is oral cancer?
Oral cancer is cancer found in the oral cavity
(the mouth area) and the oropharynx (the throat
area at the back of the mouth). Oral cancer,
which can be deadly, is diagnosed in
approximately 30,000 Americans each year,
according to the American Cancer Society.
The oral cavity includes:
- the lips,
teeth, and gums
- the lining
inside the lips and cheeks (buccal
- the floor of
the mouth (under the tongue)
- the top of
the mouth (hard palate)
- the small
area behind the wisdom teeth
- the back
one-third of the tongue
- the soft
- the tonsils
- the back of
causes oral cancer?
The main causes of oral cancer are:
- tobacco use
(80 to 90 percent of oral cancers are
caused by smoking cigarettes, cigars,
pipes, chewing tobacco, and dipping
Other causes of
oral cancer may include the following:
a condition characterized by a
whitish patch that develops inside the
mouth or throat
a condition characterized by a
red, raised patch that develops inside
- excessive sun
exposure, which, like elsewhere on the
body, can cause cancer on the lip
the symptoms of oral cancer?
The following are the most common symptoms for
oral cancer. However, each individual may
experience symptoms differently. Symptoms of oral
cancer may include:
- a lip or
mouth sore that does not heal
- a white or
red patch on the gums, tongue, or lining
- a lump on the
lip or in the mouth or throat
bleeding, pain, or numbness in the mouth
- swelling of
- pain in the
- change in
- a chronic
- feeling as if
something is caught in the throat
- pain or
difficulty in swallowing or chewing
The symptoms of
oral cancer may resemble other disorders or
medical problems. Always consult your physician
for a diagnosis.
> About 29,800 new cases
of oral cancer will be diagnosed in the
US in 1999: 20,000 men and 9,800
women (with incidence rates twice as high
for men over 40).
Eighty-three percent of oral cavity and
pharynx cancer patients survive one year
after diagnosis. For all stages, the
5-year survival rate is 53 percent, and
the 10-year survival rate is 46 percent..
Tobacco use -- smoking cigarettes,
cigars, or pipes, and chewing tobacco or
dipping snuff -- accounts for 80 to 90
percent of oral cancers.
Studies show that cigar and pipe smokers
have the same risk as cigarette smokers,
and that smokeless tobacco users are at
percent of leukoplakias develop into
cancer. However, 51 percent of
erythroplakias are found to be cancerous
when a biopsy is performed, according to
the American Cancer Society.
lip balm that contains a sunscreen or
sunscreen lotion on the lips may help
protect against cancer on the lip.
What are the
different types of oral cancer?
Oral tumors can develop anywhere in the oral cavity and
oropharynx. Some tumors are benign (non-cancerous), some
may be precancerous (a condition that may become
cancerous), while others may be cancerous. Different
types of oral cancer may develop in different areas of
the mouth and throat.
What are benign
There are many forms of benign (non-cancerous) tumors
that can appear in the oral cavity or oropharynx (in
addition to other sites in/on the body), including:
acuminatum (also known as a genital warts)
small, moist, pink or red growth that grows alone
or in cauliflower-like clusters
benign tumor which most often affects children
and adolescents and is usually found in a bone or
benign tumor consisting of fibrous connective
flesh-colored, fast-growing bump on the skin with
a keratin plug in the center (keratin, the main
component of the external layer of skin, hair,
and nails, is a tough substance)
tumor of the smooth muscle, often found in the
esophagus, small intestine, uterus, or stomach
tumor made up of mature fat cells
fibrous tumor consisting of nerve tissue
in the jaw
tumor made up of bone and cartilage
tumor that resembles a wart, growing on the
epithelium (the cells that form the skin and
small, round bump that often has an ulcerated
striated-muscle tumor that may appear on the
tongue, pharynx, uterus, vagina, or heart
single tumor that grows in the neurilemma
(Schwanns sheath) of nerves
tumors disappear on their own. Others may have to be
removed surgically. Most benign tumors do not recur.
Always consult your physician for a diagnosis.
conditions may be precancerous?
Two conditions in the mouth -- leukoplakia and
erythroplakia -- actually can be precursors to cancer.
