Let's Talk About Oral Cancer Signs and Symptoms

Tingling tongue? Lump on your jaw? White spots in the mouth? It’s time to open wide and learn what's really going on.

by Stephanie Wood Health Writer

To you, it’s your basic means of breathing and eating. To doctors, it’s a complex piece of machinery with lots of moving parts in which malignancies can grow. Fortunately, cases of oral cancer have been on the decline in the U.S., and most lumps in the mouth are nothing to worry about. Still, if you or a loved one has a pesky symptom that won’t go away, it needs to be evaluated by a doctor or dentist. Oral cancers can significantly impact how you chew, swallow, and speak, and the sooner you get treated, the better your odds of resuming your normal life.

Oral Cancer Signs and Symptoms

Our Pro Panel

We went to some of the nation’s top experts on head and neck cancers to bring you the most up-to-date information possible.

Salvatore M. Caruana, M.D.
Salvatore M. Caruana, M.D.

Salvatore M. Caruana, M.D.

Director of the Division of Head and Neck Surgery

New York-Presbyterian Hospital Columbia University Medical Center

New York, NY

Nadia Mohyuddin, M.D.
Nadia Mohyuddin, M.D.

Nadia Mohyuddin, M.D.

Head and Neck Surgical Oncologist, Associate Professor of Clinical Otolaryngology

Houston Methodist Hospital

Houston, TX

J. Kenneth Byrd, M.D.
J. Kenneth Byrd, M.D.

J. Kenneth Byrd, M.D.

Chief of Head and Neck Surgery, Medical Director and Research Director

Georgia Cancer Center at Augusta University

Augusta, GA

Oral Cancer Signs and Symptoms
Frequently Asked Questions
Are white spots in my mouth cancer?

They can be, but aren’t always. Some white spots are what’s known as leukoplakia, precancerous changes that may become full-blown cancer if left untreated. However, white spots can also be due to an easily treated fungal infection in the mouth known as thrush. Either way, you want to get those white patches evaluated ASAP.

What’s the prognosis for tongue cancer?

That depends on its stage when diagnosed and the location of the tumor. If it’s difficult to remove all of it surgically, additional treatments like radiation and chemotherapy will be used. In general, the five-year survival rate for stage 1 tongue cancer is 76%, while the five-year survival rate for stage 4 is 27%.

My mouth bleeds when I brush my teeth—should I be worried?

It’s not unusual for gums to bleed when you brush your teeth, and it may be due to gingivitis, a treatable inflammation of the gums. It can also be a side effect of pregnancy. Still, it shouldn’t happen consistently. Growths in the mouth that are cancerous tend to bleed easily when scraped during brushing or while eating, so definitely get it checked out.

Is lip cancer a form of skin cancer or oral cancer?

Actually, it can be either. The upper lip technically begins with the skin directly under your nose, and the lower lip extends to the depression just above your chin. Your mucosal lips are the pink skin you put lipstick on. If you develop a malignancy here, it’s considered lip cancer and is a part of the head and neck cancer family. But if it’s in the skin above or below, it’s considered skin cancer.

What Is Oral Cancer, Again?

Ready for a recap? The term “oral cancer” basically refers to any malignancy in your mouth, otherwise known as the oral cavity. Officially, the mouth begins at the lips and ends at the small area of the gum tucked behind the wisdom teeth (known as the retromolar trigone). It also includes the front two-thirds of the tongue, the gums, the lining inside the cheeks and lips (known as the buccal mucousa), the floor of the mouth under the tongue, and the hard bony palate at the top of the mouth. In addition, most cancers of the jawbegin in the mouth and then extend into the jaw bone.

Since the oral cavity has so many parts, or “structures” as docs like to say, the seven types of mouth cancer are named for the area they occur in. The most common sites in the mouth for oral cancer to develop are the tongue, the lips, and the floor of the mouth. More than 90% of them are squamous cell carcinomas, which develop in the flat, fish scale-like cells that form the lining of the mouth and throat.

About 30,000 people are diagnosed with cancer of the mouth each year, which accounts for about 3% of all cancers. While certainly not as common as breast or lung cancer, oral cancer is the most frequently occurring type in the head and neck cancer family. It affects men at least twice as often as women and the average age of diagnosis is 62. Early detection is everything, so don’t slack on seeing your doctor if something seems off: The oral cancer survival rate is only 57% after five years.

