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Oral cancer



Alternative Name

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

Overview

Oral cancer is cancer of the mouth.


Review Date: 2/1/2010

Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Seth Schwartz, MD, MPH, Otolaryngologist, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.



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Risk Factors

Oral cancer most commonly involves the tissue of 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 look very similar under the microscope and are called squamous cell carcinomas. These are cancerous and tend to spread quickly.

Smoking and other tobacco use are linked to 70 - 80% of oral cancer cases. Heavy alcohol use is also associated with an increased risk for oral cancer.

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

  • Chronic irritation (such as from rough teeth, dentures, or fillings)
  • Human papilloma virus infection
  • Poor dental and oral hygiene

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

Oral cancer accounts for about 5% of all cancerous growths. Men get oral cancer twice as often as women do, particularly men older than 40.

Signs/Symptoms

Sore, lump, or ulcer:

  • May be a deep, hard-edged crack in the tissue
  • Most often pale colored, but may be dark or discolored
  • On the tongue, lip, or other area of the mouth
  • Usually painless at first (may develop a burning sensation or pain when the tumor is advanced)

Other symptoms that may occur with this disease:

  • Abnormal taste in the mouth
  • Chewing problems
  • Mouth sores
  • Pain with swallowing
  • Speech difficulties
  • Swallowing difficulty
  • Tongue problems
  • Weight loss
Calling your health care provider

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

Call for an appointment with 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 chances of survival.

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. These treatments are more comon if the cancer has spread to lymph nodes in the neck.

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

Outlook

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%. However, more than half of oral cancers have already spread when the cancer is detected. Most have spread to the throat or neck.

Approximately 25% of people with oral cancer die because of delayed diagnosis and treatment.


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
Signs & Testing

Signs include:

  • Sore on the lip, tongue, or other area of the mouth that the health care provider can feel or see
  • Tumor enlarges to become an ulcer or bleeds

Tests used to confirm the diagnosis of oral cancer include:

  • Gum biopsy
  • Microscopic examination of the sore
  • Tongue biopsy