Often caused by smoking or chewing tobacco, these
(initially) benign conditions can occur anywhere in the
mouth. Only a biopsy can determine whether precancerous
cells (dysplasia) or cancer cells are present in a
leukoplakia or erythroplakia.
a condition characterized by a whitish
patch that develops inside the mouth or throat
a condition characterized by a red, raised
patch that develops inside the mouth
Treatment for leukoplakias
or erythroplakias may include use of retinoids --
medications which are related to vitamin A -- to
eliminate, reduce, and/or prevent dysplasia from forming.
What are malignant
Although there are several types of malignant oral
cancers, more than 90 percent of all diagnosed oral
cancers are squamous cell carcinoma.
||Also known as squamous cell cancer,
this type of cancer originates in the squamous
cell layer in the lining of the oral cavity and
oropharynx. In the early stages, this cancer is
present only in the lining layer of cells (called
carcinoma in situ). When the cancer spreads
beyond the lining, it is called invasive squamous
||Although also considered a type of
squamous cell carcinoma, this low-grade cancer
rarely metastasizes (spreads to distant sites).
Comprising less than five percent of all
diagnosed oral cancers, verrucous carcinoma can
spread deeply into surrounding tissue, requiring
surgical removal with a wide margin of
salivary gland cancers
||The lining of the oral cavity and
oropharynx contains numerous salivary glands.
Sometimes cancer will originate in a salivary
gland. Treatment depends on the type and location
of the salivary gland cancer, as well as the
extent of spreading. According to the American
Cancer Society, salivary gland cancers account
for less than one percent of all cancers.
is a risk factor?
A risk factor is anything that may increase a
persons chance of developing a disease. It may be
an activity, such as smoking, diet, family history, or
many other things. Different diseases, including cancers,
have different risk factors.
Although these factors can
increase a persons risk, they do not necessarily
cause the disease. Some people with one or more risk
factors never develop the disease, while others develop
disease and have no known risk factors.
But, knowing your risk
factors to any disease can help to guide you into the
appropriate actions, including changing behaviors and
being clinically monitored for the disease.
What are the risk
factors for oral cancer?
Although heredity also plays a factor, certain lifestyle
habits and health conditions can increase a persons
risk for developing oral cancer. These include, but are
not limited to:
majority of patients with oral cancer (90
percent) use tobacco in one form or another.
Tobacco can damage cells in the lining of the
oral cavity and oropharynx, causing abnormal
cells to grow more rapidly to repair the damage.
Researchers believe that the DNA-damaging
chemicals in tobacco are linked to the increased
risk of oral cancer, according to the American
majority of patients with oral cancer (75 to 80
percent) use alcohol frequently. Paired with
tobacco use, patients who drink and smoke
increase their risk of developing oral cancer
even more. Researchers have found that alcohol
increases the penetration of DNA-damaging
chemicals in the lining of the oral cavity and
oropharynx, according to the American Cancer
exposure to ultraviolet radiation from the sun
can cause skin cancer. People who are outdoors
for an extended period of time increase their
risk of lip cancer, as well.
irritation to the lining of the mouth, due to
poorly fitting dentures or other reasons, may
increase a persons risk for oral cancer.
fruits and vegetables in diet
has suggested that fruits and vegetables, which
contain antioxidants that can "trap"
harmful molecules, can decrease the risk for oral
cancer (and other cancers). Thus, it is
speculated that persons with a low intake of
these types of foods are at an increased risk for
studies have shown that mouthwash with alcohol
content increases the risk for oral cancer. In
addition, other studies have shown that smokers
and people who drink alcohol tend to use
mouthwash more often, linking all three factors
papillomavirus (HPV) infection
usually causes warts and has been linked to
cervical, vaginal, and penal cancers. HPV may
also increase the risk for oral cancers.
cancer is twice as common in men then in women,
partly because men are more likely to use tobacco
It is important to detect oral cancer as early as
possible, because treatment works best before the disease
has spread. The National Cancer Institute (NCI) and
American Cancer Society (ACS) encourage people to take an
active role in the early detection of oral cancer by
performing monthly self-examinations. The Oral Health
Education Foundation recommends the following steps
(below) when examining your mouth. Take special note of
any red or white patches, lumps or thickening of skin,
tissue, or gums, a sore that either does not heal
properly (after a 1-2 week period), or a sore that tends
to bleed easily or excessively. In addition, be sure to
take note of a persistent sore throat, hoarseness, or
difficulty maneuvering the jaw during chewing or
swallowing. Be sure to consult your physician right away
if any of these symptoms are present.
