Oral cancer refers to any cancer that affects the lips and the inside of the mouth. It is the most common form of cancer in the head or neck. While prognosis for oral cancer is relatively good—the overall 5-year survival rate for patients with an early diagnosis of oral cancer is 84%—cancer of any form is difficult on the patient and friends and family. Regular dental care is essential for early discovery and treatment.
Defining Oral Cancer
Oral cancer affects the lips and the oral cavity. This may include the floor of the mouth under the tongue, the lining of the inside of the cheeks, the most forward part of the roof of the mouth (the hard palate), the first two-thirds of the tongue, the space behind the wisdom teeth, and the gums. It can also affect the oropharynx, which includes the back of the tongue, the back of the roof of the mouth (the soft palate), the tonsils, and the sides and back of the throat. Cancer further down the oropharynx is called oropharyngeal cancer.
Causes
Oral cancer is caused by the mutation and rapid growth of the squamous cells in the oral cavity. There are a number of risk factors:
- Smoking (cigarettes, pipes, or cigars)
- Use of other tobacco products (chewing tobacco, snuff, dip, hookah, or shush)
- Regular and excessive consumption of alcohol
- Excessive exposure to solar UV rays without protective lip balm
- Poor diet low in vegetables and fruits
- Human papillomavirus (HPV)
- Age (risk increases with age)
- Sex (men are 50–70% more likely to develop oral cancer, especially if over the age of 50)
- A family history of oral cancer
While these all contribute to the risk of developing cancer in the mouth, it should be noted that 25% of oral cancer patients don’t have known risk factors.
Symptoms
Oral cancer almost always produces patches in the oral cavity of one of three varieties:
- Erythroplakia: Red patches in the mouth (either flat or slightly raised) that bleed when scraped are indicative of erythroplakia. About 70% of erythroplakia is cancerous or precancerous. The condition often arises out of an area of leukoplakia.
- Leukoplakia: Leukoplakia is characterized by flat white or gray patches in the mouth or throat. Leukoplakia looks similar to thrush, but the patches cannot be wiped away. If the patches fade on their own, they are unlikely to mutate into oral cancer. If not, see a physician right away.
- Erythroleukoplakia: The patches associated with erythroleukoplakia are red and white, a combination of both erythroplakia and leukoplakia. Erythroleukoplakia patches present a relatively high risk of malignant transformation.
The other symptoms of oral cancer are vast and unpleasant. Patients can experience inexplicable oral bleeding and other pain, numbness, or tenderness to the touch in and around the mouth. Difficulty using the jaw or tongue—for chewing, swallowing, speaking, etc.—is common, as is swelling in affected areas and halitosis. Symptoms more removed from the mouth include earache and unexplained weight loss.
Treatment
The treatment for oral cancer is similar to the treatment for other cancers. Cancerous tissue is removed during surgery, then treatments of radiation therapy and chemotherapy are used to destroy any remaining cancer cells. Radiation therapy utilizes high-energy beams, such as X-rays, while chemotherapy uses chemicals. These treatments can be administered on their own or in combination with other cancer treatments.
For example, targeted drugs alter specific growth mechanisms within oral cancer cells, and immunotherapy uses the body’s immune system to fight against cancer cells. One of the reasons cancer is so difficult to cure is because cancer cells produce proteins that disguise them from the cells of the immune system. Immunotherapy operates under the principle of inhibiting that process. The treatment is relatively new and is primarily reserved for people with advanced oral cancer that does not respond to standard treatments.
If oral cancer is not treated in time, surgery to reconstruct the mouth or jaw may be necessary. This drastic measure can be avoided if the warning signs of cancer are recognized early on.
On the Lookout for Oral Cancer
Oral cancer affects roughly 50,000 people in the United States every year. If properly treated early on, it is usually manageable. However, if it is allowed to spread to lymph nodes, tissues, and organs beyond the oral cavity, the 5-year survival rate drops to 65%.
Some risk factors for oral cancer can be removed from the lifestyle of those wishing to avoid it. Persons with a family history of cancer should avoid smoking and other carcinogens. Sometimes the disease is unavoidable, but regular dental care can discover oral cancer before it becomes unmanageable. We urge everyone to visit their dentist regularly for the sake of their own health.
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