Oral Cancers

Mouth cancer is a type of head and neck cancer that begins on the lips or in the mouth.

It affects nearly 12.6 people in one lakh Indian population each year, and it is most closely linked to tobacco and alcohol use. Another name for mouth cancer is oral cavity cancer.

The term oral cancer refers to a broader range of cancers that includes those starting in the salivary glands and throat, as well as the mouth

Mouth cancer is most often diagnosed after your dentist notices symptoms during a routine exam.

Signs of cancer in the oral cavity include:

  • a sore or lump on the lip or in the mouth
  • a white and/or red patch on the gums, tongue, or cheeks
  • unusual or persistent bleeding, pain, or numbness in the mouth
  • swelling that causes dentures to fit poorly or become uncomfortable

If the disease is diagnosed early, surgery performed by an expert in head and neck cancer is usually the main treatment. The prognosis is often very good.

Treatment for mouth cancer may also include radiation therapy, chemotherapy, or a combination of the two.

Cancer of the mouth can begin anywhere in the oral cavity, including the lips, floor of mouth, tongue, inner cheeks, hard palate (roof of the mouth), and the gums.

Mouth cancer can begin anywhere in the oral cavity. The oral cavity is another name for the mouth. It includes

 

 

  • the lips
  • the lining inside the cheeksand lips
  • the front two-thirds of the tongue
  • the upper and lower gums
  • the floor of the mouthunder the tongue
  • the hard palate(the bony portion of the roof of the mouth)
  • the small area behind the wisdom teeth

The most common areas in the mouth where cancer develops are the tongue, the lips, and the floor of the mouth.

Cancer can also begin in other nearby areas, such as the back of the throat or the salivary glands.

What You Need to Know about Mouth Cancer

  • Our surgeons’ primary goal is to cure the cancer while preserving your appearance and the function of your mouth.
  • Radiation therapyis another important treatment for mouth cancer. We recommend radiation and chemotherapy in combination (called chemoradiation). They boost the effectiveness of treatment and achieve better outcomes when used together.
  • Some people may require reconstructive surgeryas part of their operation to remove the cancer.
  • Side effects of mouth cancer and its treatment can include problems with swallowing and speech. Some people experience limited range of motion in the jaw. Others develop problems with their teeth. Having experts in rehabilitation, speech pathology, dental oncology, and more is an essential part holistic approach to mouth cancer care.
  • Tobacco and alcohol use are major risk factors for mouth cancer

Symptoms of mouth cancer include the following:

·        Mouth ulcers that do not heal

A broken area of skin (ulcer) that will not heal can be a symptom of mouth cancer. Most people with mouth cancer have this symptom.

·        Pain in your mouth

Pain or discomfort in your mouth that doesn’t go away is the other most common symptom of mouth cancer.

·        White or red patches in the mouth or throat

An abnormal-looking patch could be a sign of cancer or precancerous changes.

  • White patches are called leukoplakia.
  • Red patches are called erythroplakia.

These patches are not cancer, but if left untreated, they may lead to cancer. A fungal infection called oral thrush can also cause red and white patches.

·        Difficulty swallowing

Mouth cancer can cause pain or a burning sensation when chewing and swallowing food. Or you might feel like food is sticking in your throat. You may also cough or feel like food or liquid is going into the airway (windpipe).

·        Speech problems

Cancer in your mouth can affect your voice. It might sound different. It may be quieter or husky. It may sound as if you have a cold all the time. Or you might slur some of your words or have trouble pronouncing certain sounds.

·        A lump in your neck

You may have a lump in your neck caused by an enlarged lymph node. Swelling in one or more lymph nodes in the neck is a common symptom of mouth cancer.

Lumps that come and go are usually not due to cancer. Cancer typically forms a lump that slowly gets bigger.

·        Weight loss

Weight loss is a common symptom of many different types of cancer. Mouth cancer can make it painful to eat and difficult to swallow, which can cause weight loss.

·        Other signs of mouth cancer

These can include one or more of the following:

  • a lump or thickening in your lip
  • a lump in your mouth or throat
  • unusual bleeding or numbness in your mouth
  • loose teeth for no clear reason
  • difficulty moving your jaw

 

Your mouth is composed of many different types of cells. The type of mouth cancer you have depends on which type of cells your cancer began in.

The vast majority of mouth cancers are squamous cell carcinoma. This is true regardless of where in your mouth the cancer begins.

Squamous Cell Carcinoma of the Oral Cavity

More than 90 percent of mouth cancers are squamous cell carcinoma. Squamous cells are thin, flat cells that look like fish scales. They are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the lining of the respiratory and digestive tracts. Carcinoma means cancer.

Squamous cell carcinoma most commonly appears on parts of the body frequently exposed to the sun, such as the face, ears, and neck. But it also arises in the mouth.

