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Oral cancer

Oral cancer is cancer that starts in the mouth.

Alternative Names

Cancer - mouth; Mouth cancer; Head and neck cancer; Squamous cell cancer - mouth

Causes

Oral cancer most commonly involves the lips or the tongue. It may also occur on the:

  • Cheek lining
  • Floor of the mouth
  • Gums (gingiva)
  • Roof of the mouth (palate)

Most oral cancers are a type called squamous cell carcinoma. These cancers tend to spread quickly.

Smoking and other tobacco use are linked to most cases of oral cancer. Heavy alcohol use also increases the risk of oral cancer.

Other factors that may increase the risk of oral cancer include:

  • Chronic irritation (such as from rough teeth, dentures, or fillings)
  • Human papillomavirus (HPV) infection (same virus that causes genital warts )
  • Taking medicines that weaken the immune system (immunosuppressants)
  • Poor dental and oral hygiene

Some oral cancers begin as a white plaque (leukoplakia ) or as a mouth ulcer .

Men get oral cancer twice as often as women do, particularly men older than 40.

Symptoms

Oral cancer can appear as a lump or ulcer in the mouth that may be:

  • A deep, hard-edged crack in the tissue
  • Pale, dark, or discolored
  • On the tongue, lip, or other area of the mouth
  • Painless at first, then a burning sensation or pain when the tumor is advanced

Other symptoms may include:

  • Chewing problems
  • Mouth sores that may bleed
  • Pain with swallowing
  • Speech difficulties
  • Swallowing difficulty
  • Swollen lymph nodes in the neck
  • Tongue problems
  • Weight loss

Exams and Tests

Your doctor or dentist will examine your mouth area. The exam may show:

  • A sore on the lip, tongue, or other area of the mouth
  • An ulcer or bleeding

Tests used to confirm oral cancer include:

X-rays and CT , MRI and PET scans may be done to determine if the cancer has spread.

Treatment

Surgery to remove the tumor is usually recommended if the tumor is small enough. Surgery may be used together with radiation therapy and chemotherapy for larger tumors.

Other treatments may include speech therapy or other therapy to improve movement, chewing, swallowing, and speech.

Support Groups

You can ease the stress of illness by joining a cancer support group . Sharing with others who have common experiences and problems can help you not feel alone.

Outlook (Prognosis)

Approximately half of people with oral cancer will live more than 5 years after they are diagnosed and treated. If the cancer is found early, before it has spread to other tissues, the cure rate is nearly 90%. More than half of oral cancers have spread when the cancer is detected. Most have spread to the throat or neck.

Possible Complications

  • Complications of radiation therapy, including dry mouth and difficulty swallowing
  • Disfigurement of the face, head, and neck after surgery
  • Other spread (metastasis ) of the cancer

When to Contact a Medical Professional

Oral cancer may be discovered when the dentist does a routine cleaning and examination.

Call your health care provider if you have a sore in your mouth or lip or a lump in the neck that does not go away within 1 month. Early diagnosis and treatment of oral cancer greatly increases the chance of survival.

Prevention

Oral cancer may be prevented by:

  • Avoiding smoking or other tobacco use
  • Having dental problems corrected
  • Limiting or avoiding alcohol use
  • Visiting the dentist regularly and practicing good oral hygiene

References

National Cancer Institute: PDQ Lip and Oral Cavity Cancer Treatment. Bethesda, Md: National Cancer Institute. Date last modified: July 16, 2012. Available at: http://cancer.gov/cancertopics/pdq/treatment/lip-and-oral-cavity/HealthProfessional. Accessed: February 3, 2014.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Head and neck cancers. Version 2.2013. Available at: http://www.nccn.org/professionals/physician_gls/pdf/head-and-neck.pdf. Accessed: February 3, 2014.

Wein RO, Malone JP, Weber RS. Malignant neoplasms of the oral cavity. In: Flint PW, Haughey BH, Lund VJ, et al., eds. Cummings Otolaryngology: Head and Neck Surgery. 5th ed. Philadelphia, Pa: Elsevier Mosby; 2010:chap 96.

Updated: 2/3/2014

Ashutosh Kacker, MD, FACS, Professor of Clinical Otolaryngology, Weill Cornell Medical College, and Attending Otolaryngologist, New York-Presbyterian Hospital, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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