Cancer of the mouth, another name for oral cancer, can be life-threatening if not diagnosed and treated early.
What is oral cancer?
Oral cancer is a type of cancer that develops in the mouth, including the lips, tongue, cheeks, floor of the mouth, roof of the mouth, gums, and tonsils. It is a serious condition that can be treated effectively with early detection and treatment.
Oral cancer is not as common as some other types of cancer, but it is serious and can be deadly. According to the Oral Cancer Foundation, more than 53,000 Americans are diagnosed with oral cancer each year.
The five-year survival rate for oral cancer depends on the stage at which it is diagnosed. For localized oral cancer, the five-year survival rate is around 80%. However, this drops significantly for advanced stages.
AHN Head and Neck Cancer Center of Excellence
The AHN Head and Neck Cancer Center of Excellence is home to doctors and surgeons who have extensive experience in treating patients with these cancers. We get a precise diagnosis and develop an effective treatment plan for you. You also have access to our robust support services such as support groups, palliative care, and cancer genetics.
Our Cancer Institute team has a deep understanding of the latest oral cancer treatments. We are committed to personalized care, finding the right treatment for you. Our compassionate team of medical oncologists, dentists, and oral surgeons uses the latest research to treat even the most complex cases of cancer. We use minimally invasive techniques whenever possible, so your recovery is shorter and more comfortable. At the Cancer Institute, you can find expert cancer care, close to home.
Oral cancer symptoms and signs
Early symptoms and signs of oral cancer can be subtle or hard to spot. If you have a higher risk for developing oral cancer, screenings are crucial to early detection. There are some things you can be on the lookout for, and if you notice they persist, contact your doctor. Early symptoms and signs of mouth or oral cancer include:
- Sores that don’t heal: A sore that persists for more than two weeks should be examined by a dentist or doctor.
- White or red patches: These patches, known as leukoplakia and erythroplakia respectively, can be precancerous.
- Lumps or thickening: Any unusual lumps or thickening in the mouth should be checked.
- Numbness or tingling: A persistent feeling of numbness or tingling in the mouth could be a sign of oral cancer.
- Difficulty swallowing or chewing: Pain or difficulty swallowing or chewing can indicate a problem in the mouth or throat.
- Loose teeth: Unexplained loosening of teeth can be a symptom of oral cancer.
- Ear pain: Pain in the ear, especially on one side, can be a sign of oral cancer.
- Hoarseness: Persistent hoarseness can be a symptom of head and heck cancer, especially if it's accompanied by other symptoms.
Oral cancer risk factors
The risk of oral cancer increases with age, with most cases diagnosed in people over 50. Men are more likely to develop oral cancer than women. Like most types of cancer, a family history of oral cancer increases your risk.
It’s important to note that while these factors increase the risk of oral cancer, they don’t guarantee that someone will develop the disease. Many people with these risk factors never develop oral cancer, while others who don’t have any of these risk factors may still develop the disease. Regular checkups and conversations with your doctor can help with detection.
Risk factors include:
- Tobacco use: The use of cigarettes, cigars, pipes, and chewing tobacco is the most significant risk factors for oral cancer. The risk increases with the amount and duration of tobacco use.
- Excessive alcohol consumption: Heavy alcohol use, especially when combined with tobacco use, significantly increases the risk of oral cancer.
- Poor oral hygiene: Neglecting oral hygiene can lead to chronic inflammation and irritation in the mouth, which may increase the risk of cancer.
- Sun exposure: Excessive sun exposure to the lips can increase the risk of lip cancer.
The best way to reduce your risk of oral cancer is to avoid tobacco use, limit alcohol consumption, practice good oral hygiene, and get regular dental checkups.
Oral cancer screening and diagnosis
Regular oral cancer screenings are essential for early detection. During a screening, a dentist or doctor will examine the mouth, tongue, and throat for any abnormalities. Diagnosing oral cancer involves a multi-step process that combines visual examination, biopsies, and imaging tests.
Regular dental checkups are crucial for early detection. Dentists are trained to identify any abnormalities in the mouth, including sores, lumps, white or red patches, and changes in the texture of tissues.
It’s also helpful — and for those who are at higher risk, it is important — to perform regular self-exams of your mouth. Look for any unusual changes in your mouth, such as sores that don’t heal, lumps, white or red patches, or any pain or numbness.
Biopsy
If a suspicious area is found during a visual examination, a biopsy is typically performed. This involves taking a small sample of tissue from the affected area and examining it under a microscope.
A biopsy is usually the most comprehensive way to confirm a diagnosis of oral cancer. It helps determine the type of cancer and its characteristics.
Imaging tests
If oral cancer is confirmed, imaging tests are used to determine the extent of the cancer. These tests can help determine the size and location of the tumor, whether it has spread to nearby lymph nodes, and if it has metastasized to other parts of the body.
Common imaging tests used for oral cancer include:
- X-rays: X-rays can help visualize the bones in the jaw and surrounding areas to look for any abnormalities.
- CT scans: Computed Tomography (CT) scans provide detailed images of the head and neck, including the soft tissues and lymph nodes where the presence of cancer may be.