- Remove any dental
products in the mouth.
- Visually look and
touch your mouth, including the lips and gums.
- Check the roof of
- Check the inside of
the cheeks and the back gums.
- Check the tongue,
including the sides and underneath.
- Check for enlarged
lymph nodes in the neck and under the jaw.
Regular dental checkups
that include an examination of the entire mouth are also
important in the early detection of oral cancer or
precancerous conditions. Your physician should also check
your mouth as part of a routine physical exam.
How is oral cancer
In addition to a complete medical history and physical
examination, diagnostic procedures for oral cancer may
include one or more of the following:
- a procedure in which tissue samples are removed
(with a needle or during surgery) from the body
for examination under a microscope; to determine
if cancer or other abnormal cells are present.
tomography (CT or CAT scan) - a
non-invasive procedure that takes cross-sectional
images of the brain or other internal organs; to
detect any abnormalities that may not show up on
an ordinary x-ray.
- a diagnostic imaging technique which uses
high-frequency sound waves to create an image of
the internal organs.
resonance imaging (MRI) - a non-invasive
procedure that produces two-dimensional view of
an internal organ or structure, especially the
brain and spinal cord.
Once a diagnosis is made,
the cancer will be staged (to determine the extent of the
disease) before a treatment plan is established.
Treatment for oral
Specific treatment for oral cancer will be determined by
your physician(s) based on:
- your overall health
and medical history
- extent of the disease
- your tolerance for
specific medications, procedures, or therapies
- expectations for the
course of the disease
- your opinion or
Treatment may include:
Different surgery techniques are used to
remove specific types of oral tumors, including:
tumor resection removal of
the entire tumor and surrounding area of
removal of the tumor, including part
or all of the hard palate (roof of the
mouth), if bone is involved
micrographic surgery removal
of the tumor in "slices" to
minimize amount of normal tissue removed (may
be considered when the cancer involves the
removal of a large tumor of the tongue
or oropharynx, which may involve removing the
larynx (voice box)
dissection if cancer has
spread to the lymph nodes in the neck, these
lymph nodes may need to be removed as well.
therapy treatment that uses
high-energy rays that damage cancer cells and
halts the spread of cancer. Radiation therapy is
very localized, aimed at only the area where the
cancer is present. Radiation therapy may be
administered externally with a machine, or
internally with radioactive materials.
medications that kill cancer cells.
Chemotherapy has the ability to interfere with
the cancer cells replication. Chemotherapy
may be used in combination with surgery and
If surgery is needed to treat the oral cancer, the
National Cancer Institute recommends asking the following
- What type of
operation will I undergo?
- What can I expect
- How will any pain be
- Will I have trouble
- Will I have any
- Will there be any
long-term effects or permanent physical changes
- If I need plastic
surgery, how soon can that be done following the
- Will I need speech
- When can I resume my
What are the side
effects of oral cancer treatment?
Side effects of treatment for oral cancer vary, depending
on the type of treatment and the area being treated. Side
effects can be temporary or permanent. The following are
some of the more common side effects of oral cancer
- swelling from surgery
- sore mouth
- difficulty chewing,
swallowing, or talking
- changes to
appearance, temporarily or permanently
- weight loss due to a
sore mouth, which may make eating difficult
- inability to wear
dentures for a period of time
Depending on the type of
treatment, other side effects may include:
- dental problems
- lowered immune system
- mouth sores
- lack of appetite
after oral cancer:
Rehabilitation may vary from person-to-person depending
on the type of oral cancer treatment, and the location
and extent of the cancer. Rehabilitation may include:
counseling Many patients
recovering from oral cancer surgery have
difficulty eating, so it is often recommended
that they eat small meals consisting of soft,
Some patients may benefit from
reconstructive or plastic surgery to restore the
bones or tissues of the mouth, returning a more
If reconstructive or plastic surgery is
not an option, patients may benefit from dental
or facial-part prosthesis to restore a more
normal appearance. Special training may be needed
to learn to use a prosthetic device.
therapy If a patient experiences
difficulty in speaking following oral cancer
treatment, speech therapy may help the patient
relearn the process.