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Oral cancer

Oral cancer is cancer that starts in the mouth.

Causes

Oral cancer most commonly involves the lips or the tongue. It may also occur on the:

  • Cheek lining
  • Floor of the mouth
  • Gums (gingiva)
  • Roof of the mouth (palate)

Most oral cancers are a type called squamous cell carcinoma. These cancers tend to spread quickly.

Smoking and other tobacco use are linked to most cases of oral cancer. Heavy alcohol use also increases the risk for oral cancer.

Other factors that may increase the risk for oral cancer include:

  • Long-term (chronic) rubbing (such as from rough teeth, dentures, or fillings)
  • Human papillomavirus (HPV) infection (same virus that causes genital warts)
  • Taking medicines that weaken the immune system (immunosuppressants)
  • Poor dental and oral hygiene

Some oral cancers begin as a white plaque (leukoplakia) or as a mouth ulcer.

Men develop oral cancer twice as often as women do. It is more common in men older than 40.

Symptoms

Oral cancer can appear as a lump or ulcer in the mouth that may be:

  • A deep, hard-edged crack in the tissue
  • Pale, dark red, or discolored
  • On the tongue, lip, or other area of the mouth
  • Painless at first, then a burning sensation or pain when the tumor is more advanced

Other symptoms may include:

  • Chewing problems
  • Mouth sores that may bleed
  • Pain with swallowing
  • Speech difficulties
  • Swallowing difficulty
  • Swollen lymph nodes in the neck
  • Tongue problems
  • Weight loss
  • Difficulty opening the mouth
  • Numbness and loosening of teeth
  • Bad breath

Exams and Tests

Your doctor or dentist will examine your mouth area. The exam may show:

  • A sore on the lip, tongue, or other area of the mouth
  • An ulcer or bleeding

Tests used to confirm oral cancer include:

X-rays and CT, MRI and PET scans may be done to determine if the cancer has spread.

Treatment

Surgery to remove the tumor is recommended if the tumor is small enough. Surgery may be used together with radiation therapy and chemotherapy for larger tumors.

Depending on what type of treatment you require, supportive treatments that may be needed include:

Support Groups

You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.

Outlook (Prognosis)

Approximately half of people with oral cancer will live more than 5 years after they are diagnosed and treated. If the cancer is found early, before it has spread to other tissues, the cure rate is nearly 90%. More than half of oral cancers have spread when the cancer is detected. Most have spread to the throat or neck.

Oral cancers can recur if tobacco or alcohol use is not stopped.

Possible Complications

Complications of oral cancer may include:

  • Complications of radiation therapy, including dry mouth and difficulty swallowing
  • Disfigurement of the face, head, and neck after surgery
  • Other spread (metastasis) of the cancer

When to Contact a Medical Professional

Oral cancer may be discovered when the dentist does a routine cleaning and examination.

Call your provider if you have a sore in your mouth or lip or a lump in the neck that does not go away within 1 month. Early diagnosis and treatment of oral cancer greatly increases the chance of survival.

Prevention

Oral cancer may be prevented by:

  • Avoiding smoking or other tobacco use
  • Having dental problems corrected
  • Limiting or avoiding alcohol use
  • Visiting the dentist regularly and practicing good oral hygiene

Alternative Names

Cancer - mouth; Mouth cancer; Head and neck cancer - oral; Squamous cell cancer - mouth; Malignant neoplasm - oral

References

Little JW, Miller CS, Rhodus NL. Cancer and oral care of patients with cancer. In: Little JW, Miller CS, Rhodus NL, eds. Little And Falace's Dental Management of the Medically Compromised Patient. 9th ed. St Louis, MO: Elsevier; 2018:chap 26.

National Cancer Institute website. Lip and oral cavity cancer treatment (adult) (PDQ) - health professional version. www.cancer.gov/types/head-and-neck/hp/lip-mouth-treatment-pdq. Updated January 19, 2018. Accessed January 31, 2018.

Wein RO, Weber RS. Malignant neoplasms of the oral cavity. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 93.

Review Date 10/17/2017

Updated by: Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.