Conditions,  Health

Oral Cancer: Stages, Prevention, Pictures, Treatment, Screening, Survival Rate

Key Facts:

  • Oral cancer, also known as mouth cancer, encompasses cancers of the lips, tongue, cheeks, floor of the mouth, hard and soft palate, sinuses, and pharynx (throat)
  • Approximately 53,000 people in the United States are diagnosed with oral cancer each year (as of 2023)
  • Oral cancer is twice as common in men as in women
  • The 5-year survival rate for oral cancer is approximately 65%
  • It can be life-threatening if not diagnosed and treated early
  • Risk factors include tobacco use, heavy alcohol use, HPV infection, and prolonged sun exposure
  • Regular dental check-ups are important for early detection, which is critical for improving the prognosis

What is Oral Cancer?

Oral cancer is a type of cancer that occurs in the oral cavity or the surrounding areas. This includes the lips, tongue, inside of the cheeks, the floor of the mouth, gums, hard and soft palates, throat, and the sinuses. Like other forms of cancer, oral cancer involves the uncontrollable growth of cells that cause damage to surrounding tissue. When oral cancer is not detected early, it can spread to other parts of the body, making treatment more challenging.
There are several types of oral cancer, with squamous cell carcinomas being the most common. These cancers begin in the flat, thin cells that line the lips and the inside of the mouth.

Who is Affected by Oral Cancer?

Oral cancer affects individuals of all ages and backgrounds but is more common in certain populations.

  • Gender: Men are twice as likely to develop oral cancer as women.
  • Age: The majority of cases are diagnosed in people over the age of 50.
  • Tobacco and Alcohol Use: Tobacco use, including smoking and chewing tobacco, and heavy alcohol use are the most significant risk factors for oral cancer. The risk is even higher for people who use both tobacco and alcohol.
  • HPV Infection: Infection with certain types of human papillomavirus (HPV) increases the risk of oral cancer.
  • Sun Exposure: Exposure to the sun is linked to cancer of the lip.
  • Diet: A diet low in fruits and vegetables may play a role in oral cancer development.

How Does Oral Cancer Affect My Body?

Oral cancer affects the body in several ways:

  • Mouth and Facial Pain: As the tumor grows, it can cause pain in the mouth or face. This may be a constant ache or pain when speaking or eating.
  • Difficulty Eating and Speaking: Tumors can interfere with normal mouth function, making it difficult to chew, swallow, or speak clearly.
  • Altered Appearance: Large tumors or surgeries to remove them can alter the appearance of the face and mouth.
  • Spread to Other Areas: Oral cancer can spread (metastasize) to other parts of the body, particularly the lymph nodes of the neck.
  • Nutritional Challenges: Difficulty eating can lead to nutritional deficiencies.
  • Psychological Impact: The diagnosis and treatment of oral cancer can have a significant psychological impact, including anxiety and depression.

Oral cancer can be life-threatening if not diagnosed and treated early. Regular dental check-ups, awareness of the signs and symptoms, and reducing risk factors are crucial for prevention and early detection.

What Parts of My Body Are in My Oral Cavity?

The oral cavity is a complex and vital structure that plays a central role in the processes of speech, eating, and breathing.
It comprises various parts:

  • Lips: The soft, movable, and serving as the opening to the oral cavity.
  • Teeth: Hard, calcified structures used for biting and grinding food.
  • Gums (Gingiva): Soft tissue that surrounds and supports the teeth.
  • Tongue: A muscular organ responsible for taste sensation, aiding in chewing and swallowing food, and articulation in speech.
  • Floor of the Mouth: The area under the tongue.
  • Hard Palate: The bony front portion of the roof of the mouth.
  • Soft Palate: The muscular back part of the roof of the mouth, which separates the oral cavity from the nasal passages.
  • Uvula: The small, finger-shaped muscular structure hanging from the soft palate, plays a role in speech and preventing food from entering the nasal passages.
  • Buccal Mucosa: The inner lining of the cheeks and lips.
  • Vestibule: The space between the teeth, lips, and cheeks.
  • Retromolar Trigone: The small area behind the wisdom teeth.

What Causes Oral Cancer?

Oral cancer occurs when cells in the oral cavity undergo mutations in their DNA, allowing them to grow and divide uncontrollably. The accumulation of abnormal cells can form a tumor.
Various factors can contribute to the mutations that lead to oral cancer, including:

  • Tobacco Use: Smoking cigarettes, cigars, or pipes, as well as using chewing tobacco or snuff, significantly increase the risk of oral cancer.
  • Alcohol Consumption: Heavy alcohol use is a risk factor for oral cancer, especially when combined with tobacco use.
  • Human Papillomavirus (HPV): Certain types of HPV, a sexually transmitted infection, are associated with oral cancer.
  • Sun Exposure: Excessive sun exposure can increase the risk of lip cancer.
  • Diet: A diet low in fruits and vegetables may increase the risk of oral cancer.
  • Genetics: A family history of cancer can increase the risk.
  • Chronic Irritation: Chronic irritation from ill-fitting dentures, broken teeth, or rough fillings can increase the risk.

