Buccal carcinoma invades the entirety of the mouth including the lips, cheeks and tongue or bottom of the mouth. It belongs to head and neck carcinomas and leads to major health complications while early diagnosis and treatment can at least alleviate them. 
Oral or buccal cancer usually begin as a small white or red patch or of sore in mouth that not to heal. 
A combination of many factors can increase the probability of occurrence of buccal cancer for instance smoking or drinking and betel use or poor dental health because of the rough teeth or the existence of dental appliances as well as HPV human papillomavirus infection. 

Frequency: In Western Europe and North American there are 5–10% of squamous cell cancers in the oral cavity end up in the buccal mucosa. 
Geographical Variation: The certain localization of buccal carcinoma tends to be true in Southeast Asian countries and some South Asia countries and some parts of the continent of Africa where the use of tobacco & betel nut or alcohol is common. 
Risk Factors: Buccal carcinoma is often amongst smoking habits (tobacco or chewing) consuming alcohol in excessive quantity and poor oral health and sometimes due to the HPV virus with type 16 clearly on a higher preference. 
Gender Differences: In the past, buccal carcinoma has shown a male bias with women experiencing lower rates but in some regions this gap may be narrowing away as more women adopt a few traditionally male-dominant lifestyle habits. 
Age Distribution: It can happen to anyone at any age but buccal squamous line carcinoma (BSCC) is usually diagnosed in older people who are over 45 years of age. Yet younger people are the ones experiencing an upsurge and the reason may be due to lifestyle changes. 
Socioeconomic Factors: The poorer socioeconomic status is co-related with the high rates of buccal carcinoma primarily due to the increased smoking and alcohol abuse and scarcity of such health care services as preventive body check-ups and the detection of cancer cases at an early stage. 

Initiation: Cells of buccal mucosa may turn into buccal carcinoma owing to any of these three factors: carcinogenic agents or  inflammations and genetic factor.
Promotion: Can result from prolonged contact of harmful substances such as chemical carcinogens or skin irritation and trauma.
Progression: Genetic mutations in healthy cells lead to their becoming cancerous, after which they invade adjacent regions like the muscles, oral cavity, and marrow inside the bones.
Metastasis: Primary oral squamous cell carcinoma later metastasizes via bloodstream has an invasion into regional lymph nodes or distantly to the lung and the liver. 

This carcinoma of buccal cavity typically arises from lengthy exposure to one or more risk factors with tobacco and alcohol being the main factors. The carcinogens through smoking and drinking can cause genetic mutations in cells lining the inner cheeks (buccal mucosa) thus finally many cancers develop as a result. Moreover consistent irritation which might occur due to teeth sharpness or incorrectly fitted dentures and bad oral hygiene also increases the risk of buccal carcinoma development. Human papillomavirus is also associated with some cancerous types of buccal carcinoma. 

Tumor Stage: The stage of buccal carcinoma affects its prognosis. Cancer that is spreaded ultimately results in poor prognosis. 

Lymph Node Involvement: Lymph node metastases contribute to the cancer progression and deterioration of the patients’ welfare. 

 Tumor Grade: The cancerous cells’ abnormal appearance allows them to replicate quicker and spread widely. Grade 1 worsens the prognosis. 

Age group: The common age range for occurrence of buccal carcinoma is between the ages 40-50 years though it can occur any time. With aging this risk is higher; substances like tobacco or alcohol, which are the most prominent causes of oral cancers are the main risk factors. While the highest risk age groups are susceptible to facial cancer and the young age population is also not spared from this type of cancer if they already have existing risk factors or genetic predispositions. 

Visual Inspection 

Palpation 

Biopsy 

Lymph Node Examination 

Medical History 

Advanced Imaging 

Tobacco and alcohol users 

Betel nut chewers 

HPV infection 

Immunocompromised individuals 

The aggressiveness of the tumour, the stage of the malignancy and the health of the individual can all affect how well a presentation is made.  
Symptoms of buccal cancer may manifest as ulcers or sores that may not go away in a few weeks. The presentation includes: 
Continuous soreness or pain in the mouth 
Difficulty swallowing or chewing.  
Bulge or swelling in the neck or mouth.  
Alterations in the fit of the teeth.  
Tingling or numbness in the lips or mouth. 

Surgery: Primary treatment of buccal carcinoma is aimed towards confirmation of lesion and clearance of tissue around it containing no cancer. 

Radiation Therapy: It applies beams of high energies that can select and disintegrate cancer cells either before or after surgery. 

Chemotherapy: Drugs used either for the destruction or stoppage of cancer cell multiplication are used typically with surgery and radiation. 

