the same side as the tumor inside the mouth, There is a single lymph node with metastases smaller than 6 cm.
N2b: In the neck, There is more than one lymph node with metastases smaller than 6 cm on the same side as the tumor in the mouth.
N2c: In the neck, on the opposite side of the tumor in the mouth (for example, on the right side of the neck if the tumor is on the left in the mouth). There is a lymph node with metastasis that is smaller than 6 cm.
N3: There is a lymph node with metastasis that is larger than 6 cm on any side of the neck.
M Category
M0: No metastasis (spread) to distant organs.
M1: Beyond the neck, distant organs (lung, bone, brain and liver). There is often metastasis (splash) through blood.
Staging
Final staging refers to the combination of patient-specific T, N and M classifications. For example, a T1 N0 M0 tumor is the earliest stage, that is, stage 1. On the other hand, a tumor that has spread to distant organs such as the brain or lungs is called stage 4c (the most advanced stage).
** Important Note: This complex classification can be confusing for patients. Consult your doctor with any questions you may have.
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