Less common cancers of the oral cavity include:

Oral Verrucous Carcinoma

Verrucous carcinoma is a rare subtype of squamous cell carcinoma.

Oral Melanoma

Melanoma develops in the pigment-producing cells that give skin its color. Melanoma of the head and neck can occur anywhere on the skin or inside the nose or oral cavity. Lean more about melanoma treatment.

Where Mouth Cancer Begins

Even though most mouth cancers are squamous cell carcinoma, the treatment your doctor recommends depends on the exact location of the cancer. Learn more about the specific areas where mouth cancer can begin and the treatment options for each.

  • Floor of Mouth Cancer

Often mistaken for a canker sore, floor of mouth cancer begins in the horseshoe-shaped area under the tongue.

  • Gum Cancer

Often mistaken for gingivitis, gum cancer is highly treatable when found early.

  • Hard Palate Cancer

It is rare for cancer to begin in the hard palate, but when it does the most common sign is an ulcer on the roof of the mouth.

  • Inner Cheek Cancer (Buccal Mucosa Cancer)

Learn about the symptoms and treatment of inner cheek cancer, also called buccal mucosa cancer.

  • Lip Cancer

Lip cancer is highly curable when diagnosed early. Learn more about symptoms, causes, and treatment for cancer that begins on the lips.

Tongue Cancer

Tongue cancer is a type of head and neck cancer that begins when the cells that make up the tongue grow out of control and form lesions or tumors.

There are two parts to your tongue, the oral tongue and the base of the tongue. Cancer can develop in either part. The oral tongue is the part you see when you stick out your tongue. This is the front two-thirds of your tongue.

The base of the tongue is the back third of the tongue. This part is very near your throat (pharynx). Cancer that develops in this part is classified as oropharynx cancer, or throat cancer.

Mouth cancer can affect anyone, but using tobacco products and regularly drinking too much alcohol greatly increase your chances.

Other major risk factors include sun exposure and tanning bed use. Infection with the sexually transmitted disease human papillomavirus (HPV) has been associated with mouth cancer as well, but there is a much stronger link between HPV and throat cancer.

Mouth Cancer Risk Factors

Tobacco

Studies have shown that as many as eight in ten people with mouth cancer are tobacco users. Tobacco includes both smoking and smokeless tobacco (snuff and chewing tobacco).

  • Pipe smoking is a particularly significant risk for lip cancer, in the area where the lips touch the pipe stem.
  • Smokeless tobacco is strongly linked with lip cancer, inner cheek cancer, and gum cancer.
  • People who are exposed to secondhand smoke are at greater risk for mouth cancer.

If you smoke or chew tobacco, you can reduce your risk for mouth cancer — and the risk to those around you — by stopping now. If you’ve been diagnosed with mouth cancer or are in treatment, it’s not too late to quit.

Alcohol

Excessive consumption of alcohol is the other major risk factor for mouth cancer besides tobacco use. Most people who are diagnosed with mouth cancer drink heavily.

Tobacco and alcohol

The combination of tobacco and alcohol increases the risk for mouth cancer even further than either two risk factors alone. Studies have shown that people who use tobacco and alcohol together have a substantially greater risk for mouth cancer than people who don’t smoke or drink. According to the National Institutes of Health, nicotine and alcohol together account for around 80 percent of mouth cancers in men and around 65 percent of mouth cancers in women.

Betel quid and gutka

People who chew betel quid or gutka — which is more common in parts of Asia — have an increased risk of cancer of the mouth.

Gender

Mouth cancer is nearly twice as common in men as in women. This might be because men have higher rates of tobacco and alcohol use.

Age

Cancers of the mouth usually take many years to develop, so they are not common in young people. Most people are over 40 when cancer is first found in the mouth. The average age of diagnosis is around 60.

Ultraviolet light

Cancers of the lip are more common in people who spend time in the sun. Tanning beds use can also increase the risk for lip cancer.

Other risk factors

Other less common risk factors for mouth cancer include:

  • a diet low in fruits and vegetables
  • a weakened immune system
  • graft-versus-host disease, a condition that sometimes occurs after a stem cell transplant
  • lichen planus, a disease that often affects the skin
  • certain genetic syndromes, such as Fanconi anemia and dyskeratosis congenital

 

Here are the top ways to reduce your mouth cancer risk:

  1. If you smoke or use other tobacco products, reach out to a tobacco cessation program, to get help quitting.
  2. If you drink alcohol, do so in moderation.
  3. Protect yourself against HPV infection by practicing safe sex.
  4. Do not use tanning beds and avoid extended periods of time in the sun.

It’s also important to schedule regular checkups with your dentist, particularly if you do use tobacco or drink heavily. That’s because many mouth cancers are found during routine dental appointments.

Finding mouth cancer early increases your chances for a cure and minimizes the impact of cancer on your quality of life.

