In medical terms, cancer is defined as an uncontrollable growth of cells inside an organ or tissue that invade and cause damage to surrounding tissues.
Most people have heard of cancer affecting parts of the body such as the lungs, breasts or liver. However, a cancerous tumor can also develop in the lining of the mouth.
By understanding the causes and early signs of oral cancer, you can learn how to prevent and treat this life-threatening disease. It is very important to remember that if mouth cancer is diagnosed early, a complete cure is very often possible.
Mouth cancer, also known as oral cancer, usually appears as a growth or sore in the mouth that does not go away. Oral cancer may develop:
- on the surface, side or the back of the tongue
- the insides of the cheeks
- the roof of the mouth, which includes the hard and/or the soft palate
- the floor of the mouth
- the lips or the gums
Other, less common places where mouth cancer may appear are in the glands that produce saliva, the tonsils at the back of the mouth, the sinuses or the pharynx (throat).
Mouth cancer can be life-threatening if not diagnosed and treated early. However, if mouth cancer is caught early, there is a very high chance of curing the disease so it never comes back.
Who's affected by mouth cancer ?
Mouth cancer is the sixth most common cancer in the world. Mouth cancers are more common in people over 40; however, recent studies have shown that mouth cancer is becoming more common in younger patients. HPV infection is thought to be associated with the majority of cases that occur in younger people.
Oral cancer is more frequent in men than in women. One of the reasons may be that, on average, men tend to drink more alcohol than women.
What can cause mouth cancer ?
The leading causes of mouth cancer are tobacco and alcohol. Both contain chemicals that can damage the DNA in cells and lead to cancer.
Tobacco of any kind increases the risk of mouth cancer. Cigarette, cigar, or pipe smokers are all at a higher risk of developing cancers of the cheek, gums, and lining of the lips. Smokeless tobacco products aren't harmless either; users of dip, snuff, or chewing tobacco products are 50 times more likely to develop mouth cancer.
Smoking increases the risk of developing other types of cancer, such as liver cancer, pancreatic cancer, and esophageal cancer. Recent reports show that 90 percent of those with oral cancer consume tobacco.
Excessive consumption of alcohol
Heavy use of alcohol increases a person's chance of developing oral cancer, and if tobacco and alcohol are consumed together the risk is even greater.
There is evidence that a poor diet may increase your risk of developing some types of mouth cancer. A healthy and balanced diet that includes plenty of fruit and vegetables is believed to reduce the chances of developing cancer.
Over-exposure to sunlight
Excessive sun exposure can increase the risk of cancer of the lips, especially at a young age.
Human papillomavirus (HPV)
The human papilloma virus (HPV) is a family of viruses that affect the skin and moist membranes that line the body, such as those in the cervix, mouth, and throat. HPV can be spread through normal sex, oral sex or even close skin-to-skin contact with a person who's already infected.
HPV can cause abnormal tissue growth and it is the major cause of cervical cancer. Recent research suggests that it could soon rival smoking and drinking as one of the main causes of mouth cancer.
Long-standing mouth wounds
There is a small chance that broken teeth, which cause persistent ulcers or wounds on the tongue or the insides of the cheeks, can increase the chance of mouth cancer developing there. The same can be true with ill-fitting dentures.
Types of mouth cancer
All body cancers can be categorized by the type of cell the condition starts in. There are five types of cancer that can develop inside the mouth; the first one is the most common:
- Squamous cell carcinoma is the most common type of mouth cancer, accounting for 9 out of 10 cases. Squamous cells can be found in many places of the body, especially the skin and the inside of the mouth.
- Adenocarcinomas develop inside the salivary glands.
- Sarcomas: these types of cancer grow from cells inside the bone, cartilage or muscle.
- Melanomas: cancer starts in melanocytes, the cells that produce skin pigment; they appear as very dark, mottled swellings that often bleed.
- Lymphomas grow from cells normally found in lymph glands, but sometimes, they can develop inside the mouth.
Mouth cancer signs. Mouth cancer symptoms
Oral cancer can occur anywhere in the mouth. An early detection is crucial in overcoming this disease. As a result, you should see your doctor immediately if any of these signs or symptoms persist for more than two weeks.
Sometimes, mouth cancer can appear as a painless mouth ulcer that does not heal normally. A lump or swelling that does not go away, as well as white or red patches inside the mouth, can also develop into cancer.
The most common signs of oral cancer include:
- sore mouth ulcers that don't heal within two weeks
- unexplained swellings, lumps or bumps, rough spots or eroded areas anywhere in your mouth that don't go away
- unexplained bleeding in the mouth
- persistent lumps in the neck that don't go away
- white or red patches or lesions in your mouth that don't heal within several weeks
- unexplained, persistent numbness or an odd feeling on the lip or tongue
- loose teeth with no apparent dental cause or sockets that don't heal after extractions
- problems with chewing, swallowing or speaking
- hoarseness, chronic sore throat, or change in voice
- swellings that make wearing dentures uncomfortable
- ear pain
- dramatic weight loss
Mouth cancer screening
Regular oral cancer examinations by your dentist are crucial in detecting the disease in its early stages. These regular checkups are also known as oral cancer screening.
