Oral Cancer: Complete Guide to Symptoms, Causes, and Treatment

Oral cancer is a serious disease that can affect the lips, tongue, mouth, and throat. It is the most common form of head and neck cancer and accounts for about 48% of all HNC cases. Unfortunately, many cases are detected at later stages, making treatment more difficult.

However, understanding the signs, risk factors, and ongoing advancements in care, patients and healthcare providers can take informed steps toward prevention and effective treatment.

This blog will cover everything you need to know about oral cancer, while highlighting how clinical research is advancing better outcomes.

What is Oral Cancer?

Oral cancer (mouth cancer) is a broad term used for cancers that start in the region of the mouth. It occurs when cells in the mouth start growing uncontrollably. These abnormal cells can form tumors and sometimes spread to nearby tissues or lymph nodes.

It can appear in many areas of the mouth, including the lips, tongue, gums, floor of the mouth, palate, and inner cheeks. Unlike common mouth sores or infections, oral cavity cancer does not heal on its own and may worsen over time.

Types of Oral Cancer

There are different types of oral cancer, classified based on the type of cells they originate from and the region of the mouth where they begin.

Types of Oral Cancer Based on Cells Involved

1. Squamous Cell Carcinoma (SCC)

Squamous cell carcinoma is the most common type of cancer in the mouth. It accounts for nearly 90% of all cases and appears as a persistent sore, lump, or red/white patch. Early detection is crucial as it can spread to nearby lymph nodes.

2. Verrucous Carcinoma

A slow-growing, wart-like cancer in the mouth. Rarely spreads to other parts of the body. Surgery is the main treatment, and early detection ensures a good prognosis.

3. Salivary Gland Cancer

Salivary Gland Cancer is a rare cancer affecting the glands that produce saliva. Symptoms include lumps, swelling, or pain in the mouth or jaw. Treatment often involves surgery and sometimes radiation.

4. Lymphomas

Lymphomas are cancers of the lymphatic system in the mouth. They may appear as painless lumps or swelling. Treatment usually involves chemotherapy or radiation.

Types of Oral Cancer Based on Location

1. Lip Cancer

Most commonly affects the lower lip, linked to sun exposure and tobacco use. Early detection is easy, making treatment more effective. Minor surgery or radiation is usually sufficient.

2. Tongue Cancer

It can occur on the front or back of the tongue. Signs include lumps, pain, or red/white patches. Surgery, radiation, or chemotherapy may be needed depending on the stage.

3. Gum Cancer

Appears as persistent sores, lumps, or bleeding gums. Tobacco use increases the risk. Surgery, sometimes followed by radiation, is the main treatment.

4. Throat Cancer

Affects the pharynx or larynx, causing difficulty swallowing or speaking. HPV is a known risk factor. Treatment often involves surgery, radiation, or chemotherapy.

5. Palate Cancer (Roof of Mouth)

Cancer on the roof of the mouth (palate) usually appears as swelling or pain on the hard or soft palate. Surgery is usually the primary treatment, sometimes with radiation.

6. Floor of Mouth Cancer

Cancer on the floor of the mouth appears under the tongue as lumps or ulcers and can spread quickly to nearby tissues. Surgery is the main treatment, often with additional radiation.

7. Buccal Mucosa (Inner Cheeks) Cancer

Presents as persistent sores or lumps. Chewing tobacco is a major risk factor. Surgery is usually required, sometimes with radiation therapy.

If you have any form of these cancers, you may be eligible for our head and neck clinical trials. By participating, you can help researchers better understand these cancers and contribute to the development of more effective treatments for each type.

Causes and Risk Factors

Several factors increase the risk of mouth cancer, such as:

• Smoking or using chewing tobacco is the leading cause of oral cancer.
• Drinking alcohol heavily over time increases the risk.
• Infection with Human Papillomavirus (HPV), especially HPV-16, can lead to cancer, particularly at the back of the throat.
• Prolonged sun exposure can increase the risk of lip cancer.
• Poor oral hygiene or chronic irritation in the mouth may contribute to cancer over time.
• Adults over 40 and men are at higher risk, and a family history of cancer can also increase susceptibility.

Signs and Symptoms

Oral cancer can develop silently and could be mistaken for everyday mouth issues. However, recognizing the following warning signs of oral cancer can make a life-saving difference.