Risk Factors: Are There Specific Activities That Can Increase My Risk of Developing Oral Cancer?

Certain lifestyle choices and activities can increase the risk of developing oral cancer:

  • Smoking and Tobacco Use: This is the most significant risk factor for oral cancer. The risk increases with the amount and length of tobacco use.
  • Excessive Alcohol Consumption: Consuming alcohol, especially in combination with smoking, heightens the risk of oral cancer.
  • Unprotected Sun Exposure: Spending long periods in the sun without protection can increase the risk of cancer on the lips.
  • Unhealthy Diet: A diet low in fruits and vegetables or high in processed foods may contribute to the development of oral cancer.
  • Engaging in Oral Sex without Protection: This can increase the risk of HPV infection, which is associated with oral cancer.
  • Neglecting Oral Hygiene: Poor oral hygiene practices can contribute to an unhealthy oral environment, increasing the risk of oral cancer.

Being mindful of these risk factors and making lifestyle changes can help reduce the risk of developing oral cancer. It is also essential to have regular oral examinations, as early detection is crucial for effective treatment.

What are Oral Cancer Symptoms?

The early stages of oral cancer may not present obvious symptoms, which is why regular dental checkups are essential. However, as the cancer progresses, symptoms may include:

  • Sores, Swellings, or Lumps in the Mouth or Throat: Any sore, swelling, or lump that does not heal within two weeks should be examined.
  • White or Red Patches in the Mouth: Unexplained white or red patches inside the mouth or on the lips that persist may be a sign of oral cancer.
  • Pain or Difficulty When Swallowing: This may be felt in the mouth or throat and can be an indicator of an underlying issue.
  • Numbness or Loss of Sensation: Particularly in any part of the mouth or on the lips.
  • Loose Teeth: With no apparent cause like trauma or infection.
  • Change in Voice or Hoarseness: Any unexplained change in voice quality or persistent hoarseness should be investigated.
  • Ear Pain: Sometimes oral cancer may cause pain that feels like it’s originating in the ear.
  • Change in the Way Dentures or Teeth Fit Together: If there’s a sudden change in the alignment of the teeth or the way dentures fit, it should be checked.
  • Difficulty Chewing or Moving the Jaw: Difficulty or pain when chewing or opening and closing the mouth can be a sign.
  • Unexplained Weight Loss: Weight loss that cannot be explained by dieting or other factors should be investigated.

Diagnosis: How do Healthcare Providers Diagnose Oral Cancer?

Diagnosing oral cancer usually involves a series of steps:

  • Oral Examination: A dentist or doctor will examine the mouth and throat for any abnormal areas, such as sores, lumps, or color changes.
  • Medical History: The healthcare provider will ask about your medical history, habits such as smoking or alcohol consumption, and any symptoms you may be experiencing.
  • Biopsy: If any suspicious areas are identified, a small tissue sample may be taken for laboratory testing to determine if cancer cells are present.
  • Imaging Tests: X-rays, CT scans, MRIs, or PET scans might be used to determine the extent of the cancer or to check for spread to other areas.
  • Endoscopy: A flexible tube with a camera may be used to check areas like the throat and part of the pharynx, which are not visible during a routine oral examination.

The diagnosis of oral cancer should be thorough and may involve the collaboration of different healthcare professionals, such as dentists, oral surgeons, and oncologists.

What Are Oral Cancer Stages?

Like many other types of cancer, oral cancer is classified into stages, which helps in understanding the extent of the cancer and planning treatment. Staging is a way of describing the size of a cancer and how far it has grown.
The stages of oral cancer are usually described using the TNM staging system, which stands for:

  • T (Tumor): Describes the size of the tumor
  • N (Nodes): Indicates whether cancer has spread to the lymph nodes
  • M (Metastasis): Indicates whether cancer has spread to other parts of the body

The stages of oral cancer are:

  • Stage 0 (Carcinoma in situ): There are abnormal cells in the lining of the mouth that might become cancerous.
  • Stage I: The tumor is 2 cm across or smaller, and cancer hasn’t spread to the lymph nodes or other parts of the body.
  • Stage II: The tumor is larger than 2 cm but not larger than 4 cm, and hasn’t spread to the lymph nodes or other parts of the body.
  • Stage III: The tumor is larger than 4 cm, or cancer has spread to one lymph node but not to other parts of the body.
  • Stage IV: This stage can mean different things – the tumor might be any size, but cancer has spread to the lymph nodes, surrounding tissues, or other parts of the body.

