There are several types of cancer that can affect the mouth, including the lips, tongue, cheeks, gums, palate, and throat. There are many symptoms associated with oral cancer, including ulcers, sores, lumps, pain, bleeding, and difficulty swallowing. Although oral cancer can occur anywhere in the mouth, it is more common on the tongue, the floor of the mouth, or the lower lip. Tobacco use, alcohol use, human papillomavirus (HPV) infection, or sun exposure can all contribute to oral cancer. Depending on the stage and location of the cancer, oral cancer can be diagnosed through a physical examination, biopsy, or imaging test. It is possible to treat oral cancer with surgery, radiation therapy, chemotherapy, or immunotherapy. A number of risk factors can be avoided or reduced in order to prevent oral cancer, including tobacco use, alcohol use, HPV infection, and sun exposure.
Causes
It is unknown what causes oral cancer, but it is believed to be related to damage to the DNA of the cells that line the mouth, which causes abnormal growth and division of the cells.
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Using tobacco products, such as cigarettes, cigars, pipes, or chewing tobacco, can expose the mouth to harmful chemicals, such as nicotine, tar, or carcinogens, which can damage DNA.
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In combination with tobacco use, alcohol can dehydrate the mouth, making it more susceptible to tobacco and other irritations
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Infection with Human Papillomavirus (HPV), which causes warts or lesions that can turn into cancerous lesions in the mouth and throat
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Excessive sun exposure, especially on the lips, can cause sunburn and increase the risk of skin cancer
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Oral cancer can be caused by poor oral hygiene, which can cause chronic inflammation, infection, or irritation of the mouth
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Oral cancer susceptibility may be influenced by genetic or environmental factors, such as family history, age, gender, race, or diet.
Symptoms
Symptoms of oral cancer vary depending on the part of the mouth affected, the size and stage of the cancer, and the patient's response.
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White, red, or mixed-colored ulcers, sores, or patches that don't heal or bleed easily
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Various lumps, bumps, or swellings that may be hard or soft, and may be painful or not
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Mouth, tongue, jaw, or throat pain that worsens with chewing, swallowing, or speaking, which may be constant or intermittent
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Blood, pus, or saliva discharge from the mouth
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It may cause drooling, slurred speech, or facial asymmetry if you have difficulty swallowing, chewing, speaking, or moving the tongue or jaw
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Voice changes, such as hoarseness, raspiness, or loss of voice
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An altered taste, smell, or sensation in the mouth, such as numbness, tingling, or burning
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The inability to eat or swallow may cause weight loss or loss of appetite
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Dentures or teeth that are loose because of tumor growth or erosion of the gums or jawbone
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There may be ear pain or hearing loss if the cancer has spread to the ear or nerves
Diagnosis
Based on the clinical presentation, the medical history, and the diagnostic tests, oral cancer can be diagnosed. During the examination, the doctor will ask about the patient's symptoms, their onset and duration, as well as his or her medical history and family history. Additionally, the doctor will examine the patient's general health and oral health during the physical examination. During the oral examination, the doctor will check the mouth, the tongue, the teeth, and the throat for any abnormalities, such as ulcers, sores, lumps, or bleeding.
Diagnostic tests may also be ordered by the doctor, such as:
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A biopsy is the removal of a small sample of tissue from a suspicious area and its examination under a microscope to confirm the presence and type of cancer
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A detailed view of the mouth and the surrounding structures can be obtained with imaging tests such as x-rays, CT scans, MRI scans, or PET scans.
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As part of endoscopy, a thin tube with a camera and light (endoscope) is inserted through the mouth or the nose and into the throat or esophagus, providing a direct view of the inside of the mouth and throat, as well as the removal of tissue samples for biopsy.
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Tests like complete blood counts, liver function tests, and tumor marker tests can be used to assess the overall health and function of the organs, and to detect infections, inflammations, and cancers.
Treatment
It depends on the location, size, stage, and type of oral cancer as well as the patient's overall health and preference how it should be treated. In addition to removing or destroying the cancer cells, the treatment also preserves the function and appearance of the mouth, and prevents or treats any complications or recurrences of the cancer. Treatment options include:
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In addition to removing the tumor and some of the surrounding healthy tissue, surgery may also remove lymph nodes nearby, which filter lymph fluid and aid in infection prevention. Depending on the size and location of the tumor, surgery can be done with a variety of techniques, including excision, laser, or cryosurgery. Using skin grafts, flaps, or implants, surgery can also restore function and appearance to the mouth, tongue, jaw, or face. In addition to the risks associated with surgery, a hospital stay and recovery time may be required, as well as bleeding, infection, pain, or scarring.
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To kill or damage cancer cells, radiation uses high-energy rays or particles, such as x-rays, gamma rays, or protons, to shrink tumors. An external radiation machine can be used to deliver radiation to the tumor, or an internal radioactive material can be used to deliver radiation to the tumor. Depending on the stage and location of the cancer, radiation can be used alone or with surgery or chemotherapy. There can be some side effects from radiation, including skin irritation, dry mouth, sore throat, difficulty swallowing, and tooth decay, and a regular schedule and follow-up may be necessary.
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In chemotherapy, drugs are used to kill or stop cancer cells from growing and from spreading to other parts of the body. Depending on the type and stage of the cancer, chemotherapy can be administered intravenously, orally, or topically. The stage and location of the cancer determine whether chemotherapy should be used alone or with surgery or radiation. The side effects of chemotherapy may include nausea, vomiting, hair loss, fatigue, or infection, and follow-up appointments may be required.
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The purpose of immunotherapy is to stimulate or enhance the immune system in order to help it recognize and fight cancer cells. Depending on the type and stage of the cancer, immunotherapy can be administered intravenously, subcutaneously, or intramuscularly. Based on the stage and location of the cancer, immunotherapy can be used alone or in combination with surgery, radiation, or chemotherapy. It is important to note that immunotherapy may have some side effects, such as rash, fever, chills, or allergic reactions, and may require a regular schedule and follow-ups.
Prevention
Although oral cancer cannot always be prevented, you can reduce your risk by following some preventive measures, such as:
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Avoiding or quitting tobacco use, such as smoking cigarettes, cigars, pipes, or chewing tobacco, which can expose the mouth to damaging chemicals, such as nicotine, tar, or carcinogens, that can damage DNA.
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Avoiding or limiting alcohol consumption, especially when combined with tobacco use, which can dehydrate the mouth and make it more vulnerable to tobacco and other irritants
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Infection with human papillomavirus (HPV), a common sexually transmitted infection that can lead to warts or lesions that can be cancerous, can be prevented or treated. You can avoid HPV infection by practicing safe sex, such as using condoms or dental dams, or by getting vaccinated against HPV, which can protect against some strains of HPV that can cause oral cancer.
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Wearing a hat, sunglasses, or sunscreen can protect you from sun exposure, especially on your lips, which can cause sunburn and increase the risk of skin cancer.
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Good oral hygiene can prevent chronic inflammation, infection, or irritation of the mouth, and increase the risk of oral cancer
