Oral Cancer

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What is oral cancer?

Oral cancers are malignant tumors that occur anywhere inside the mouth. Most oral cancers are squamous cell carcinomas that start in the surface lining of the mouth. The most common location is the lip or tongue, but oral cancers can occur anywhere in the mouth. Common symptoms include pain, a sore that does not heal, and problems with talking or swallowing.

Alcohol and tobacco use are the biggest risk factors for oral cancer. It is more common in men than in women and typically occurs after the age of 40. Each year, about 37,000 people in the United States are diagnosed with some type of oral cancer (Source: ACS).

Oral cancers, when caught early, are often treatable with either surgery or radiation therapy, depending upon their location and size. After surgery to remove the cancer, reconstructive surgery can help restore structures that have been removed and rehabilitation can help you relearn how to eat, swallow or talk, if needed.

Emergencies related to oral cancers are rare. Seek immediate medical care (call 911) for serious symptoms, such as uncontrolled or heavy bleeding or changes that make it difficult to swallow or breathe. Seek prompt medical care if you develop sores or lumps in your mouth, or if you start having problems eating, swallowing or speaking.

What are the symptoms of oral cancer?

Oral cancer may start as a sore or lump in the mouth that does not go away. Problems with eating, swallowing and talking may occur, and the sense of taste may be altered. Lymph nodes in the neck may be enlarged and unexplained weight loss may occur.

Common symptoms of oral cancer

Common symptoms of oral cancer include:

  • Altered sense of taste

  • Bleeding

  • Cracking of an area of the mouth

  • Difficulty eating or swallowing

  • Difficulty talking

  • Lump that does not go away

  • Nonhealing sore, which may be white, pale, red, dark, or otherwise discolored

  • Oral pain

  • Swollen lymph nodes in the neck

  • Thickened area in the mouth

  • Unexplained weight loss

Symptoms that might indicate a serious condition

Oral cancers can have significant complications. Seek prompt medical care if you, or someone you are with, have any of these symptoms:

  • Altered sense of taste

  • Bleeding in the mouth

  • Difficulty eating or swallowing

  • Difficulty talking

  • Oral pain

  • Persistent swollen lymph nodes (for more than two weeks)

  • Sore or lump of the mouth that does not heal

  • Unexplained weight loss

What causes oral cancer?

What causes cells to undergo changes that lead to cancer is not known; however, several risk factors are known, including tobacco use, which is the strongest single risk factor for developing cancer of the mouth, and alcohol use. Infection by human papilloma virus plays an important role in the development of genetic changes that initiate the development of cancer.

What are the risk factors for oral cancer?

A number of factors increase the risk of developing oral cancer. Not all people with risk factors will get oral cancer. Risk factors for oral cancer include:

  • Age over 35 years
  • Alcohol abuse
  • Chronic irritation of the mouth
  • Diet low in vegetables and fruits
  • Human papilloma virus (HPV) infection
  • Male gender
  • Poor oral hygeine
  • Smoking or use of other tobacco products
  • Sun exposure

Reducing your risk of oral cancer

You may be able to lower your risk of oral cancer by:

  • Eating plenty of vegetables and fruits

  • Practicing good oral care

  • Quitting use of tobacco products, including cigarettes and smokeless tobacco

  • Reducing alcohol consumption

  • Reducing sun exposure

  • Seeing your dentist regularly

  • Wearing sunscreen year round, including on your lips

How is oral cancer treated?

Treatment of oral cancer begins with seeking regular medical care throughout your life, including regular dental care. Regular medical care allows a health care professional to provide early screening tests. Regular medical care also provides an opportunity for your health care professional to promptly evaluate symptoms and your risks for developing oral cancer.

The goal of oral cancer treatment is to permanently cure the cancer or to bring about a complete remission of the disease. Remission means that there is no longer any sign of the disease in the body, although it may recur or relapse later.

Common treatments for oral cancer

Common treatments for oral cancer include:

  • Chemotherapy to attack cancer cells

  • Participation in a clinical trial that is testing promising new therapies and targeted treatments for oral cancer

  • Participation in a clinical trial that is testing promising new therapies and treatments for oral cancer

  • Radiation therapy to attack cancer cells

  • Surgery to remove the cancer and evaluate how far it has spread

Other treatments for oral cancer

Other therapies may be added to help with your general state of health and any side effects of cancer treatment:

  • Antinausea medications if nausea occurs

  • Blood cell growth factors to increase the number of white blood cells if these get too low

  • Blood transfusions to temporarily replace blood components (such as red blood cells) that have dropped to low levels

  • Dietary counseling to help maintain strength and nutritional status

  • Reconstructive surgery to restore structures that have been removed

  • Occupational and physical therapy to help with eating, swallowing, or talking problems

  • Pain medications as needed to increase comfort

Complementary treatments

Some complementary treatments may help some people to better deal with oral cancer and its treatments. These treatments, sometimes referred to as alternative therapies, are used in conjunction with traditional medical treatments. Complementary treatments are not meant to substitute for traditional medical care. Be sure to notify your doctor if you are consuming nutritional supplements or homeopathic (nonprescription) remedies as they may interact with the prescribed medical therapy.

Complementary treatments may include:

  • Acupuncture

  • Massage therapy

  • Nutritional dietary supplements, herbal remedies, tea beverages, and similar products

  • Yoga

Hospice care

In cases in which oral cancer has progressed to an advanced stage and has become unresponsive to treatment, the goal of treatment may shift away from curing the disease and focus on measures to keep a person comfortable and maximize the quality of life. Hospice care involves medically controlling pain and other symptoms while providing psychological and spiritual support as well as services to support the patient’s family.

What are the potential complications of oral cancer?

Complications of untreated oral cancer can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of oral cancer include:

  • Adverse effects of treatment for oral cancer
  • Decreased ability to eat, drink, talk or breathe
  • Hemorrhage (uncontrolled bleeding)
  • Recurring cancer after treatment
  • Spread of cancer into nearby structures
  • Spread of cancer to distant areas of the body
  • Spread of cancer to lymph nodes in the neck
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jan 5
  1. Oral cancer. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002030/.
  2. Oral cancer. American Cancer Society. http://www.cancer.org/acs/groups/content/@nho/documents/document/oralcancerpdf.pdf.
  3. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin 2013; 63:11.
  4. Bessell A, Glenny AM, Furness S, et al. Interventions for the treatment of oral and oropharyngeal cancers: surgical treatment. Cochrane Database Syst Rev 2011; :CD006205.
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