Mouth cancer is not as common as many other types, but still a serious health concern: More than 370,000 people in the U.S. are living with the condition. While it can be treated successfully, it is often not detected until late in its development.
Oral cancer occurs in men twice as often as women, usually after age 50. The biggest causes are tobacco use, alcohol use, poor diet, and the human papillomavirus (HPV).
Types, Treatments and Causes of Oral Cancer
The two types of oral cancer are related, but there are important distinctions between them:
- Oral cavity cancer affects the inside of the lips and lining of the cheeks, gums roof of the mouth and the visible part of the tongue. Surgery is the primary treatment, potentially followed by radiation or radiation and chemotherapy combined. Tobacco use is the most common cause. Heavy drinking also increases risk.
- Oropharyngeal cancer impacts the back part of the roof of the mouth, the base of the tongue, and/or the throat. Chemo and radiation are standard treatments, followed by surgery if needed. In 70% of cases, this cancer is caused by HPV, which is transmitted through oral sex. That’s one reason public health professionals strongly recommend young people get the HPV vaccine starting at age 11, before sexual activity. The remaining 30% of oropharyngeal cancers are caused by tobacco and alcohol.
How can you tell if you may have oral cancer?
These symptoms can indicated oral cancer and should be addressed if it lingers:
- Mouth sores that don’t heal
- Red, irritated patches
- Unexplained mouth pain
- Mouth bleeding
- A lump or mass in the in the neck that may or may not hurt
- Change in color of the inner lining of your mouth
- Loose teeth without a clear dental cause
- Sore throat, hoarseness or other voice changes
- Trouble swallowing
Signs of oral cancer are often picked up during routine doctor or dentist checkups. Health professionals often notice and document changes that can signal a premalignant lesion that needs to be reviewed more thoroughly.
In order to diagnose oral cancer, a physician or dentist will start with a physical exam. If signs of possible cancer are found, the patient will get a thorough mouth inspection. The practitioner will be looking for lumps on the lips, gums, cheeks and neck. A medical history will be taken.
The clinician will then examine the voice box and neck lymph nodes. An endoscopy may be needed, along with imaging tests.
A biopsy is usually done to make a definitive cancer diagnosis.
Surgery, radiation and/or chemotherapy
If a tumor is found, it is removed through surgery. Robotic surgery and laser microsurgery can remove tumors with only small incisions.
Chemotherapy may also be part of the treatment. Radiation is used on its own or in combination with chemotherapy, before or after surgery.
Rehab is an important part of oral cancer treatment. It may begin in the hospital and continue on an outpatient basis. Pain and swallowing problems can occur. A feeding tube may be temporarily needed.
Oral cancer treatments can affect appetite and taste, cause dry mouth, and impair the ability to chew and swallow. Nutritionists help patients choose appropriate foods.
Emotional effects are common. When people can’t speak well or eat in front of others, they can feel isolated.
Sixty-five percent of people diagnosed with oral cancer live at least five years post-diagnosis. The best treatment, as with all disease, is prevention, followed by early detection.