Oral Cancer

Oral cancer is cancer of the mouth, also called the oral cavity. It can develop in the lips, gums, front two-thirds of the tongue, inner cheeks, floor of the mouth, hard palate (the roof of the mouth), and the small area behind the wisdom teeth.

Most oral cancers begin in the squamous cells, the thin, flat cells that line these parts of the mouth. Like other cancers, oral cancer can grow into nearby tissue and, in some cases, spread to other parts of the body.

Types & Stages

More than 90 percent of oral cancers are squamous cell carcinomas. These start in the cells that line the inside of the mouth and lips.

Doctors also describe oral cancer by where it begins, such as the:

• Inner cheek
• Floor of the mouth
• Gums
• Hard palate
• Lips
• Oral tongue (the front part of the tongue)
• Retromolar trigone (the area behind the back lower teeth)

A few less common types can also occur, such as verrucous carcinoma and oral melanoma.

Oral cancer is not described with a single simple number. Instead, doctors look at:

• The size of the tumor
• How deeply it has grown
• Whether it has reached nearby lymph nodes
• Whether it has spread to other parts of the body

This helps your care team plan the best treatment.

Signs & Symptoms

Oral cancer can look like common mouth problems at first, so symptoms that do not go away should be checked.

Visit a doctor or dentist if you are experiencing any of these symptoms:

• A mouth or lip sore or ulcer that does not heal
• A white or red patch inside the mouth
• A lump or thickening in the mouth
• Loose teeth
• Mouth pain
• Pain or trouble swallowing
• Swelling in the jaw or neck
• Numbness in the face, mouth or neck
• Ear pain
• Persistent bad breath

Many of these symptoms can be caused by conditions that are not cancer. Still, if a symptom is new, lasting or worries you, talk with a healthcare provider.

Diagnosis

Tests and procedures used to diagnose oral cancer may include:

• Medical history and exam. Your doctor or dentist reviews your symptoms and examines your mouth, throat, and neck.
   
• Biopsy. A small sample of tissue is removed and examined under a microscope by a pathologist. This is the only way to confirm oral cancer.
   
• Imaging tests. A CT scan, MRI, PET scan, ultrasound, or chest X-ray may be used to learn the size and location of the tumor and whether it has spread.
   
• Endoscopy. A thin, lighted tube may be used to look beyond the mouth and check nearby areas for signs of cancer.

Treatment

Treatment depends on the size and location of the tumor, whether it has spread, and your overall health. Surgery is the main treatment for most oral cancers. Your care team can help explain the benefits and risks of each option.

Treatment may include:

• Surgery. The surgeon removes the tumor. Depending on its location and spread, surgery may also remove part of the tongue, jaw, upper jaw, or nearby tissue. Lymph nodes in the neck may be checked or removed if cancer may have spread. Reconstructive surgery may be done to help restore appearance and functions such as speaking, chewing and swallowing.
   
• Radiation therapy. Radiation uses high-energy beams to kill cancer cells. It is often used after surgery to destroy any remaining cancer cells.
   
• Other treatments. Chemotherapy, targeted therapy or immunotherapy may be used in select cases, especially for more advanced cancer.

Clinical trials may also be an option. These studies test new treatments or new ways to use current ones.

Ask your care team whether a clinical trial may be right for you.

Causes & Risk Factors

The exact cause of oral cancer is not always known. Some factors may raise the risk, including:

• Older age. Most cases develop in adults aged 50 and older.
   
• Being male. Oral cancer is more common in men than in women.
   
• Tobacco use. All forms of tobacco, including cigarettes, cigars, pipes and chewing tobacco, raise the risk.
   
• Alcohol use. Frequent or heavy drinking raises the risk, especially when combined with tobacco.
   
• Sun exposure to the lips. Ultraviolet light from the sun or tanning lamps can increase the risk of lip cancer.
   
• HPV. Human papillomavirus (HPV) is a common virus passed through sexual contact and is linked to some mouth and throat cancers.
   
• A weakened immune system. A weaker immune system, due to certain medicines or conditions such as HIV, can raise the risk.

Having a risk factor does not mean you will develop oral cancer, and some people with the disease have no clear risk factors. Talk with your healthcare provider about your personal risk.

Screening

There is no standard oral cancer screening program for everyone.

Even so, many dentists check the mouth for early signs of oral cancer during routine dental visits. The goal is to find any problem early, when it is easiest to treat. In some cases, a dentist may use extra tools, such as a special dye or light, to help spot abnormal areas in the mouth.

If you have a mouth sore, lump, or other symptom that does not go away, talk with a healthcare provider or dentist about whether further evaluation is needed.

This information is for general education only and is not a substitute for medical advice. Please consult a qualified healthcare provider for diagnosis, treatment recommendations, and guidance based on your personal health history.