Mouth cancer or Oral cancer
Its types, causes, symptoms, diagnosis and treatment

What is mouth cancer?

Mouth cancer refers to cancer that occurs in mouth affecting lips, gums, tongue, inner cheek, roof and floor of mouth, and throat. Cancers affecting areas inside the mouth are collectively called as oral cancers.

What are the symptoms and early warning signs of mouth cancer?

Some of the common symptoms of mouth cancer include:

• White or red patches in the mouth
• Mouth sore that bleeds or doesn’t heal
• A growth, lump, or thickening of the inner lining of the mouth
• A lump in the neck or sore throat
• Difficult and painful swallowing or chewing
• A persistent earache
• Tongue pain
• Jaw pain or stiffness
• Loose teeth

It is important to visit the dentist if these symptoms persist for more than two weeks.

What are the causes of mouth cancer?

Mouth cancer results from mutations (DNA changes) in the concerned cells. These mutations cause cells to divide and grow uncontrollably thereby leading to the formation of a tumor. Though the reason for mutation is not established yet, there are certain factors that predispose cells to these changes.

What are the risk factors for mouth cancer?

Certain factors that increase your risk of developing mouth cancer include:

• Tobacco intake in any form like a cigarette, cigar, snuff dipping etc.
• Excessive consumption of alcohol
• Overexposure of lips to sunlight for a prolonged duration
• A sexually transmitted virus called Human Papilloma Virus (HPV) that majorly causes cervical cancer
• Compromised immunity

What are the stages of mouth cancer?

Once the diagnosis is done, the stage of the cancer is determined.

Staging of cancer is done to assess the size and extent of spread. It also helps the oncologist to decide the treatment plan.

Cancer staging is done in two ways: TNM (Tumour, Node, Metastasis) staging and Number staging from I to IV. It was developed by the International Union against Cancer and the American Joint Committee on Cancer (AJCC).

• ‘T’ refers to the size of the primary tumor
• ‘N’ refers to whether the lymph nodes in the neck area have become cancerous
• ‘M’ refers to whether cancer has spread to distant organs in the body (metastasized), such as your lungs, bones, or liver

Stages progress from I to IV ranging from smallest and confined to biggest and widespread to other areas.

Stage 0: In stage 0, oral cancer begins to grow on the surface (protective lining) of the oral cavity.

Stage 1: Cancer has begun to grow deeper into the tissues in the oral cavity. Stage 1 oral cancer is small in size and localized to oral cavity but has not yet spread to lymph nodes or distant sites.

Stage 2: In stage 2, cancer has grown larger (up to 4 cm), but cancer is still localized.

Stage 3: Oral cancer has grown larger than 4 cm. Stage 3 oropharyngeal cancer has grown into the epiglottis (the base of the tongue). There are chances that cancer has spread to the lymph node on the same side of the primary tumor. However, cancer has not spread to the distant sites.

Stage 4: Stage 4 oral cancer may vary greatly in size. In moderately advanced local disease (stage 4A), the nearby bone, skin and sinus may be involved.

• Lip cancers: Cancer may grow into nearby structures such as skin of the chin or nose, jawbone, floor of the mouth, and the inferior alveolar nerve (the nerve to the jawbone).
• Oral cavity cancers: Cancer may spread to bones of the jaw or face, maxillary sinus, and deep muscle of the tongue.
• Oropharyngeal cancer: Cancer may spread to bones of the jaw or face, larynx (voice box), and deep muscle of the tongue.

In stage 4A, the cancer may or may not have spread to the lymph nodes (on the same or opposite side of the tumor). As cancer progresses to stage 4B, the size of cancer becomes larger and grows outside the lymph node(s). Cancer grows further and spreads to nearby structures such as the base of the skull or bones nearby and carotid artery. This is called as a very advanced local disease (stage 4B). Once cancer spreads to nearby soft tissues, lymph nodes and distant organs, it is called as stage 4C oral cancer.

How is mouth cancer diagnosed?

Your dentist or oncologist will be able to diagnose mouth cancer by

• Medical history
• Physical examination – examination of areas in and around the mouth for the presence of any sores, white/red patches, and areas of irritation
• Endoscopy
• Biopsy – once the suspicious area is detected, a sample of cells from that area is removed and analyzed microscopically for the presence of cancerous or pre-cancerous changes in the cells.
•  Imaging tests:
  • – CT scan
  • – MRI
  • – PET Scan

How is mouth cancer diagnosed?

What is the treatment for mouth cancer?

The treatment plan for mouth cancer is determined by location and stage of cancer, overall health of the patient, and personal preference. The treatment modalities may be used individually or in combination.

• Surgery is done for removal of primary cancer and lymph nodes if involved and mouth reconstruction to replace the mouthparts lost during the corrective surgery
• Radiation therapy: Use of high-powered energy beams to destroy cancer cells
• Chemotherapy: Use of drugs to destroy cancer cells
• Radiosurgery: Also known as Stereotactic body radiotherapy, intense radiation is used instead of surgery
• Targeted-drug therapy: Use of drugs that act on cancer cells and selectively destroy only cancer cells
• Biological therapy: Makes use of the body’s immune system to fight cancer cells
• Palliative care: Intended to improve the quality of life of cancer patients who may not be amenable to treatment

Since mouth cancer requires a multidisciplinary management, look for a hospital that has an expert team of oral and maxillofacial surgeons, oncologist, onco-surgeon and radiation oncologist with a trained staff. The hospital should also have infrastructure like diagnostic support, modular OT, ICU and facility for radiation therapy and chemotherapy.

What is the survival rate for mouth cancer?

Survival rates are often used by doctors to determine the patient’s prognosis. The 5-year survival rate implies to the percentage of people surviving 5 years after the diagnosis of their disease. It depends on many factors like overall health of the patient, stage and site of the tumor. The 5-year survival rate is 83% for localized mouth cancers, 62% for cancers spreading to surrounding lymph nodes, and 38% for cancers spreading to distant body parts.

How can one prevent mouth cancer?

How can one prevent mouth cancer?

Poor personal habits are a major risk factor for mouth cancer hence some of the following ways should be adopted to prevent mouth cancer:

• Follow a healthy lifestyle and eating habits
• Stop consuming tobacco and alcohol
• Avoid things known to cause cancer
• Inspect mouth periodically for any abnormal change and its constant presence
• Consult your dentist for a regular screening

To know more about mouth cancer, you can request for a callback and our mouth cancer specialist will call you and answer all your queries.

References:

• Mayo Clinic. Mouth cancer. Available at: https://www.mayoclinic.org/diseases-conditions/mouth-cancer. Accessed on April 6, 2018.
• Oral Health Foundation. Available at: http://www.mouthcancer.org/what-is-mouth-cancer/. Accessed on April 6, 2018.
• US National Library of Medicine. Mouth cancer. Available at: https://medlineplus.gov/oralcancer.html. Accessed on April 6, 2018
• Cancer Research UK. Mouth cancer. Available at:http://www.cancerresearchuk.org/about-cancer/mouth-cancer/survival Accessed on April 6, 2018

Disclaimer:

“The content of this publication has been developed by a third party content provider who is clinicians and/or medical writers and/or experts. The information contained herein is for educational purpose only and we request you to please consult a Registered Medical Practitioner or Doctor before deciding the appropriate diagnosis and treatment plan.”