Treatment Options for Oral Cancer: How do Healthcare Providers Treat Oral (Mouth) Cancer?

The treatment for oral cancer depends on the stage and location of the cancer, as well as the patient’s overall health. Common treatments for oral cancer include:

  • Surgery: Removing the tumor along with a margin of healthy tissue around it.
  • Radiation Therapy: Using high-energy beams, such as X-rays, to kill cancer cells or shrink tumors.
  • Chemotherapy: Using drugs to kill cancer cells or stop them from growing.
  • Targeted Drug Therapy: Focuses on specific molecules involved in cancer growth and spread, potentially having fewer side effects than chemotherapy.
  • Immunotherapy: Using the body’s immune system to fight cancer.

What Surgeries Treat Oral Cancer?

There are different surgical procedures that can be used to treat oral cancer, including:

  • Tumor Resection: Removing the tumor and a margin of healthy tissue.
  • Glossectomy: Partial or total removal of the tongue if the cancer is located there.
  • Mandibulectomy: Removal of a part or all of the lower jaw if cancer is in this location.
  • Maxillectomy: Removing part of the upper jaw.
  • Lymph Node Dissection: Removing lymph nodes in the neck, if the cancer has spread there.
  • Reconstructive Surgery: Rebuilding the bones or tissues in the mouth, which might involve bone grafts or implants.

It’s important to note that the surgical approach to oral cancer treatment is often complex and requires careful consideration of functional and aesthetic outcomes. Therefore, it is often approached as part of a multidisciplinary treatment plan, often in conjunction with radiation therapy and/or chemotherapy.

What Are Other Ways to Treat Oral Cancer?

Besides surgery, radiation therapy, and chemotherapy, there are other approaches to treating oral cancer:

  • Targeted Therapy: This involves the use of medications that specifically target the cancer cells’ vulnerabilities. For example, cetuximab is a drug that’s sometimes used in conjunction with radiation in treating oral cancer.
  • Immunotherapy: This treatment boosts the body’s natural defenses to fight the cancer. It uses substances made by the body or in a lab to improve or restore immune system function. Pembrolizumab and nivolumab are examples of immunotherapy drugs used in treating advanced oral cancer.
  • Photodynamic Therapy (PDT): This treatment uses a special laser light along with a light-activated drug to kill cancer cells. This is typically used for early-stage oral cancer.
  • Nutritional Support: Proper nutrition is critical during and after treatment for oral cancer. A nutritionist or dietitian may work closely with the healthcare team to ensure the patient is getting the nutrients they need.
  • Palliative Care: For advanced stages of oral cancer, the focus may shift to improving quality of life and relieving symptoms rather than curing the disease.

Preventing Oral Cancer: What Can I Do to Prevent Developing Oral Cancer?

While it is not possible to prevent all cases of oral cancer, there are steps you can take to lower your risks:

  • Tobacco and Alcohol: Avoid smoking and using tobacco products. Limit alcohol consumption. Using tobacco and alcohol together increases the risk much more than using either alone.
  • HPV Vaccination: Some oral cancers are associated with the human papillomavirus (HPV). Getting vaccinated against HPV might reduce the risk of oral cancer related to this virus.
  • Sun Exposure: Protect your lips from excessive sun exposure by wearing a hat with a wide brim or using a lip balm with sunscreen.
  • Eat a Balanced Diet: Consume a diet rich in fruits and vegetables, as these contain antioxidants that can lower the risk of cancer.
  • Regular Dental Check-ups: Regular visits to the dentist can help detect oral cancer at an early stage. Inform your dentist immediately if you notice any changes in your mouth.

Can I Spot Potential Oral Cancer?

It is possible to spot signs that might suggest oral cancer, but it’s important to remember that only a healthcare provider can make a definitive diagnosis.
Here are some signs to watch for:

  • Sores, swellings, lumps, or thick patches anywhere inside or on the lips/mouth
  • White or red lesions in the mouth or on the lips
  • Unexplained bleeding in the mouth
  • Numbness or tenderness in the mouth, lips, or tongue
  • Difficulty or discomfort in chewing or swallowing
  • A feeling that something is caught in the throat
  • Chronic sore throat or changes in the voice
  • Persistent ear pain
  • Sudden weight loss

If you notice any of these symptoms, especially if they last for more than two weeks, it is important to consult a healthcare provider for an evaluation. Early detection and treatment are crucial in improving the outcomes for oral cancer patients.

