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Jaw cancer

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was reviewed on May 31, 2022.

Jaw cancer is a rare type of head and neck cancer and one of many types of oral cancer. The various head and neck cancers make up about 4 percent of all cancers in the United States, according to the American Society of Clinical Oncology.

Most often, jaw cancer develops when head and neck cancers—situated in the floor of the mouth, tongue, tonsils, salivary glands or palate—metastasize (spread) there.

Rarely, jaw cancer may arise on its own as an osteosarcoma, a type of cancer that forms in the bone.

Jaw cancer can be located in the upper or lower portion of the jaw:

  • Mandibular cancer is jaw cancer that forms in the lower portion, or the mandible.
  • When jaw cancer is located in the upper portion, or maxilla, it’s called hard palate cancer.

Jaw cancer occurs in more advanced stages of oral cavity or oropharyngeal cancers, including stage 4. These cancers may or may not have HPV (human papillomavirus) DNA. Cancers that contain HPV DNA are referred to as p-16 positive, and they have a better prognosis than those that don’t have HPV DNA (p-16 negative).

Types of jaw cancer

Squamous cell carcinoma (SCC) is the most common oral cancer, making up more than 90 percent of cases, according to the Surgery Oncology Clinics of North America journal, but only a small percentage are squamous cell cancers of the jaw. Less commonly, other types of cancer may affect the jaw, including osteosarcomas, metastatic cancers and multiple myeloma. Tumors that arise in the jaw can be either malignant or benign and are called odontogenic tumors.

The types of cancerous odontogenic tumors include:

Ameloblastic carcinoma: a rare but aggressive tumor

Primary intraosseous carcinoma: a rare squamous cell carcinoma arising in the bone

Sclerosing odontogenic carcinoma: a rare primary intraosseous carcinoma arising in the bone

Clear cell odontogenic carcinoma: a rare odontogenic (arising from tooth-forming tissues) tumor

Ghost cell odontogenic carcinoma: an extremely rare odontogenic epithelial tumor

Odontogenic carcinosarcoma: an extremely rare odontogenic tumor

Odontogenic sarcomas: connective tissue tumors containing epithelium

In general, most of these malignant tumors grow in the back of the mouth, near the molars on the lower jaw (mandible). Some affect the upper jaw (maxilla).

What causes jaw cancer?

Causes of jaw cancer (mandibular or hard palate) may be attributed to a combination of environmental factors and genetics, although certain risk factors can increase your risk of developing the disease. These risk factors include:

Tobacco: Smoking or chewing tobacco is the most common risk factor for both hard palate and mandibular cancers.

Alcohol: Drinking excessive alcohol increases the risk of oral squamous cell cancers; smoking along with excessive alcohol consumption almost doubles this risk.

Betel nut: People who chew betel nut, a seed from the areca tree, are at a greater risk of developing jaw cancer.

Excess weight: Carrying too much body weight can increase the risk of oropharyngeal and laryngeal cancers.

Age: Oral cavity and oropharyngeal cancers are most common in people older than age 55.

Poor oral hygiene: Research is ongoing, but the health of your mouth and gums may be a contributing factor to oral cavity and oropharyngeal cancers.

Viral infections: Viral infections such as HPV increase the risk of occurrence in people younger than age 50.

Poor nutrition: A diet low in fruits and vegetables increases oral cavity and oropharynx cancers.

Genetics: People with genetic mutations that are inherited — such as Fanconi anemia and dyskeratosis congenita — have a high risk of developing mouth and middle throat cancers.

Oral and jaw cancer signs and symptoms

The signs and symptoms of oral cancer or jaw cancer vary depending by stage. For example, in the early stages, you may feel no symptoms, or you may begin to feel some pain. Some jaw cancer symptoms you may experience include:

  • Pain or difficulty swallowing
  • Painful mouth sores or ulcers that don’t heal
  • Difficulty opening the mouth
  • Red or white patches in the mouth that persist for weeks
  • Bleeding from the mouth that is recurrent
  • Halitosis, or bad breath
  • Swelling that causes difficulty swallowing
  • Numbness in the mouth or tongue
  • Jaw or ear pain
  • Difficulty speaking
  • Dentures that don’t fit any longer
  • Damage to bones, such as loose teeth

How is jaw cancer diagnosed?

If you’re experiencing jaw cancer symptoms, your doctor may complete a full physical examination, including checking for lumps in your neck, mouth and cheeks, as well as gather your personal and family medical history. Oral and oropharyngeal cancers are linked to an increased risk of other types of head and neck cancers, so the doctor may also examine the larynx, behind your nose and the lymph nodes on the back of your neck.

If cancer is suspected, your doctor will likely refer you to an expert such as an ENT (ear, nose and throat doctor) or an otolaryngologist (head and neck surgeon) who will perform a complete head and neck exam in addition to one or more of the following tests.

Biopsy: A small piece of tissue from an area of suspicion in the mouth or neck may be removed with an incisional or punch biopsy. If warranted, a fine needle aspiration (FNA) biopsy of nearby lymph nodes may be performed. These samples will be examined under a microscope in order to detect cancer.

Panendoscopy: Endoscopes are used to ensure there are no other related cancers.

Imaging tests may also be performed in order to diagnose and stage the cancer. These may include:

X-rays, to provide images of the neck, mouth and jaw

Computed tomography (CT) scan, for cross-sectional images to help determine the size and location of a tumor and whether it has spread

Magnetic resonance imaging (MRI), for detailed images of the body’s soft tissues to help determine whether cancer has spread to other tissues or reached the bone marrow.

Jaw cancer treatment

Specific treatment will depend on the location and extent of your cancer as well as the stage. Most often, surgery is the initial treatment for oral cavity cancers, but radiation and/or chemotherapy may also be options.

Surgery

Unless you’re not healthy enough to undergo surgery, or surgery wouldn’t be an appropriate treatment option for you, doctors try to remove the tumor. The type of surgery depends on the location of the tumor.

  • Hard palate surgery may include a maxillectomy to remove part of the maxilla, or bone that makes up the roof of the mouth.
  • Mandibular surgery may include a mandibulectomy, or surgery to remove part of the lower jaw.

Radiation therapy

For both hard palate and mandibular cancers, radiation therapy is often recommended after surgery. Known as adjuvant radiation, this is done to prevent the tumor from recurring, if the tumor couldn’t be completely removed surgically, or if the cancer metastasized to lymph nodes, nerves or blood vessels. Radiation may also be given for aggressive or advanced-stage cancers.

Chemotherapy

Though not commonly used to treat jaw cancer, sometimes chemotherapy is done in combination with adjuvant radiation therapy if cancer has spread from lymph nodes to surrounding tissues or remains after surgery.

Jaw cancer survival rates

Survival rates by stage and specifically for jaw cancer are not available. According to the American Cancer Society, the five-year relative survival rate for cancers of the gums and other parts of the mouth, which would include the jaw, was 60 percent.

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