Overview
Oral cancer, also known as mouth cancer, is considered an entity of head and neck cancers. As per statistics, oral cancer develops in 10.5 adults per 100,000 population. The most common causes include a combination of excessive smoking and alcohol abuse. The most common sign of developing oral cancer is an ulcer that doesn’t heal beyond two weeks. The key to surviving oral cancer is its timely detection and treatment.
Types of Oral Cancer
Oral cancer can be divided based on the part of oral tissue affected or location of cancer growth, such as cancers of the:
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Tongue
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Lips
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Cheeks (buccal mucosa)
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The floor of the mouth
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Gums (lower and upper alveolus)
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Hard palate
Oral Cancer Symptoms
Cancer growth is usually asymptomatic and appears as a non-healing ulcer, a growth, or a patch. Other associated oral cancer symptoms may be:
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A typical oral cancer symptoms is the appearance of painless mass on any mouth surface.
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It usually does not have a red base like an aphthous ulcer but has the base of the normal oral mucosa (tissue) with the centre white in colour.
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It may initially look like a minor swelling, lump, rough spot, crust/eroded area on the lips, cheek, gums, palate, tongue or any other areas of the mouth.
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Red or white patches in the mouth (erythroplakia/leukoplakia)
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It is often detected when it starts interfering with usual activities such as eating.
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Unexplained bleeding may occur from surrounding gums.
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Persistent soreness or inability to swallow food, speak, or move the jaw comfortably may indicate the growth of a lump.
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Decreased mouth opening
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Restricted tongue motility
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Changes in voice, constant sore throat, or hoarseness may occur.
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Ear pain
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Discomfort when wearing a denture, or a previously fitting denture becoming loose
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Unexplained weight loss of over 10% of total body weight without trying in a short span of about 3 to 6 months indicates the presence of cancer.
Oral Cancer Causes
The most common cause of oral cancer is regular tobacco use, smoking cigarettes, and consuming alcohol. Some of the other contributing factors may be:
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Tobacco Use
When consumed recklessly, tobacco in any form, especially placing it in the mouth for long hours in specific places such as the vestibule of the mouth, may eventually develop cancer. This includes the use of commonly available preparations like pan masala, gutkha, toombak, etc.
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Alcohol
Heavy alcohol use may also increase the risk of developing cancer. Using a combination of both tobacco and alcohol increases the risk even further.
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Areca Nut/Supari
It causes a condition called as oral sub-mucous fibrosis where the mouth opening decreases progressively. It can further lead onto cancer.
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Sun Exposure
Cancer of the lip and surrounding areas can occur due to excessive sun exposure.
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Chronic Trauma from Sharp Tooth/Denture
Oral cancer can also develop due to constant irritation from a sharp tooth or non-fitting dentures.
Diagnosis of Oral Cancer
Diagnosis of cancer may happen at a routine clinic visit. Doctors usually check for any lumps in the neck or around the jaws. On examination, any patches, non-healing ulcers or abnormal growth if suspicious might require a biopsy. If the lesion is small, the growth may be removed in toto/completely. Different biopsy methods may be advised based on the type of lesion present.
Oral Cancer Treatment
Cancers of the mouth can be assessed based on the TNM staging, which gives the treating surgeon – Head & Neck cancer surgeon, an idea about the local extent of cancer and if it metastases (spread) to the draining lymph nodes or other parts of the body exists. On this basis, the doctor would formulate a oral cancer treatment plan.
Treatment of oral cancers involves excision or surgical removal of the lesion with adequate margins all around. Along with this, the lymph nodes are also removed from the neck. Depending upon the extent of resection, we may need to reconstruct the defect created in the mouth, this may be in the form of local or regional flaps or even free flaps.
Adjuvant therapy in form of adjuvant radiotherapy or chemo-radiation may be considered to prevent recurrence.
Prevention From Oral Cancer
- Quit chewing tobacco and smoking altogether.
- A nutritious, balanced diet inclusive of anti-oxidant-rich foods may prevent the development of oral cancer.
- Limiting alcohol intake and avoiding using a combination of smoking and drinking can prevent cancer of the mouth.
- Preventing excessive exposure to the sun and using sunscreens regularly can help prevent lip or skin cancer.
- High risk individuals, such as those consuming tobacco, smoking or taking alcohol, in presence of any suspicious symptoms merit an early examination/screening by a head and neck cancer surgeon.
Oral Cancer Prognosis
Early stage tumours have got excellent prognosis. Even advanced stage tumours with proper oral cancer treatment fare reasonably well.
Last Update
Reviewed by Dr. Rohit Nayyar, Director, Cancer Care / Oncology, Head & Neck Oncology, Surgical Oncology on 19-May-2022.