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Oral cancer

  • Definition
    • Oral cancer is cancer that starts in the mouth.

  • Alternative Names
    • Cancer - mouth; Mouth cancer; Head and neck cancer; Squamous cell cancer - mouth; Malignant neoplasm - oral

  • Causes
    • Oral cancer 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 carcinoma. These cancers tend to spread quickly.

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

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

      • Chronic rubbing (such as from rough teeth, dentures, or fillings)
      • Human papillomavirus (HPV) infection (same virus that causes genital warts)
      • Taking medicines 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 develop oral cancer twice as often as women do. It is more common in men older than 40.

  • Symptoms
    • Oral cancer can appear as a lump or ulcer in the mouth that may be:

      • A deep, hard-edged crack in the tissue
      • Pale, dark, or discolored
      • On the tongue, lip, or other area of the mouth
      • Painless at first, then a burning sensation or pain when the tumor is more advanced

      Other symptoms may include:

      • Chewing problems
      • Mouth sores that may bleed
      • Pain with swallowing
      • Speech difficulties
      • Swallowing difficulty
      • Swollen lymph nodes in the neck
      • Tongue problems
      • Weight loss
  • Exams and Tests
    • Your doctor 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:

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

  • Treatment
  • Support Groups
    • You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.

  • Outlook (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%. More than half of oral cancers have spread when the cancer is detected. Most have spread to the throat or neck.

  • Possible Complications
    • Complications of oral cancer may include:

      • 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
  • When to Contact a Medical Professional
    • Oral cancer may be discovered when the dentist does a routine cleaning and examination.

      Call 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 chance of survival.

  • Prevention
    • Oral cancer may be prevented by:

      • Avoiding smoking or other tobacco use
      • Having dental problems corrected
      • Limiting or avoiding alcohol use
      • Visiting the dentist regularly and practicing good oral hygiene
  • References
    • National Cancer Institute. PDQ lip and oral cavity cancer treatment. Bethesda, MD: National Cancer Institute. Date last modified: September 25, 2015. Accessed: January 4, 2016.

      National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology (NCCN guidelines): Head and neck cancers. Version 1.2015. Accessed: January 4, 2016.

      Romesser PB, Riaz N, Ho AL, Wong RJ, Lee NY. Cancer of the head and neck. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 68.