What You Need to Know About Oral Cancer

by Kathleen Hall, MBA Health Writer

Oral cancers are those that develop on the lips, the tongue, and the sides, roof, and floor of the mouth. They are a type of head and neck cancer. If you or someone you know have been recently diagnosed with oral cancer, you probably have many questions. Here’s what you need to know about this disease.

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How common is oral cancer?

According to the National Institute of Dental and Craniofacial Research, about 3 percent of all cancer diagnoses in the U.S. each year are oral cancers. The Surveillance, Epidemiology, and End Results Program (SEER) of the National Cancer Institute estimates that more than 51,500 people will be diagnosed with oral and throat cancers in 2018. However, oral cancer is much more common in other parts of the world. When caught early, oral cancers are highly treatable and the prognosis is good.

hands holding a cigarette and a beer.

Alcohol and tobacco are major risk factors for oral cancer

The two biggest risk factors are using tobacco and excess alcohol consumption. In fact, 75 to 90 percent of oral cancers are attributed to cigarette smoking, and smoking and heavy drinking are associated with a 300-times greater risk of developing oral and pharyngeal cancer. It appears that when saliva is exposed to cigarette smoke, it loses its antioxidant capacity and becomes a “pro-oxidant milieu.” In plain English, this mean the mouth becomes an environment that’s conducive to cancer.

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Who gets head and neck cancer?

Oral cancer is more common in men than women, and it generally occurs in older adults. African Americans have a 50 percent higher prevalence of oral cancer than whites do. Additionally, if you are someone who often endures prolonged exposure to the sun, this can increase your risk of cancer on the lips, especially the lower lip. Having a human papillomavirus (HPV) infection is also a risk factor for some oral cancers.

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Signs of oral cancer

Oral cancer lesions are most often found on the sides of the tongue, the top of the throat at the back of the mouth (oropharynx), and the floor of the mouth. Lesions can appear red, white, or mixed. Red and mixed lesions are more likely to be cancerous. If you have a change in your mouth that lasts for more than three weeks, see your doctor or dentist. Other symptoms include a change in voice, jaw swelling, trouble chewing or swallowing, or bleeding, pain, or numbness in and around the mouth.

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Screening for oral cancer

Screening is the process of looking for signs of cancer in people who have no symptoms. Currently, the Food and Drug Administration has not approved any type of screening test for oral cancers, and the U.S. Preventive Services Task Force, an independent body that reviews medical evidence, has not endorsed screening for oral cancers in adults who don’t have symptoms. However, your dentist may check for changes and problems during your routine dental exam.

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The staging system for oral cancer

Oncologists use a standard staging system to describe tumors so that everyone who treats a patient understands the tumor the same way. This system drives treatment decisions. The TNM staging system refers to the primary tumor (T), whether it has spread to the lymph nodes (N), and if it has metastasized, or spread (M). Tumors are classified as stage 0 (abnormal cells that may progress to cancer) to stage IV (the cancer has spread). The stage of your tumor determines the best approach to treatment.

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How is oral cancer treated?

Treatment for oral cancer depends on how advanced the cancer is (whether it has spread), where it is, and how big it is. The standard treatment for most oral cancers is surgery to remove the tumor and a bit of healthy tissue surrounding the tumor. In some cases, you may also need radiation therapy to kill any remaining cancer cells. According to the National Cancer Institute, several new types of treatments for oral cancer are currently in clinical trials, including certain types of chemotherapy and a procedure called hyperthermia, which uses heat to kill or damage cancer cells.

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Secondary tumors with oral cancer

It’s not uncommon for people with oral cancer develop a secondary primary tumor in the head and neck. This is an entirely different cancer, not the original tumor spreading. Your oncologist will monitor you closely following treatment for signs of an additional tumor.

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When oral cancer spreads

Oral cancer tends to spread (metastasize) to other locations in the head and neck or to regional lymph nodes, especially those in the front of the neck. When oral cancer metastasizes to other parts of the body, it most frequently spreads to the lungs, liver, or bone.

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Complications from oral cancer treatment

Surgery and radiation therapy for oral cancer are complex because there are so many important structures in close proximity to each other. Treatment can cause difficulties in chewing, swallowing, or talking. You may need reconstructive surgery following treatment to restore function in the areas affected or to make cosmetic improvements. A speech and language therapist can also help you regain your ability to eat or talk.

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How to prevent oral cancer

While there’s no guarantee that you won’t develop cancer, you can lower your risk of developing oral cancer by not using tobacco, drinking in moderation, and eating a diet rich in fruits and vegetables. Talk to your doctor if you are concerned about risk factors.

Kathleen Hall, MBA
Meet Our Writer
Kathleen Hall, MBA

Kathleen Hall is a health writer who writes articles for consumer and health professionals as well as health care marketing material for corporate clients. Kathleen has a BS in psychology from the University of Maryland, an MBA from Virginia Commonwealth University and is a member of the Association of Health Care Journalists. She divides her time between Richmond, Virginia, and Bar Harbor, Maine. Kathleen is also a professional artist and runner.