Oral Cancers: Diagnosis, Risk Factors and Treatments

8 min read
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Feb 19, 2024
Oral Cancers: Diagnosis, Risk Factors and Treatments
Cancer that appears in the tissues of the mouth or throat is known as oral cancer. It is a member of the broader class of tumors known as head and neck cancers. The majority grow in the squamous cells of your lips, tongue, and mouth.
In the US, there are approximately 53,000 new cases of oral cancer identified annually, with adults over 40 being the most common age group.
Most typically, oral malignancies are found after they have progressed to the neck lymph nodes. The key to surviving oral cancer is early identification. Find more about risk factors, phases of risk, and more.

Types of oral cancers

Cancers of the mouth include those of the:
  • Lips
  • Tongue
  • Inner lining of the cheek
  • Gums
  • Floor of the mouth
  • Hard and soft palate
When oral cancer first appears, your dentist is frequently the first medical professional to detect it. Having biannual dental exams might help your dentist stay informed about your oral health.

Risk factors for developing oral cancer

The use of tobacco products is one of the main risk factors for oral cancer. This include the use of chewing tobacco in addition to smoking cigarettes, cigars, and pipes.
Individuals who regularly use both tobacco and alcohol are even more at danger, especially if they drink considerable quantities of both.
Other risk variables consist of:
  • human papillomavirus (HPV) infection
  • chronic facial sun exposure
  • a previous diagnosis of oral cancer
  • a family history of cancer, either oral or otherwise
  • a weakened immune system
  • poor nutrition
  • genetic syndromes
  • being male
Oral cancer affects men twice as frequently as it does women.

What are symptoms of oral cancer?

Oral cancer symptoms include:
  • A mouth or lip sore that refuses to go away.
  • Any growth or lump in your mouth.
  • Gushing blood from your mouth.
  • Loose teeth.
  • Discomfort or trouble when swallowing.
  • Difficulty putting on dentures.
  • A bump on your throat.
  • An earache that is persistent.
  • Significant reduction in weight.
  • Numbness in the lower lip, face, neck, or chin.
  • Patches of crimson, white, or red and white in your lips or mouth.
  • A painful throat.
  • Stiffness or pain in the jaw.
  • Ache in the tongue.
A sore throat or an earache are two examples of symptoms that could point to other illnesses. See your dentist or physician right once if you experience any of these symptoms, particularly if they persist or if you experience more than one at once.

How is oral cancer diagnosed?

Your physician or dentist will examine you physically first. This involves taking a detailed look at your tongue, cheeks, back of the throat, and the lymph nodes in your neck in addition to the roof and floor of your mouth.
Your doctor might recommend you to an ear, nose, and throat (ENT) specialist if they are unable to diagnose the cause of your symptoms.
Your doctor will do a brush biopsy or a tissue biopsy if they discover any tumors, growths, or questionable blemishes. Brush biopsy is a non-invasive procedure that involves brushing tumor cells onto a slide. During a tissue biopsy, a sample of the tissue is taken in order to look for malignant cells under a microscope.
Furthermore, your physician might carry out one or more of the subsequent examinations:
  • X-rays to check for the presence of cancerous cells in the lungs, chest, or jaw.
  • a CT scan to find any cancers in your neck, lungs, mouth, throat, or anywhere else in your body.
  • a PET scan to find out if the cancer has spread to the organs or lymph nodes.
  • an MRI scan to provide a more precise view of the head and neck and ascertain the cancer's stage.
  • an endoscopy to look at the trachea, inside throat, sinuses, and nasal passageways.

What are the stages of oral cancer?

Oral cancer can progress through four stages.
  • Stage 1: The malignancy has not progressed to the lymph nodes, and the tumor is no more than 2 centimeters (cm).
  • Stage 2: The tumor's size ranges from 2 to 4 cm, and the cancer cells haven't reached the lymph nodes yet.
  • Stage 3: Either the tumor is bigger than 4 cm and hasn't reached any lymph nodes, or it can be of any size and has only reached one lymph node without reaching any other body parts.
  • Stage 4: Cancer cells have spread to neighboring tissues, lymph nodes, and other regions of the body in tumors of any size.
The following are the five-year survival rates for pharyngeal and oral malignancies, per the National Cancer Institute:
  • 83 percent, for cancer that is contained and has not spread
  • 64 percent, for cancer that has spread to lymph nodes in the area
  • 38 percent, for cancer that has metastasized to other bodily parts
In total, 60% of patients with oral cancer will live for five years or more. The likelihood of survival following treatment increases with early diagnosis.
Actually, between 70 and 90 percent of patients with stage 1 and stage 2 oral malignancies survive for five years or longer overall. This underscores the significance of prompt identification and treatment.

How is oral cancer treated?

Depending on the kind, location, and stage of the cancer at diagnosis, there are different treatment options for oral cancer.

Surgery

Surgery to remove the tumor and malignant lymph nodes is typically required for treatment in its early stages. Furthermore, additional tissue surrounding the lips and neck might be removed.

Radiation therapy

An additional choice is radiation therapy. For two to eight weeks, a doctor will direct radiation beams to the tumor once or twice a day, five days a week. Chemotherapy and radiation therapy are typically used in conjunction for advanced stage treatment.

