FA-Basics - The What, Why & How

How does oral cancer develop?


Healthy cells

As already explained HERE, errors and damage to the genetic material (DNA) of a cell are usually repaired or these cells die (Fig 1).

Small damages

If the DNA repair mechanism (called the ‘FA pathway’) is disturbed, such as in FA (and other diseases), some damage is insufficiently repaired or not repaired at all (Fig. 2). If there are only a small number of defective cells, the immune system can clear these cells and it has no consequences.

Precancer

If damaged cells continue to divide, defective (= dysplastic) cells will gradually multiply. If these defects are severe, this can lead to “carcinoma in situ”, i.e. a preliminary stage of cancer (Fig. 3). The good thing about this preliminary stage is that no metastases – i.e. spread of the cancer elsewhere in the body – can develop.

Breakthrough

However, if the defective cells continue to multiply, they can overcome what is known as the ‘basement membrane’, and uncontrolled multiplication can occur. Figure 4 shows the "cancer" stage. At this point, metastases can develop.


Cancer does not develop overnight

The development of cancer usually takes place over the course of many years. So, cancer does not develop overnight! Only in exceptional cases and under certain conditions do we sometimes observe an accelerated development of cancer. In this case, it is particularly important to visit a specialist often for check-ups.
It's also important to understand that the likelihood of developing tumors increases with age, not just for people with FA but for everyone. The older you get, the more important is the topic of prevention.

Age plays a role

In observational studies of people with FA, it has been seen that those under the age of 25 are only slightly affected by oral mucosal cancer. However, the risk increases with age and is unfortunately very young compared to the general population without FA.

You should always remind your specialist of this increased cancer risk in young age.

It is believed that improved precautions, such as regular mouth self-examination, will result in much earlier detection and that the altered cells (image 3) will therefore be removed at an earlier stage. This should result in fewer oral mucosal cancers in young FA adults.


Use the visibility

In the development of oral cavity cancer in people with FA, the first defective cells will always arise as a result of visible changes in the oral mucosa. The oral mucosa is what you see when you look into the mouth, i.e. the area covered with saliva. Therefore, the process of cancer development described above starts with this visible change, and it can’t progress to deeper (less visible) layers without first going through this initial change.

And that is exactly why you can discover changed cells in the oral mucosa already very early!
The goal of early detection

Unfortunately, in the past, mucosal changes were often discovered too late. Either the check-ups didn't take place regularly enough, or the doctor overlooked something.


And this is where you come in!
You can support your health and keep track of what's happening in your mouth by conducting monthly oral self-examinations.

The earlier, the easier

We all know that the earlier a tumor is discovered, the easier it is to treat. The use of radiation for people with FA, while possible, can be difficult. Classic chemotherapy for oral mucosal cancer is even more problematic for people with FA (it is not comparable to the chemo received during BMT, by the way). Therefore, surgery is the best treatment for mucosal tumors.

And the earlier a tumor is discovered, the smaller the spot, and therefore the less tissue that has to be removed during the surgery!


Social media & sharing icons powered by UltimatelySocial