Outlook for Someone with Oral Cancer: What Can I Expect If I Have Oral Cancer?

If you have been diagnosed with oral cancer, you may experience a range of emotions including fear, anxiety, and uncertainty.
Knowing what to expect can help alleviate some of these feelings:

  • Treatment Planning: Your healthcare provider will discuss with you the stage of the cancer, and will work with a team of specialists to develop a personalized treatment plan.
  • Treatment Regimen: Depending on the stage and type of the oral cancer, the treatment may involve surgery, radiation therapy, chemotherapy, or a combination of these. Each of these treatments comes with its own side effects and impact on your daily life.
  • Physical Changes: Oral cancer and its treatment can lead to changes in your appearance and the way your mouth functions. You might experience difficulty in speaking, swallowing, and eating.
  • Emotional Support: Emotional support is an important aspect of dealing with cancer. Family, friends, counseling, and support groups can be invaluable in helping you through this time.
  • Follow-up Care: Regular follow-up appointments are necessary to monitor for any signs of cancer recurrence and to manage any long-term side effects of treatment.

What Can I Expect After Completing My Treatment for Oral Cancer?

  • Recovery Period: After completing treatment for oral cancer, there is a recovery period. The length of this period varies from person to person and depends on the type of treatment you have undergone.
  • Side Effects and Complications: Some side effects of treatment can last for a while, and new ones can appear after treatment ends. Difficulty swallowing, changes in taste or speech, and mouth sores are common.
  • Rehabilitation: Depending on how extensive your treatment was, you might need rehabilitation to help you with speech or swallowing.
  • Lifestyle Changes: You might need to make lifestyle changes regarding diet, physical activity, and oral hygiene. Stopping the use of tobacco and limiting alcohol consumpion are important steps in preventing a recurrence.
  • Regular Monitoring: It’s important to have regular check-ups with your healthcare provider to monitor for any signs of the cancer returning or new cancers developing.
  • Emotional Adjustment: It might take time to emotionally adjust to the changes in your life and cope with your experiences. Psychological counseling or joining support groups may be helpful.

When Should I Contact My Healthcare Provider?

You should contact your healthcare provider if you:

  • Have completed treatment and are experiencing new or worsening symptoms.
  • Are struggling emotionally and think you might benefit from counseling or support groups.
  • Have questions or concerns about your long-term care plan.
  • Notice any signs or symptoms that were similar to those when you were first diagnosed with oral cancer, such as new lumps, pain, or changes in your mouth.

Remember, ongoing care and monitoring are essential after oral cancer treatment. Your healthcare provider is your ally in this process, and it is important to maintain open communication.

What Questions Should I Ask My Provider?

When you are dealing with oral cancer, it’s important to have clear communication with your healthcare provider.
Here are some questions that you might consider asking:

  • What type and stage of oral cancer do I have?
  • What is the prognosis for my type and stage of oral cancer?
  • What treatment options are available for my type of oral cancer?
  • What are the potential side effects of each treatment option?
  • How will treatment affect my quality of life and daily activities?
  • Is there a possibility that my treatment could affect my ability to speak or eat?
  • Are there any clinical trials or experimental treatments that I should consider?
  • What lifestyle changes can I make to improve my prognosis or reduce the risk of recurrence?
  • How often will I need follow-up visits after treatment is complete?
  • What signs of recurrence should I be on the lookout for?
  • Should I seek a second opinion?
  • What support services or resources are available to me and my family?
  • Will I need rehabilitation services such as speech therapy?
  • How can I manage the pain or discomfort associated with oral cancer or its treatment?
  • What steps can I take to maintain good oral hygiene during and after treatment?
  • How will oral cancer and its treatment affect my dental health?
  • What are the costs associated with the treatment, and will my insurance cover them?
  • How can I maintain my nutrition during treatment?
  • Is it safe to take my current medications during cancer treatment?
  • What should I do if I experience side effects or complications during treatment?
  • Bottom line

    Oral cancer is a serious condition that requires comprehensive treatment and care. Being well-informed about your diagnosis, treatment options, and what to expect can help in making informed decisions and coping with the disease. It’s important to be actively involved in your care, and having open communication with your healthcare provider is key. Remember that there are resources and support available for individuals diagnosed with oral cancer and their families. Taking steps to lead a healthy lifestyle, adhering to your treatment plan, and having regular follow-up visits with your healthcare provider are vital in managing oral cancer.

    This article is complete and was published on June 15, 2023, and last updated on August 25, 2023.

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