Oral cancer is cancer of the mouth. It can occur in the lining of the mouth or in the deeper tissues such as the bone, muscle, and nerves. Cancer of the mouth lining is called a carcinoma and makes up 90% of all oral cancer. Cancer of the mouth is most common in people over 40 years of age, but it can occur in younger people.
Oral cancer is one of the most preventable cancers when caught early. Unfortunately, more people die from oral cancer than from cervical cancer, Hodgkin's lymphoma, or melanoma. This is because oral cancer is often diagnosed when it is already advanced. Early diagnosis and treatment is the most effective way to treat oral cancer.
Oral cancer is not caused by one thing, but certain factors increase its risk. Factors include smoking, chewing tobacco or using snuff, drinking excessive alcohol, having unprotected sun exposure to the lips, having a history of leukoplakia (usually a harmless, thick, white patch inside the mouth that cannot be removed), and chewing betel nut – all these increase the risk of developing oral cancer. This risk of oral cancer is even higher when people have more than one or more of these unhealthy habits.
Infections of the mouth with the human papillomavirus (HPV, particularly HPV-16 strain) may also increase the risk of oral cancer. For some, oral cancer develops without any of these risks. People that have had head and neck cancer in the past may also have an increased risk of oral cancer.
Symptoms and Complications
Oral cancers commonly affect the sides of the tongue and the floor and roof of the mouth.
The possible signs of cancer include:
- ulcer or painless sore in the mouth that does not heal within 14 days
- a lump in the mouth or neck
- changes in colour or texture of the mouth
- difficult or painful chewing or swallowing
- change in taste or tongue sensation
- thickening of the cheek
- numbness of the mouth or face
- hoarse voice that lasts a long time
- white or red patches in the mouth
- difficulty moving the jaw or tongue
- dentures that don't fit well
- loose teeth
- problems speaking
- bleeding or pain in the mouth or on the lip
- flat, hard spot on the outside of the bottom lip
- a wart-like growth in the mouth
It is important to have any of these changes checked by your doctor or dentist. Having these symptoms does not always mean the person has cancer, but because it could be cancerous, it is best to get it checked.
Making the Diagnosis
Most oral cancers are diagnosed by examining the signs or symptoms, including lumps, ulcers, sores, and abnormal swellings. If your doctor thinks you may have oral cancer, they will examine you and may order more tests that could include X-rays, laboratory tests, ultrasounds, scans, or a biopsy. A biopsy is a small sample of tissue that's been removed so it can be looked at under the microscope.
These tests will help confirm a diagnosis of oral cancer and determine whether the cancer has spread. Oral cancer may spread to the lymph nodes in the neck. It can also spread to the bone, liver, and lungs, but this is not very common.
Since oral cancers can be painless and have no symptoms in the beginning, it's important to have regular oral checkups by your doctor or dentist to catch oral cancer early. When oral cancer is caught early, treatment is more successful.
Treatment and Prevention
By quitting smoking and limiting alcohol intake, many oral cancers can be prevented. Staying out of the sun also decreases the risk of lip cancer. Checking your mouth regularly and reporting any abnormal changes or signs and symptoms to your doctor/ dentist may help you take a proactive approach towards preventing oral cancer.
Treatment for oral and lip cancers depends on how far the cancer has spread and on individual needs. Treatment may include radiation, surgery, and chemotherapy – either separately or in combination.
Radiation is used as the main treatment, after surgery, or to relieve pain for people with advanced oral cancer. The side effects will depend on the area that is receiving the radiation. Some general side effects include feeling tired, skin redness, and mouth irritation. Radiation can also cause dry mouth, which can last a long time. Since radiation can cause dental problems, any existing dental problems are always treated and given enough time to properly heal before radiation therapy is underway.
Surgery is another treatment option for oral cancer. If the cancer is removed before it has spread to the lymph nodes, the cure rate is much higher. Surgery is also used to remove lymph nodes and to reconstruct areas of the mouth or face after the cancer has been removed.
Chemotherapy is typically reserved for cancers that have spread and it's combined with other treatment strategies (i.e., surgery or radiation).