• Mouth sores or ulcers that don’t heal
• Unexplained bleeding, pain, and numbness in the mouth
• Lumps or thickening in the cheek, gums, or tongue
• White or red patches inside the mouth
• Difficulty chewing, swallowing, or speaking
• Unintentional weight loss
• Persistent earache
• Chronic bad breath

If you notice any of these symptoms lasting more than two weeks, it’s important to see a dentist or doctor immediately.

Diagnostic Approaches

Doctors use several methods to diagnose mouth cancer, such as:

• Dental exam: A dentist may notice any changes during a routine checkup and refer you to a specialist.
• Physical examination: The provider examines the mouth, head, face, and neck for signs of cancer or pre-cancer.
• Brush (scrape) biopsy: Cells are gently collected from the affected area and examined for cancer.
• Incisional biopsy: A small tissue sample is removed for laboratory testing.
• Laryngoscopy or pharyngoscopy: Mirrors or a flexible scope is used to examine the throat, tongue base, and voice box.
• Imaging tests: CT scans, MRI, or PET scans help determine the size and spread.

Stages of Oral Cancer

Oral cancer staging describes the size of the tumor and whether it has spread to nearby lymph nodes or other parts of the body. This information helps doctors determine how advanced the cancer is and choose the most effective treatment plan.

Mouth cancers are staged using the TNM system:

• T (Tumor): Size of the primary tumor
• N (Nodes): Spread to nearby lymph nodes
• M (Metastasis): Spread to distant parts of the body

Based on the TNM system, stages are generally classified as:

• Stage 0: Also called carcinoma in situ, abnormal cells are present but have not spread into deeper tissues.
• Stage 1: The tumor is small, 2 cm or less, and has not spread.
• Stage 2: The tumor is larger than 2 cm but not more than 4 cm and has not spread.
• Stage 3: The tumor is larger than 4 cm or has spread to one nearby lymph node.
• Stage 4: The cancer has spread to multiple lymph nodes, nearby structures, or distant parts of the body and is considered advanced.

Treatment Options

Treatment for oral cancer depends on the stage, size, and location of the tumor. In many cases, more than one treatment approach is used to achieve the best results.

Common treatment options include:

• Surgery: Often the primary treatment, especially in early stages. It may involve removing the tumor, surrounding tissue, and sometimes nearby lymph nodes to prevent spreading.
• Radiation Therapy: Uses high-energy rays to destroy cancer cells. It can be used alone for small tumors or after surgery to eliminate remaining cancer cells.
• Chemotherapy: Uses drugs to destroy cancer cells and is often combined with radiation therapy for advanced stages or if the cancer has spread.
• Targeted Therapy and Immunotherapy: Focus on specific cancer cell features or help the immune system fight cancer. These are usually used for advanced or recurrent cases.

Additionally, some patients may have the option to participate in clinical trials for oncology, exploring newer and more effective treatment approaches for cancer.

Also read: Immunotherapy vs Chemotherapy: Understanding the Difference in Cancer Treatment

Prognosis and Outlook

The outlook for mouth cancer largely depends on how early it is diagnosed and the stage at which treatment begins. When oral cancer is detected early and remains localized, the prognosis is generally very good, with a five-year survival rate of about 85%.

However, if the cancer spreads to lymph nodes or distant sites, rates drop to 39–69%, highlighting the importance of timely diagnosis and treatment. Moreover, other factors such as age, HPV status, and lifestyle habits can also affect prognosis.

Living with Oral Cancer

Living with oral cancer can be challenging, but healthy habits and proper care can support recovery. Here are some useful tips for a better prognosis:

• Avoid tobacco and limit alcohol
• Maintain oral hygiene
• Get HPV vaccination
• Protect lips from the sun
• Eat a diet rich in fruits and vegetables
• Seek support from family, counseling, or support groups
• Manage fatigue and discomfort with rest and medical guidance

Conclusion

In conclusion, oral cancer is a serious but manageable condition if detected early. Regular dental visits, avoiding risk factors, and adopting a healthy lifestyle are key. Furthermore, if you notice unusual changes in your mouth, it’s important to act quickly and seek medical attention.

Lastly, if you want to contribute to advancing care, you can participate in our ongoing clinical research studies in Nebraska, exploring better treatments and support options for cancer.