Oral cancer

Oral cancer is cancer of the mouth, which most commonly involves the lips or the tongue. It may also occur on the:

• Cheek lining
• Floor of the mouth
• Gums (gingiva)
• Roof of the mouth (palate)

Most oral cancers are a type called squamous cell carcinomas. These tend to spread quickly.

Smoking and other tobacco use are linked to most cases of oral cancer. Heavy alcohol use also increases your risk for oral cancer.

Other factors that may increase the risk for oral cancer include:

• Chronic irritation (such as from rough teeth, dentures, or fillings)
• Human papilloma virus (HPV) infection
• Taking medications that weaken the immune system (immunosuppressants)
• Poor dental and oral hygiene

Some oral cancers begin as a white plaque (leukoplakia) or as a mouth ulcer.

Men get oral cancer twice as often as women do, particularly men older than 40.

Symptoms

Sore, lump, or ulcer in the mouth:

• May be a deep, hard-edged crack in the tissue
• Most often pale coloured, but may be dark or discoloured
• On the tongue, lip, or other area of the mouth
• Usually painless at first (may develop a burning sensation or pain when the tumour is advanced)
• Bleeding

Other symptoms that may occur with oral cancer include:

• Chewing problems
• Mouth sores
• Pain with swallowing
• Speech difficulties
• Swallowing difficulty
• Swollen lymph nodes in the neck
• Tongue problems
• Weight loss

Signs and tests

Your doctor and/or dentist will examine your mouth area. The exam may show:

• A sore on the lip, tongue, or other area of the mouth
• An ulcer or bleeding

Tests used to confirm oral cancer include:

• Gum biopsy
• Tongue biopsy

X-rays and CT scans may be done to determine if the cancer has spread.

Treatment

Surgery to remove the tumour is usually recommended if the tumour is small enough. Surgery may be used together with radiation therapy and chemotherapy for larger tumours. Surgery is not commonly done if the cancer has spread to lymph nodes in the neck.

Other treatments may include speech therapy or other therapy to improve movement, chewing, swallowing, and speech.

Support Groups

You can ease the stress of illness by joining a support group of people who share common experiences and problems.

Expectations (prognosis)

Approximately half of people with oral cancer will live more than 5 years after they are diagnosed and treated. If the cancer is found early, before it has spread to other tissues, the cure rate is nearly 90%. However, more than half of oral cancers have already spread when the cancer is detected. Most have spread to the throat or neck.

About 1 in 4 persons with oral cancer die because of delayed diagnosis and treatment.

Complications

• Complications of radiation therapy, including dry mouth and difficulty swallowing
• Disfigurement of the face, head, and neck after surgery
• Other spread (metastasis) of the cancer

Calling your health care provider

Oral cancer may be discovered when the dentist performs a routine cleaning and examination.

Call for an appointment with your health care provider if you have a sore in your mouth or lip or a lump in the neck that does not go away within 1 month. Early diagnosis and treatment of oral cancer greatly increases the chances of survival.

Prevention

• Avoid smoking or other tobacco use
• Have dental problems corrected
• Limit or avoid alcohol use
• Practice good oral hygiene