Causes of oral cancer
Oral or mouth cancer most commonly 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 malignant 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 malignant growths. Men are affected twice as often as women, particularly men older than 40.
Symptoms of oral cancer
Skin lesion, lump, or ulcer:
- On the tongue, lip, or other mouth area
- Usually small
- Most often pale colored, may be dark or discolored
- May be a deep, hard edged crack in the tissue
- Usually 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
Complications of oral cancer
- Postoperative disfigurement of the face, head and neck
- Complications of radiation therapy, including dry mouth and difficulty swallowing
- Other metastasis (spread) of the cancer
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, particularly if the cancer is on the tongue.
A tongue biopsy, gum biopsy, and microscopic examination of the lesion confirm the diagnosis of oral cancer.
Staging of oral cancer
- See staging system for oral cancer
Treatment of oral cancer
Surgical excision (removal) of the tumor is usually recommended if the tumor is small enough. Radiation therapy 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 therapy or other therapy to improve movement, chewing, swallowing, and speech.