- MRI scans: Magnetic Resonance Imaging (MRI) scans offer high-resolution images of the soft tissues, which can help identify the extent of the tumor and its relationship to surrounding structures.
- PET scans: Positron Emission Tomography (PET) scans use a radioactive tracer to detect areas of increased metabolic activity, which can indicate the presence of cancer cells.
Additional tests may be necessary. Your doctor and care team will discuss your options to decide what is best for you. These include a lymph node biopsy, to determine if cancer cells have spread to the lymph nodes, or blood tests to check for certain markers that may indicate the presence of cancer.
Types and stages of oral cancer
Staging oral cancer helps doctors determine the best treatment options, estimate the prognosis (outlook), and plan follow-up care. Oral cancer is classified based on the type of cells involved and the stage of the disease.
The most common types include:
- Squamous cell carcinoma: This is the most common type of oral cancer, accounting for about 90% of cases.
- Verrucous carcinoma: This is a slow-growing type of oral cancer that is less aggressive than squamous cell carcinoma.
- Adenocarcinoma: This type of oral cancer originates in the salivary glands.
The stage of oral cancer is determined by the size and location of the tumor, whether it has spread to nearby lymph nodes, and whether it has metastasized to other parts of the body. The stages are typically numbered from 0 to IV, with stage IV being the most advanced.
A common breakdown of the staging system is based on the size, location, and spread of the cancer:
- Stage 0 (Carcinoma in Situ): This is the earliest stage, where abnormal cells are found only in the top layer of tissue. It is considered precancerous.
- Stage I: The tumor is small (less than 2 cm) and has not spread to lymph nodes or other parts of the body.
- Stage II: The tumor is larger (2 – 4 cm) or has spread to nearby lymph nodes.
- Stage III: The tumor is larger than 4 cm or has spread to lymph nodes on the same side of the neck.
- Stage IV: The cancer has spread to distant parts of the body (metastasis) or has invaded other parts of the body, like the jaw bone.
Within each stage, there are subcategories (e.g., T1, T2, T3, etc.) that provide more specific information about the tumor size, location, and spread.
Oral cancer treatment
Treatment for oral cancer depends on the type, stage, and location of the cancer, as well as the patient’'s overall health. Your Cancer Institute team will look at your specific diagnosis and circumstances to help develop a treatment plan that can work for you. At AHN, we see you, and your care plan is reflective of your unique needs. Options include:
Surgery
Surgery is often the most direct way to remove the cancer. Your surgeon carefully removes the tumor and some surrounding healthy tissue to make sure they get all the cancerous cells. The amount of tissue removed depends on the size and location of the tumor. While surgery can feel daunting, the advancements in surgical techniques used at AHN help preserve as much healthy tissue as possible. The recovery time varies depending on the extent of the surgery.
Radiation therapy
Radiation therapy uses high-energy beams (like X-rays) to target and kill cancer cells. It’s often used after surgery to destroy any remaining microscopic cancer cells that might be hiding, reducing the risk of recurrence. In some cases, radiation might be used alone, especially for smaller tumors. Radiation can cause some side effects like fatigue, skin irritation, and changes in taste, but these are usually temporary and manageable.
Chemotherapy
Chemotherapy uses powerful drugs to target and kill cancer cells, helping to shrink oral tumors before surgery, eradicate microscopic cancer cells after surgery, and prevent recurrence. These drugs interfere with cell division, damage DNA, or target specific molecules involved in cancer cell growth. Chemotherapy can also be used to manage symptoms and improve quality of life in advanced stages of the disease. The specific regimen depends on the stage of the cancer, location of the tumor, and patient health, and should be discussed with a qualified oncology team.
Targeted therapy
Targeted therapy, a type of cancer treatment, focuses on cancer cell growth and leaving healthy cells largely untouched in the oral cavity. This approach uses drugs to inhibit tumor growth and potentially eliminate cancer cells. For oral cancer, targeted therapy can be used alone or in combination with other treatments like chemotherapy or radiation. This approach is particularly promising in treating certain types of oral cancer, often leading to better outcomes and fewer side effects compared to traditional chemotherapy.
Immunotherapy
In the context of oral cancer, immunotherapy drugs work by activating the immune system to recognize and attack oral cancer cells. These drugs help the immune system identify and destroy cancer cells, leading to tumor shrinkage or even complete remission. Immunotherapy is particularly effective for certain types of oral cancer, and it can be used alone or in combination with other treatments like chemotherapy and radiation.
Treatment for oral cancer can have significant side effects, including pain, swelling, difficulty swallowing, and changes in taste. However, early detection and treatment can significantly improve the chances of survival and recovery.
Contact us
Call the AHN Cancer Institute at (412) 578-HOPE (412) 578-4673 to connect with a nurse navigator or schedule an appointment.
Second opinions
If you have cancer, you have a team of oncology specialists ready to review your medical records and offer you a second opinion. After completing their review, they’ll talk with you about your goals to determine a course of treatment that’s right for you. To get started, fill out our Second Opinion Request form. A nurse navigator will contact you within the next 24 to 48 hours to discuss next steps and schedule.