Targeted Therapy: Targets the tumor cells directly and aiming at destroying them with the minimal damage to normal cells.

Immunotherapy: When used either as the alone or in conjunction with other therapy especially for advanced cases or utilize the immune system of the body for fighting cancer. 

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Tobacco Control: Smoking and tobacco increase the risk of cancer. Relevant programs such as Quit smoking advertisements can minimize the exposure. 
Alcohol Consumption: Excessive drinking is a high-risk factor for mouth cancer diagnosis. 
Dietary Changes: Fruits and vegetables can lessen chance of developing oral cancer; thus the recommendation of a balanced diet reduces risks of this malignancy. 
HPV Vaccination: HPV infection, which is highly associated with HPV-type-16 has a favourable link to oral cancer and has been proven to be one of the leading causes of HPV-related cancers. However, vaccination before one begins their sexual life activity significantly decreases the risk of developing HPV-related cancers. 
Oral Hygiene: Increased oral cancer risk resulted from the bad dental hygiene; the check-ups and hygiene education is significant factor in reducing the risk. 
Environmental Pollution: Chemically toxic substance that increases the risk of oral cancers so regulations and clean environments reduce exposure. 
Sun Protection: Sunscreen and hat can reduce lip cancer risks so the sunscreen should be used daily. 
Education and Awareness: Public education and screening programs also alleviate the oral cancer infection. 

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In certain situations where surgery is not suitable due to the size or location of the tumour and due to medical reasons for these conditions, radiation therapy may be used as the main treatment for buccal carcinoma. 
 
Radiation can be employed to eliminate any cancer cells which remain after the tumour has been taken out.  

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Cisplatin: This is the primary drug being used to treat different carcinomas such as buccal carcinoma and this is the most common one that is used. Its mechanism is related to the DNA inside the cancer cells, stopping them from dividing and thus preventing to grow. 
5-Fluorouracil (5-FU): This is antimetabolite drug that causes a tumor to stop proliferating since it targets the metabolic pathways that cancer cells use for survival. It is administered with other chemo drugs to achieve combination therapy for oral cancers treatment. 
Carboplatin: Another platinum-based drug which is having same action like cisplatin is commonly used as chemotherapy drug especially in oral cancer treatment. It shares genetic mechanism of DNA targeted as symptomatic structure of cancer cells growth and division. 
 

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Wide Local Excision: In this technique removing the tumour together with surrounding healthy tissue of a chosen width to ensure complete removal of the cancerous cells. The amount of tissue removed is based on whether the tumor is small or bulging and deep or shallow. 
 
Mohs Micrographic Surgery: This procedure is undertaken by carefully multipartially stripping thin layers of tissue and checking them under a microscope directly after removal. With the help of it, in a highly targeted manner cancerous cells are removed yet safe the healthy cells. 
 
Reconstructive Surgery: Surgery reconstruction which might be necessary depend on how much tissue removal was done and may be used to restore this area’s local features and function. It might incorporate techniques such as grafts of skin and tissues nearby or microvascular free transfer of tissue. 
 
Maxillectomy or Mandibulectomy: If the tumor does incorporate the jawbone (maxilla or mandible) invasion then to cut off the recurrence of the tumor partial or complete extraction of the affected bone may be required. 

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Diagnosis: The exact diagnosis is cleared thorough clinical exam and imaging (CT, MRI) in combination with the biopsy of the tumor to determine its presence and extent within the body. 
 
Staging: Discover the tumor stage in carcinoma and that helps to determine the treatment by being able to determine a tumor of what size and depth and the presence of it in nearby organs/tissues. 
 
Treatment Planning: Tailored plan has risks and benefits based on the localized progress or physical status of patients and referrals to specialists doctors such as surgeons or oncologists and radiation professionals. 
 
Surgery: First-line treatment includes tumor removal by surgery (possibly with the deviation of cheek and lymph nodes); reconstruction operation might be required as well. 
 
Radiation Therapy: It destroys the left over cancer cells and thus it lessens the risk of recurrence of cancer. It can be used either before or after the surgery or even primary treatment. 
 
Chemotherapy: Added to surgical/radiation treatment mostly for when the cancers are in their later stages or to decrease their size prior to surgery. 
 
Rehabilitation and Supportive Care: The use of assistive technologies and psychotherapy facilitates the restorative process during and after the treatment the aim of which is to address speech, swallowing, and aesthetic disorders. Palliative care includes pain relief and nutrition. 
 
Follow-up and Surveillance: Follow up visits often involve tracking for recurrence of the cancer for particularly adverse complications and to assist in the management of side effects related to treatment.