Oral Cancer

Oral Cancer

What 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 cavity and oropharyngeal cancer will be diagnosed in 35,000 U.S. adults in 2012, according to the American Cancer Society (ACS).

The oral cavity includes:

The oropharynx includes:

What causes oral cancer?

The main causes of oral cancer are:

Other causes of oral cancer may include the following:

What are the symptoms of oral cancer?

The following are the most common symptoms for oral cancer. However, each individual may experience symptoms differently. Symptoms may include:

The symptoms of oral cancer may resemble other disorders or medical problems. Always consult your health care provider for a diagnosis.

What are the different types of oral cancer?

Oral tumors can develop anywhere in the oral cavity and oropharynx (or the back of the mouth where it connects with the throat). Some tumors are benign (noncancerous), 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 tumors?

There are many forms of benign (noncancerous) tumors that can appear in the oral cavity or oropharynx (in addition to other sites in/on the body), including:

Condyloma acuminatum (also known as genital warts) A small, moist, pink or red growth that grows alone or in cauliflower-like clusters
Eosinophilic granuloma A benign tumor that most often affects children and adolescents and is usually found in a bone or the lungs
Fibroma A benign tumor consisting of fibrous connective tissues
Keratoacanthoma A 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)
Leiomyoma A tumor of the smooth muscle, often found in the esophagus, small intestine, uterus, or stomach
Lipoma A tumor made up of mature fat cells
Neurofibroma A fibrous tumor consisting of nerve tissue
Odontogenic tumors Tumors in the jaw that start in the tooth-forming tissues
Osteochondroma A tumor made up of bone and cartilage
Papilloma A tumor that resembles a wart, growing on the epithelium (the cells that form the skin and mucous membranes)
Pyogenic granuloma A small, round bump that often has an ulcerated surface
Rhabdomyoma A striated-muscle tumor that may appear on the tongue, pharynx, uterus, vagina, or heart
Schwannoma A single tumor that grows in the neurilemma (Schwann's sheath) of nerves
Verruciform xanthoma Wart-shaped tumors

Some benign tumors disappear on their own. Others may have to be removed surgically. Most benign tumors do not recur (come back). Always consult your health care provider for a diagnosis.

What oral 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.

Did You Know?

Only 25 percent of leukoplakias develop into cancer. However, 70 percent of erythroplakias are found to be cancerous when a biopsy is performed, according to the ACS.

Treatment for leukoplakias or erythroplakias may include use of retinoids—medications that are related to vitamin A—to eliminate, reduce, and/or prevent dysplasia from forming.

What are malignant oral tumors?

Although there are several types of malignant oral cancers, more than 90 percent of all diagnosed oral cancers are squamous cell carcinoma.

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 cell cancer.
Verrucous carcinoma Although also considered a type of squamous cell carcinoma, this low-grade cancer rarely metastasizes (spreads to distant sites). Comprising less than 5 percent of all diagnosed oral cancers, verrucous carcinoma can spread deeply into surrounding tissue, requiring surgical removal with a wide margin of surrounding tissue.
Minor 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 ACS, salivary gland cancers are rare.

What is a risk factor?

A risk factor is anything that may increase a person's 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 person's 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 person's risk for developing oral cancer. These include, but are not limited to:

Tobacco use The majority of patients with oral cancer 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 ACS.
Alcohol use The majority of patients with oral cancer 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 ACS.
Sunlight Prolonged 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.
Chronic irritation Chronic irritation to the lining of the mouth, due to poorly fitting dentures or other reasons, may increase a person's risk for oral cancer.
Lack of fruits and vegetables in diet Research 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 (oral) cancer.
Human papillomavirus (HPV) infection HPV usually causes warts and has been linked to cervical, vaginal, and penile cancers. HPV also increases the risk for oral cancers.
Males Oral cancer is twice as common in men then in women, partly because men are more likely to use tobacco and alcohol.

Can oral cancer be prevented?

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 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- to 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 health care provider right away if any of these symptoms are present:

Did You Know?

Wearing lip balm that contains a sunscreen or sunscreen lotion on the lips may help protect against cancer on the lip.

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 health care provider should also check your mouth as part of a routine physical exam.

How is oral cancer diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for oral cancer may include one or more of the following:

Once a diagnosis is made, the cancer will be staged (to determine the extent of the disease) before a treatment plan is established.

What is the treatment for oral cancer?

Specific treatment for oral cancer will be determined by your health care provider based on:

Treatment may include:

How do people prepare for oral cancer surgery?

If surgery is needed to treat the oral cancer, the NCI recommends asking the following questions:

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 treatment:

Depending on the type of treatment, other side effects may include:

What type of rehabilitation is needed 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:

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