What you should know about oral cancer
The incidence of oral cancer is closely tied to excessive alcohol and tobacco use. About 80 percent of people with oral cancer use tobacco, and about 70 percent are heavy drinkers. For people who both smoke and drink heavily, the risk of oral cancer may be twice as high as the risk for people who do not smoke or drink. Other major risk factors for oral cancer include gender—men are twice as likely as women to develop oral cancer—and age, with most patients diagnosed at 55 or older.
Surgery is typically the first-line treatment for oral cancers that are caught early. Other common treatments include chemotherapy, radiation therapy and targeted therapy. Studies have shown that many oral cancer cells contain too many copies of the epidermal growth factor receptor, or EGFR, which allows cancer cells to grow faster and become resistant to radiation and/or chemotherapy. For this reason, treating oral cancer with a drug that targets EGFR may help kill cancer cells without harming normal tissues. Targeted therapy may be used by itself or in combination with other therapies.
Oral cancer and its treatment often cause side effects, including weight loss, fatigue, nausea, diarrhea and constipation. Supportive care services may help patients prevent or manage these symptoms.
What is oral cancer?
Oral cancer develops when cancer cells begin growing out of control in the mouth, which includes the lips, the inside lining of the lips and cheeks, the teeth, the gums, most of the tongue, the bottom of the mouth, and the bony roof of the mouth, or hard palate.
More than 90 percent of oral cancers are squamous cell carcinomas, meaning they form in the flat, thin squamous cells that line the mouth and throat.
What are the symptoms of oral cancer?
Symptoms of oral cancer are commonly mistaken for other, less serious conditions, such as a toothache or mouth sore. If seemingly benign symptoms persist, however, you should call your doctor, who may recommend tests to check for oral cancer.
Symptoms may include:
- A mouth sore that won’t heal
- Mouth pain that won’t go away
- A lump or thickening in the cheek
- A white or red patch on the gums, tongue, tonsil or lining of the mouth
- A sore throat or persistent feeling that something is caught in the throat
- Difficulty swallowing or chewing
- Pain in the teeth or jaw
- Voice changes
How is oral cancer typically diagnosed?
A doctor or dentist may find some cancers or pre-cancers of the mouth during an exam, but most oral cancers are detected after the patient experiences signs or symptoms. Diagnosing oral cancer may involve a physical exam, including a complete head and neck exam, biopsy and imaging tests. Sometimes, blood tests and/or a dental exam are performed, as well.
What are the main types of oral cancer?
Almost all oral cancers are squamous cell carcinomas. That’s why treatment is often guided not by the cancer type but by its location. Even though the oral cavity is a small space, it’s made up of many different types of tissue. The most common locations for cancer in the oral cavity are the tongue, tonsils, oropharynx (throat), gums and floor of the mouth.
What type of doctor should I see if I think I have oral cancer?
If you have a symptom of oral cancer that lasts longer than two weeks, consider requesting a diagnostic evaluation with an oncologist or otolaryngologist specifically trained in treating diseases of the mouth and throat. Oral cancer is more treatable when caught early.