The cause of oral cancer is pretty clear. About 90% of cases come from using tobacco in any form—cigarettes, pipes, cigars, or chewing. Pipe smoking, for instance, is known to cause cancer in the lips where they touch the pipe stem, and chewing tobacco (snuff) increases the risk of cancer in the areas where the tobacco has the most contact: the cheeks, gums, and inner lips. If tobacco is used in conjunction with alcohol, your risk rises even more, since alcohol acts as an irritant, allowing the carcinogens more access to cells in your mouth.

While not every case is caused by tobacco, the evidence overwhelmingly suggests that it’s totally within most people’s power to prevent cancers of the mouth.

What Are the Signs and Symptoms of Oral Cancer?

Oral cavity cancers are not tucked away where they can grow unseen. They are often visible to a primary care doctor or dentist in a routine physical exam. That’s the good news. The catch: There may not be any symptoms in the early stages, which can delay the diagnosis. For this reason, it’s smart to look inside your mouth in a mirror once a month to get familiar with it. That way, if changes occur, you can recognize them pronto.

The signs and symptoms of oral cancer vary somewhat based on the type and location, but there’s plenty of overlap, too. These are some common red flags that apply to all or most types of mouth cancer:

  • A painful sore that doesn’t heal (most common)

  • White, red, or dark patches

  • A noticeable lump

  • Mouth, throat, or ear pain

Zeroing in a little closer, certain types of cancers have additional signs. Follow this road map of the mouth and what to watch for in each location:

Buccal Cancer

Buccal cancer begins in the mucosal lining of the cheek. It may also be referred to as inner cheek cancer. Symptoms may include:

  • Dentures that no longer fit

  • Difficulty moving your jaw

  • Hoarseness

  • Loose teeth or pain around your teeth

  • Recurrent bleeding from the mouth

  • Soreness or a feeling that something is caught in your throat

Gum Cancer

Gum cancer starts in the upper or lower gums and may be mistaken for gingivitis. Symptoms may include:

  • Bleeding or cracking gums

  • Thick areas of the gums

Hard Palate Cancer

Hard palate cancer begins in the roof of the mouth (the hard palate) or the upper alveolar ridge (part of the maxilla or upper jaw). It’s also known as palatomaxillary cancer for the two primary bones here: the palatine bone, which separates the oral cavity and nasal cavity, and the maxilla. Symptoms may include:

  • An ulcer on the roof of the mouth that may bleed (most common)

  • Bad breath

  • Changes in speech

  • Dentures that no longer fit

  • Difficulty swallowing

  • Difficulty moving your jaw

  • Loose teeth or pain around your teeth

  • Recurrent bleeding from the mouth

Lip Cancer

Lip cancer begins on either the upper or, most commonly, lower lips. Symptoms may include:

  • A lump on or thickening of the lips

  • Bleeding, pain, or numbness in the lip

Oromandibular Cancer

Oromandibular cancer involves the lower jaw. It almost always begins elsewhere in the mouth—most typically the gums, floor of the mouth, or behind the wisdom teeth—and then invades the jaw. Symptoms may include:

  • Difficulty opening the mouth

  • Loose teeth or dentures that don’t fit correctly

  • Numbness in the lower teeth, lip, or chin area

  • Swelling on the side of the face, the roof of the mouth, or beneath your teeth

Tongue Cancer

Tongue cancer begins in the front two-thirds of the tongue, known as the oral tongue. Symptoms may include:

  • A sore throat that does not go away

  • A sore spot (ulcer) or lump on the tongue that does not go away

  • Bleeding from the tongue

  • Difficulty speaking

  • Mouth numbness

When Should I See a Doctor?

The general rule of thumb here—and for other head and neck cancers—is that sooner is better. Any symptoms that stick around for more than two weeks need to be checked out. Don’t panic: There’s a good chance it’s just a run-of-the-mill canker sore or fever blister, but cancer is not something you want to take a gamble on.

Also, a symptom that’s only occurring on one side of the mouth is concerning. The head and neck are what’s known as paired systems, meaning they’re usually symmetrical and what happens on one side will happen on the other. If a lump or pain is only on the right or left side, it’s time to see your doc. (If you’ve got a dental appointment coming up, that’s fine for a first step, too, because these pros know what to look for and can refer you to a head and neck expert for further evaluation if need be.)

Remember, your odds of getting this type of cancer are super-slim. But the survival rates are not great, and the longer you wait to seek help, the more time the cancer has to grow and spread, reducing the odds of recovery further. So if anything feels not-quite-right, don’t wait. See your doctor now.

Stephanie Wood
Meet Our Writer
Stephanie Wood

Stephanie Wood is a award-winning freelance writer and former magazine editor specializing in health, nutrition, wellness, and parenting.