Mouth cancer, also known as oral cancer, is a tumor that develops in any part of the mouth. It can occur on the surface of the tongue, the roof of the mouth, inside the cheeks, the lips, or gums.
Cancer cells grow and multiply faster than normal cells. Mouth cancer can grow by spreading to nearby tissues of the surrounding skin. This tumor can also develop in salivary glands and tonsillitis symptoms. However, these are less common. Smokers and heavy drinkers are at higher risk of mouth cancer.
The mouth is composed of several types of cells. Mouth cancer is categorized by the cell type where cancer begins to grow. The different types of mouth cancer are categorized by the part and the cell where cancer develops. Among the other types, Squamous cell cancer is the most common mouth cancer. These squamous cells are found in many parts of the body, mostly inside the mouth and in the skin. The types of mouth cancer include:
Squamous Cell Carcinoma (Cancer)
Over 90% of mouth cancer cases are of squamous cell carcinoma. These are flat and thin cells normally found in the tissue under the surface of the skin. They form the lining for different organs of the body, including the respiratory and digestive tracts. Apart from the mouth, squamous cell carcinoma also appears on body parts that are frequently exposed to the sun, like face, neck, and ears.
Oral Malignant Melanoma
Oral malignant Melanoma develops in pigment-producing cells that give skin color and pigmentation. This cancer can occur on the skin or inside the nasal or oral cavity.
Lymphoma cancer usually grows from the cells found inside lymph glands, but can also grow in the oral cavity.
Tobacco and alcohol are major causes of mouth cancer as they are carcinogenic. They contain chemicals that damage the DNA in cells, leading to cancer. One is at a higher risk of developing mouth cancer in case of:
Smoking or chewing tobacco
Infected with human papillomavirus (HPV)
In case of mouth cancer symptoms, the doctor will conduct a physical examination and might ask a few questions. It can also be detected using the following methods:
A small sample of the affected tissue is collected and checked for cancerous cells. The collected samples are examined under a microscope by a pathologist (specialist doctor). In the case of suspected mouth cancer, the different methods used to do a biopsy are:
- Incision Biopsy: An incision biopsy is done using local anesthesia if the affected area is easily accessible, like the tongue or inside of the cheek. The doctor will cut away a small section of the affected tissue for the sample. The tissue is closed with stitches, though the procedure is not painful; it may feel sore afterward.
- Punch Biopsy: A punch biopsy is a similar method where an even smaller piece of tissue is removed and no stitching is needed.
- Fine Needle Aspiration Cytology: FNAC is used in case of swelling (lump) in the neck that may be a secondary mouth cancer symptom. In fine needle aspiration cytology, a very small needle is used to extract a sample of cells and fluid from the lump to check for cancer.
- Fibre Optic Nasopharyngoscopy: Nasendoscopy uses a thin, long, and flexible tube with an attached camera and light at one end. This device is inserted into the nose and the throat. This method is used if cancer is suspected inside the nose and throat. The process takes about 30 seconds, anesthesia can be sprayed on the nose to reduce the discomfort.
- Panendoscopy: Panendoscopy uses a similar device to nasendoscopy with a large tube which gives better access. Local anesthesia is given before the procedure starts. This method is used to examine the mouth, nose, voice box, and top of the food pipe.
If the biopsy results confirm mouth cancer, a few other tests are conducted to check the mouth cancer stages before proceeding with treatment. The doctor can ask to do the tests like:
Staging and Grading
Staging is a method of measuring how far cancer has spread. Staging uses the TNM system, where:
T refers to the size of the tumor,
N used to show the spread of cancer into nearby lymph nodes
M refers to the spread of cancer to other body parts.
Grading is used to describe how aggressive and fast cancer is likely to spread in the body. Mouth cancer has 3 grades:
Treatment for mouth cancer focuses majorly on preserving the functions of the mouth such as speaking and eating. The treatment available for mouth cancer is:
The cancerous cells are removed surgically along with a few healthy tissues of the surroundings to prevent them from spreading.
Also known as radiation therapy, it uses beams of ionizing radiation to control or kill malignant cancerous cells. It may be used in the early stages of cancer, to prevent the spread or after surgery to prevent disease coming back
Chemotherapy is a drug treatment that uses powerful medicines and chemicals to kill the fastest-growing cancer cells. It's the most common treatment. These treatments are often used in combination to ensure and prevent recurrence of cancer.
Mouth cancer is the world's 6th most common cancer. Men have a higher risk of getting mouth cancer, as they smoke and drink more often than women. Cancer is linked with long-standing wounds, broken teeth, ulcers, or wounds on the tongue.
Oral hygiene plays a very important role, as it can increase the chances of mouth cancer.
Here are the most effective ways of preventing cancer, preventing its return after successful mouth cancer treatment:
Stop smoking and using tobacco
Stop or limit alcohol consumption (ask the doctor for guidelines)
Eat a healthy, balanced, and nutritious diet (including fresh vegetables and fruits)
Schedule regular dental checkups, especially in case of smoking, drinking, or chewing tobacco. The dentist can identify the early stages of mouth cancer.
Mouth cancer and its treatment may cause complications. Even though precautions are taken to preserve the functions and appearance of the mouth, it can still affect the appearance and cause problems while speaking and swallowing.
The outlook for mouth cancer depends on which part of the mouth is affected and its spread into surrounding tissue. The rate of recovery is better for mouth cancer that affects the tongue, lip, or oral cavity. Complete recovery is possible in the case of early diagnosis.
Even at later stages of mouth cancer, advancement in radiotherapy, surgery, and chemotherapy have resulted in improved recovery rates.
Reviewed by Dr. Rohit Nayyar, Director, Cancer Care / Oncology, Head & Neck Oncology, Surgical Oncology on 18-May-2022
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