Oral Cancer

Overview

Oral cancer includes cancers of the mouth and the back of the throat. Oral cancers develop on the tongue, on the tissue lining the mouth and gums, under the tongue, at the base of the tongue, and the area of the throat at the back of the mouth.

Oral cancer accounts for roughly three percent of all cancers diagnosed annually in the United States, or about 54,000 new cases in 2022.

Oral cancer most often occurs in people over the age of 40 and affects more than twice as many men as women. Most cancers in the mouth are related to tobacco use, drinking alcohol, or both, and most throat cancers are caused by the human papilloma virus (HPV). The incidence of HPV-positive oral cancer has risen in recent years.

Causes

Tobacco and alcohol use. Tobacco use of any kind, including cigarette, pipe and cigar, and electronic cigarette smoking, as well as chewing tobacco and snuff puts you at risk for developing oral cancers. Heavy alcohol use also increases the risk. Using both tobacco and alcohol increases the risk even further.

HPV. Infection with the sexually transmitted human papillomavirus (specifically the HPV 16 type) has been linked to oral cancers.

Age. Risk increases with age. Oral cancers most often occur in people over the age of 40.

Sun Exposure. Cancer of the lip can be caused by sun exposure.

Poor Nutrition. A diet low in fruits and vegetables has been linked with increased risk of oral cancer.

Genetics. People with inherited defects in certain genes have a high risk of mouth and middle throat cancer.

Symptoms

If you have any of these symptoms for more than two weeks, see a dentist or a doctor.

• A sore, irritation, lump or thick patch in your mouth, lip, or throat.
• A white or red patch in your mouth.
• Persistent sore throat, a feeling that something is caught in your throat, or hoarseness or loss of your voice.
• A lump in the neck.
• Difficulty chewing, swallowing, or speaking.
• Difficulty moving your jaw or tongue.
• Swelling of your jaw that causes dentures to fit poorly or become uncomfortable.
• Pain or bleeding in the mouth.
• Numbness in your tongue or other areas of your mouth.
• Ear pain.

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Diagnosis

• Because oral cancer can spread quickly, early detection is important. An oral cancer examination can detect early signs of cancer. The exam is painless and takes only a few minutes. Your regular dental checkup is an excellent opportunity to have the examination.
• During the examination, your dentist or dental hygienist will check your face, neck, lips, entire mouth, and the back of the throat for possible signs of cancer.
• If the dentist finds anything unusual, he or she will recommend additional tests and/or refer you to a specialist.

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Treatment

Oral cancer is treated with surgery and possibly radiation therapy or chemotherapy. Oral cancer that is further along when it is diagnosed may need a combination of treatments.

Another treatment option is targeted therapy, which is a newer type of cancer treatment that uses drugs to precisely identify and attack cancer cells. Immunotherapy may also be a potential treatment; it can work with the body’s natural defenses to improve immune function. The choice of treatment depends on your general health, where in your mouth or throat the cancer began, the size and type of the tumor, and whether the cancer has spread.

Your doctor may refer you to a specialist. Specialists who treat oral cancer include:

• Head and neck surgeons.
• Dentists who specialize in surgery of the mouth, face, and jaw (oral and maxillofacial surgeons).
• Ear, nose, and throat doctors (otolaryngologists).
• Doctors who specifically treat cancer (medical and radiation oncologists).

Other health care professionals who may be part of a treatment team include dentists, plastic surgeons, reconstructive surgeons, speech pathologists, oncology nurses, registered dietitians, genetic counselors, and mental health counselors.

Helpful Tips

Oral cancer and its treatment can cause dental problems. It’s important that your mouth is in good health before cancer treatment begins.

• See a dentist for a thorough examination one month, if possible, before starting cancer treatment to give your mouth time to heal after any dental work you might need.
• Before, during, and after cancer treatment, ask your health care provider for ways to control pain and other symptoms and to relieve the side effects of therapy.
• Talk to your health care team about financial aid, transportation, home care, and emotional and social support for yourself and your family.

Additional Resources

• Head and Neck Cancers: Questions and Answers
  A fact sheet from the NIH's National Cancer Institute that answers questions about cancers of the mouth (oral cavity), salivary glands, sinuses, throat (pharynx), and voice box (larynx).
• The National Cancer Information Service
  To find out about helpful programs, services, and publications, call the National Cancer Institute.
• NCI Head and Neck Cancer Home Page — Patient Version
  The NIH National Cancer Institute's gateway for information about head and neck cancers.
• Radiation Therapy and You: Support for People with Cancer
  A booklet from the National Cancer Institute (NCI) for people who are about to receive or are now receiving radiation therapy for cancer.
• MedlinePlus: Oral Cancer
  The NIH National Library of Medicine's collection of links to government, professional and non-profit/voluntary organizations with information on oral cancer.
• The Oral Cancer Foundation
  The Oral Cancer Foundation is a charity whose goal is to reduce suffering and save lives through prevention, education, research funding, advocacy, and patient support activities.
• Support for People with Oral and Head and Neck Cancer, Inc.
  With more than 100 local chapters nationwide, SPOHNC was founded to meet the psychosocial needs of patients and to provide patient and family education on oral, head and neck cancers.