Oral Cancer: Causes, Symptoms And Treatments

In 2017, nearly 50,000 people will get oral or oropharyngeal cancer in the United States alone and more than 9500 of them will die from it, according to researchers at the American Cancer Society.¹

Doctors and researchers consider oral cancer particularly dangerous because this specific form of cancer comes with an unusually high risk of producing other cancers. Studies show that people who survive oral cancer are 20 times more likely to develop a second cancer!²

What Is Oral Cancer?

Oral and oropharyngeal cancers occur when cancerous, malignant cells form in the mouth and/or throat. Most of these cancers start in the squamous cells that are found in the lining of the oral cavity. This is why oral cancer is also known as squamous cell carcinoma. Oral cancer can develop in any of the tissues found in the oral cavity including the tongue, gums, lining of the cheeks, roof of the mouth, the area under the tongue, as well the area behind the wisdom teeth.³

Oral Cancer Facts

• Oral cancer is the sixth most common cancer in the world.⁴
• According to the World Health Organization, incidences of oral and oropharyngeal cancers are more common in developing nations compared to developed countries.⁵
• On average, about 57% of patients diagnosed with oral cancer will live longer than 5 years.⁶
• Oral cancer is overwhelmingly more prevalent among men than in women, with men being twice as likely to be affected.⁷

Risk Factors For Oral Cancer

Although anyone can get oral cancer, people who tick the following boxes are more likely to develop this form of cancer.⁸
[pullquote]Generally speaking, drinking too much alcohol and using tobacco products (including smokeless ones) account for about 90% of all oral and oropharyngeal cancer cases.⁹[/pullquote]

• Being male and over 40
• Excessive alcohol consumption
• Regular use of tobacco products
• Human papilloma virus (HPV) infection
• Family history of head/neck cancer

Interestingly, those who use both alcohol and tobacco are 15 times more likely to develop oral cancer compared to those who use one or the other.¹⁰

Regular use of tanning beds and prolonged sun exposure are also considered risk factors for developing lip cancer.¹¹

Symptoms Of Oral Cancer To Watch Out For

Unfortunately, in its very early stages, oral cancer doesn’t present any symptoms that are easily noticeable. As a result, the cancer can grow and spread for months or even years without most people realizing it.¹² That said, with annual screenings and monthly self-exams, the likelihood of catching early signs of oral cancer is pretty good.

So, what should you be looking for? According to the World Health Organization, National Institutes of Health, and the American Association of Oral and Maxillofacial Surgeons, the following are possible symptoms of oral cancer:^13 14 15

• Sores in the mouth or on the face or neck that have not healed in about 2 weeks
• Frequent bleeding in the mouth
• Numbness or partial loss of feeling inside the mouth or on the face or neck
• Bumps, lumps, or swelling inside the mouth or on the lips
• Dark, red, or white patches inside the mouth
• Loose teeth
• Pain while swallowing
• Earaches
• Thickening of the gums or lips
• A sudden change in voice
• Swelling of the jaw

Oral Cancer Diagnosis

It is important to tell your doctor if you’re experiencing any of the symptoms associated with oral cancer. Your doctor (or an oral cancer specialist) can use a number of methods to detect and diagnose oral cancer.

It is normal for your physician to start with a physical exam and then order diagnostic tests to confirm or rule out oral cancer. During a physical exam, your doctor will check your oral cavity for any abnormalities by looking and feeling inside your mouth. He or she will also feel for swollen lymph nodes on both sides of the neck.¹⁶

If any abnormalities are detected, your doctor can order a biopsy, endoscopy, or an exfoliative cytology in which cell or tissue samples from your lip or oral cavity are collected and then examined under a microscope.

Your physician may also order an MRI or CT scan to take detailed images of your oral cavity.¹⁷

Treatment Options For Oral Cancer

As with all forms of cancer, early detection is key in the treatment of oral cancer. If oral cancer is caught early enough, treatment is easier and more effective and the long-term prognosis is much better.

Historically, the mortality rate associated with oral cancer has been high, not because this cancer is difficult to treat but because it is diagnosed too late.¹⁸

So, again, those regular screenings and self-exams are critical, especially if you have any of the risk factors associated with oral cancer. Most patients who are diagnosed with oral cancer in its early stages are highly likely to be cured, with cure rates of 90–100%.¹⁹

Prognosis and treatment of oral cancer usually depend on certain factors, including the stage of oral cancer, the location of oral cancer, and whether the cancer has spread to blood vessels.²⁰

There are several types of treatment options available to patients with mouth cancer. The two most standard forms of treatment include surgery and radiation therapy, but clinical trials are also testing the efficacy of chemotherapy, hyperthermia therapy, and hyperfractionated radiation therapy in the treatment of oral cancer.²¹

1. Surgery

Surgical oncologists routinely perform surgery to remove cancerous growths from the oral cavity. Surgeries may include:

• Wide local excision: In this type of surgery, the surgeon will remove the cancerous tissue as well as some of the surrounding healthy tissue.²²
• Neck dissection: This involves removing lymph nodes and other tissues from the neck. This procedure is usually required when the cancer has spread beyond the oral cavity.²³

After the removal of the cancerous growth, your surgeon may refer you to a plastic surgeon who may then use skin grafts, dental implants, or other devices to repair the site of incision.²⁴ Additionally, your surgeon may also refer you to a speech therapist, dietitian, psychologist, and rehabilitation specialist depending on your specific medical needs.

2. Radiation Therapy

Radiation therapy is also frequently used in the treatment of oral cancer. During radiation therapy, high-energy x-rays are used to destroy cancer cells and/or inhibit their growth. For small cancerous growths, radiation therapy might be enough. For larger cancers, radiation therapy may be used after surgery. Radiation therapy can also be used in the treatment of oral cancer in its advanced stages to address pain, bleeding, and difficulty chewing or swallowing.²⁵

Hyperfractionated radiation therapy is being tested in clinical trials for treating oral cancer as well. In this form of treatment, the total amount of radiation is divided into smaller doses and administered several times a day.²⁶

3. Hyperthermia Therapy

Researchers are also looking into hyperthermia therapy in treating oral cancer. In this treatment, body tissue is heated above normal body temperature in order to kill cancer cells or make them more receptive to the effects of radiation and medication.²⁷

4. Complementary And Alternative Treatments

While alternative treatments and complementary therapies may not help in actually curing oral cancer, they can help alleviate some of the symptoms associated with oral cancer and related treatments.

• Acupuncture can help manage pain, nausea, and vomiting.
• Massage therapy can aid in mental and physical relaxation and alleviate anxiety and fatigue.
• Yoga can help address stress and sleep issues.²⁸

Regular Oral Examination For Early Detection

Regular screening for oral cancer is crucial. Ask your doctor or dentist to perform an oral examination once a year to look for possible signs of oral cancer, especially if you have any of the risk factors listed above.

In addition to this annual exam, doctors recommend performing an oral cancer self-exam every month or every few months. All you need is a mirror and a well-lit area such as your bathroom.

• Start by looking and feeling around your gums and inside your lips
• Examine the roof of your mouth as well.
• Run your fingers around the inside of your cheeks to feel/look for any bumps or lumps.
• Stick your tongue out and look for anomalies in color and texture
• Feel for any lumps on both sides of your neck and along your lower jaw.²⁹