Oral cancer

Introduction to Cancer of the Mouth and Oral Cavity

Mouth cancer

Cancer of the lip and oral cavity is a disease in which cancer (cancerous) cells are found in the tissues of the lip or mouth. The oral cavity includes the front two thirds of the tongue, the upper and lower gums (the gingiva), the lining of the inside of the cheeks and lips (the buccal mucosa), the bottom (floor) of the mouth under the tongue, the bony top of the mouth (the hard palate), and the small area behind the wisdom teeth (the retromolar trigone).

Cancers of the head and neck are most often found in people who are over the age of 45. Cancer of the lip is more common in men than in women, and is more likely to develop in people with light-colored skin who have been in the sun a lot. Cancer of the oral cavity is more common in people who chew tobacco or smoke pipes.

Oral cancer involves abnormal, cancer tissue growth in the mouth.

Causes

Oral or mouth cancer most usually involves the tissue of the lips or the tongue. It may also occur on the floor of the mouth, cheek lining, gingiva (gums), or palate (roof of the mouth). Most oral cancers look very similar under the microscope and are called squamous cell carcinomas. These are cancerous and tend to spread rapidly.

The exact cause is unknown. Smoking and other tobacco use are associated with 70 percent to 80 percent of oral cancer cases. Smoke and heat from cigarettes, cigars, and pipes irritate the mucous membranes of the mouth. Use of chewing tobacco or snuff causes irritation from direct contact with the mucous membranes. Heavy alcohol use is another high-risk activity associated with oral cancer.

Other risks include poor dental and oral hygiene and chronic irritation (such as that from rough teeth, dentures, or fillings). Some oral cancers begin as leukoplakia or mouth ulcers. Oral cancer accounts for about 8 percent of all cancerous growths. Men are affected twice as often as women, especially men older than 40/60.

Symptoms

Skin lesion, lump, or ulcer:

• On the tongue, lip, or other mouth area
• Commonly small
• Most often pale colored, may be dark or discolored
• May be a deep, hard edged crack in the tissue
• Commonly painless initially
• May develop a burning sensation or pain when the tumor is advanced

Additional symptoms that may be associated with this disease:

• Tongue problems
• Swallowing difficulty
• Mouth sores
• Abnormal taste

Signs and tests

An examination of the mouth by the health care provider or dentist shows a visible and/or palpable (can be felt) lesion of the lip, tongue, or other mouth area. As the tumor enlarges, it may become an ulcer and bleed. Speech difficulties, chewing problems, or swallowing difficulties may develop, especially if the cancer is on the tongue.

A tongue biopsy, gum biopsy, and microscopic examination of the lesion confirm the diagnosis of oral cancer.

Treatment

Surgical excision (removal) of the tumor is commonly recommended if the tumor is small enough. Radiation treatment and chemotherapy would likely be used when the tumor is larger or has spread to lymph nodes in the neck. Surgery may be necessary for large tumors.

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

Complications

• Postoperative disfigurement of the face, head and neck
• Complications of radiation treatment, including dry mouth and difficulty swallowing
• Other metastasis (spread) of the cancer