During a routine screening, your dentist will look for any sores or discolored tissue inside your mouth. He or she will also check for any signs and symptoms mentioned above, palpate the neck and jaw area, and examine both the top and underside of your tongue.
If your dentist finds something unusual, he will likely recommend a biopsy of the area. A biopsy is a small sample of the cells gathered from the area, that will be examined under the microscope to see whether they are cancerous or not.
If the result is positive, more tests will be carried out to decide the course of the treatment. These may include overall health checks, blood tests, x-rays or scans.
New oral cancer screening technology is also available: VELscope is a brand new oral cancer screening system that uses incandescent light so your dentist can see abnormalities that may not be apparent or visible to the naked eye. ViziLite is a painless screening tool for the detection of small changes in your mouth.
Oral cancer screenings should be conducted every six months. Most doctors will perform them during the regular dental checkups.
Preventing mouth cancer
Preventing mouth cancer together with the early detection are the most effective ways of dealing with this condition. You can do a lot of things to prevent oral cancer or to make sure it is not coming back after successful treatment:
Quit smoking and do not use any tobacco products. Regardless of how long you have used tobacco products, quitting now can greatly reduce the risk of mouth cancer and other serious risks to your health.
Don't drink alcohol in excess.
Limit your exposure to the sun, as repeated exposure increases the chances of cancer of the lip, especially the lower lip. When in the sun, be sure to use a good protective sun cream, and put the correct type of barrier cream on your lips.
A rich and balanced diet, with plenty of fruits and vegetables (rich in vitamins A, C and E) provides protection against the development of mouth cancer. Olive oil and fish are also recommended.
Practicing safe sex and limiting the number of partners you have may help reduce your chances of contracting HPV.
Another crucial measure is to visit your doctor immediately if you notice any abnormal changes in your mouth that do not heal in two weeks. As mentioned before, oral cancer screenings should be performed every six months.
How is oral cancer treated ?
If mouth cancer is caught early, there is a very high chance of curing it. That's why you should promptly report any changes in your mouth to your dentist or doctor.
Why is an early catch so important ?
Throughout this article, we have stressed several times the vital importance of an early diagnose for mouth cancer. There are two main reasons for that:
If oral cancer is caught early, relatively minor surgery can be performed. Consequently, the aesthetic results and the overall outcome will be much better.
There are two ways mouth cancer can spread:
- Directly - cancer can spread out of the mouth and into nearby tissues
- Through the lymphatic system, which is a series of vessels and glands spread throughout the body. Mouth cancer that spreads to another part of the body is known as metastatic oral cancer. Oral cancer can spread to vital organs such as the lungs, liver or pancreas. These types of cancer are life-threatening and, most often, treatment in this stage is very difficult.
Therefore, it is crucial to catch and treat mouth cancer, before it has the chance to spread throughout the body.
What are the main treatment options ?
Mouth cancer is treated the same way many other cancers are treated. There are three main treatment options for mouth cancer:
The entire cancerous growth (or tumor) is surgically removed, along with a small part of the surrounding normal tissue or cells to ensure the cancer is completely removed. The aim of surgery is to remove any affected tissue while minimizing damage to the rest of the mouth.
Radiotherapy uses high-energy X-rays to kill cancerous cells. In mouth cancer, it is usually used after surgery to prevent a cancer recurrence. Generally, the treatment is given every day over the course of six weeks, depending on the size of cancer and how far it's spread.
Chemotherapy uses powerful medications to kill cancerous cells. This medication will damage the DNA of the cancerous cells, interrupting their ability to reproduce. Chemotherapy can be used in combination with radiotherapy when the cancer is widespread or when it is a high risk of the cancer returning.
Most of the times, these treatments are performed in combination: surgery is used to remove the cancerous tumor, followed by radiotherapy and/or chemotherapy to destroy any remaining cancer cells. Besides removing the entire cancerous tissues, treatment of mouth cancer will have to focus on two important goals:
- Maintaining the aesthetics and appearance of your mouth and face
- Restoring all the important functions of the mouth, such as breathing, speaking, and eating
A new treatment approach is offered by Tempus, a company who focuses on technology-based cancer treatment research. One of the main goals of this new approach is analyzing DNA and RNA data to understand a patient's tumor at a molecular level and uncover more personalized treatment options.
The good news is that because of the improvements in surgery, radiotherapy, medication, and technology, the chances of a cure are better than ever. Moreover, if mouth cancer is diagnosed early, a complete cure is often possible in up to 90% of cases using surgery alone.
Webmd: Oral Cancer
NHS Choices: Mouth cancer
Colgate, Oral Care Center: Early Signs Of Mouth Cancer by Donna Pleis
Last review and update: December 2020