Chemotherapy

A treatment called chemotherapy uses medications to destroy cancer cells. You can receive the medication orally or via an intravenous (IV) line. Although some patients need to be hospitalized, the majority of patients get chemotherapy as outpatients.

Targeted therapy

Another type of therapy is targeted therapy. Both early and advanced stages of cancer can benefit from it. Drugs used in targeted therapy will attach to particular proteins on cancer cells to prevent their proliferation.

Nutrition

A crucial component of your treatment for oral cancer is nutrition. Poor appetite and weight loss are common side effects of several medications, which can make eating and swallowing uncomfortable or difficult. Make sure you talk to your doctor about your diet.
Consulting with a nutritionist can assist you in creating a meal plan that will provide your body with the calories, vitamins, and minerals it requires to recover while also being easy on your tongue and throat.

Keeping your mouth healthy

And last, maintaining oral health is an essential component of cancer treatment. Maintaining clean teeth and gums and a moist mouth are important.

Recovering from oral cancer treatment

Every sort of treatment will have a different recovery rate. Pain and edema are common postoperative symptoms, however excision of tiny tumors typically has no lasting effects.
It is possible that the removal of larger tumors will impair your pre-surgery ability to chew, swallow, and speak. In order to repair the bones and tissues in your face that were removed during surgery, reconstructive surgery can also be necessary.
The body may experience adverse effects from radiation therapy. Among the adverse consequences of radiation are:
  • A painful mouth or throat.
  • Decrease of salivary gland function and dry mouth.
  • Decaying teeth.
  • Vomiting as well as nausea.
  • Bleeding or sore gums.
  • Oral and skin infections.
  • Jaw soreness and stiffness.
  • Wearing dentures not going well.
  • Fatigue.
  • A shift in your senses of smell and taste.
  • Alterations to your skin, such as burning and dryness.
  • Weight loss.
  • Thyroid changes.
Drugs used in chemotherapy may be hazardous to noncancerous cells that divide quickly. This may result in adverse effects like:
  • Hair loss
  • Painful mouth and gums
  • Bleeding in the mouth
  • Severe anemia
  • Weakness
  • Poor appetite
  • Nausea
  • Vomiting
  • Diarrhea
  • Mouth and lip sores
  • Numbness in the hands and feet
Following focused therapy, recovery is typically limited. The following are possible negative effects of this treatment:
  • Fever
  • Headache
  • Vomiting
  • Diarrhea
  • An allergic reaction
  • Skin rashes
Despite the negative effects of these medicines, they are frequently essential for overcoming cancer. In addition to helping you assess the benefits and drawbacks of each treatment choice, your doctor will go over the side effects.

Reconstruction and rehabilitation after oral cancer treatment

Advanced oral cancer patients will probably require reconstructive surgery as well as some therapy to help them speak and eat during their recovery.
Dental implants or grafts may be used in reconstruction to replace lost facial or oral bone and tissue. Any lost tissue or teeth are replaced with artificial palates.
When cancer is advanced, rehabilitation is also required. From the time you emerge from surgery until you achieve the highest possible degree of improvement, speech therapy can be given.

Outlook

The prognosis for oral cancers varies according to the exact kind and stage of the disease at diagnosis. It also relies on your age, overall health, treatment tolerance, and response.
Because treating stage 1 and stage 2 tumors may take less work and have a higher probability of success, early diagnosis is essential.
Your doctor will want regular follow-ups to make sure you're healing after treatment. X-rays, CT scans, blood tests, and physical examinations are typically part of your checks. If you see something unusual, be sure to follow up with your oncologist or dentist.

FAQ for Oral Cancers

  • What is oral cancer? Cancer of the mouth and throat tissues.
  • Who is at risk? Tobacco users, heavy drinkers, HPV-infected individuals, sun exposure, etc.
  • What are the symptoms? Mouth sores, lumps, bleeding, loose teeth, swallowing problems, etc.
  • How is it diagnosed? Physical exams, biopsies, imaging tests.
  • What are the stages? 1-4, with higher stages indicating spread.
  • What is the survival rate? Varies by stage, early detection is crucial.
  • How is it treated? Surgery, radiation, chemotherapy, targeted therapy, nutrition support.
  • What are the side effects of treatment? Pain, swelling, dry mouth, fatigue, taste changes, etc.
  • What is the recovery process like? Varies by treatment, may involve reconstruction and rehabilitation.
  • What is the outlook? Depends on stage and individual factors, early diagnosis is key.
  • What are the different types of oral cancer? Lips, tongue, cheeks, gums, etc.
  • What causes oral cancer besides tobacco and alcohol? HPV, sun exposure, genetics, etc.
  • What if I have one symptom, but not others? See a doctor or dentist regardless.
  • What tests will I need if I have symptoms? Varies, may include biopsies, X-rays, CT scans, etc.
  • What are the different treatment options for each stage? Talk to your doctor for specific recommendations.
  • How can I manage the side effects of treatment? Your doctor can advise on medication, diet, and other strategies.
  • What support resources are available for oral cancer patients? Ask your doctor or search online for support groups and organizations.
  • How can I prevent oral cancer? Quit tobacco, limit alcohol, protect your lips from sun, see your dentist regularly.