Before you begin treatment, your care team will need to diagnose which type of mouth cancer you have. This is a key first step in developing the best treatment plan for you.

To start, your care team will take a complete medical history. They will want to know about any risk factors you may have, including your history of tobacco use and alcohol consumption.

If you have an ulcer or other possible signs of cancer, your doctor will ask you questions, such as when it developed and whether it has changed in size or appearance.

sophisticated pathology and imaging tests provide your care team with a great deal of information. The radiologists and pathologists who perform these tests not only focus on oncology but specialize in head and neck cancer. This training gives our team the expertise to ensure that you get the right diagnosis and to personalize your care as much as possible.

Throughout the course of your treatment, we’ll continue to use some of these tests to track the size of your tumor and assess your response.

Oral Tissue Biopsy

An oral tissue biopsy is the first step in diagnosing mouth cancer. During the biopsy, your surgeon removes a small amount of abnormal tissue from the area where mouth cancer is suspected. The tissue sample is then sent to a pathologist, who examines it under a microscope and works with the other members of your care team to make a diagnosis.

If surgery is part of your treatment, your pathologist will examine a sample of the tumor your surgeon removed to confirm the diagnosis.

we have a team of pathologists whose sole focus is diagnosing cancers of the head and neck. This specialization allows them to make the most precise diagnosis possible. A more precise diagnosis can improve the effectiveness of your treatment or spare you from treatment that won’t work against your disease.

Diagnostic Imaging for Mouth Cancer

As part of making a diagnosis, a radiologist will take special x-rays of your mouth, such as CT scans, MRIs, or Panorex. (A Panorex is an x-ray that shows the full upper and lower jaw, plus the sinuses.)

These imaging tests provide more details about the tissue. If cancer is found, the scans can show how deep the cancer is and if it has spread.

our radiologists use the most advanced imaging technologies to safely detect and monitor cancer. Their deep knowledge of mouth cancer allows them to choose the imaging approach that’s best for you and to define the precise extent of your tumor.

Genomic Testing for Advanced Mouth Cancer

Genomic testing is also called tumor sequencing or molecular profiling. It involves looking at the cells obtained from a biopsy to see if there are any genetic mutations (changes in your genes) that could be linked to the type of cancer you have.

Genetic information about your tumor can also help us predict the chances that your cancer will return after treatment.

Almost all of these genetic changes are found only in cancer cells, not in normal cells, which means they cannot be passed on to your children.

At some point, your doctor will tell you what stage of mouth cancer you have. Put simply, the stage describes how widespread or advanced the cancer is. Determining the stage helps doctors explain the extent of the cancer to you. It also helps them determine how to move forward with treatment, including surgery, radiation therapy, or chemotherapy.

Your doctor will assign a stage to your cancer after your physical exam and the initial results from your oral tissue biopsy or imaging tests. The stage may be adjusted if you have additional tests or after surgery. There are five stages of mouth cancer, starting at zero and going up to four. (They are represented by the Roman numerals I, II, III, and IV.)

These are the basic stages of mouth cancer:

Stage 0 Mouth Cancer

Stage 0 is also called carcinoma in situ, and this is the very beginning of the scale. It describes abnormal cells in the lining of the lips or oral cavity, which have the potential to become cancer.

Stage I Mouth Cancer

Stage I describes a very early stage of cancer. The tumor is not more than 2 centimeters, and the cancer has not reached the lymph nodes.

Read more

Some people may be offered the option of having dental implants as part of their care. Dental implants are metal posts that attach to the jawbone and are used to mount replacement teeth. For patients who choose to have dental implants,Our  maxillofacial prosthodontists may be able to use innovative approaches to enhance your quality of life and speed the recovery process.

Radiation Therapy for Mouth Cancer


KIMS
has a team of radiation oncologists, including Nancy Lee, who specialize in the care of people with mouth cancers.

Radiation therapy for mouth cancer involves sending high-energy beams of particles (usually photons or protons) through the skin toward the tumor. When the beams reach the tumor, they destroy the cancer cells by damaging their DNA. Radiation therapy is known for its particular effectiveness against head and neck tumors, including cancers of the mouth.

 

Radiation therapy can be used in one of several ways for mouth cancers. It may be recommended after surgery to prevent the cancer’s regrowth. Radiation may also be used as the sole treatment if the tumor cannot be removed surgically or if the tumor regrows after surgery.

Why Choose for Mouth Cancer Radiation Therapy

  • KIMS
    ’s radiation therapy team has special training in caring for people with mouth cancer and works closely with the other members of your care team.
  • KIMS
    is the only center to offer weekly MRI imaging at no cost to patients. This mapping allows your radiation oncologist to optimize your radiation plan in real time.
  • You may be eligible to participate in clinical trials exploring new ways to boost the effectiveness of your treatment.

Types of Radiation Therapy for Mouth Cancer

There are many ways to treat mouth cancer with radiation.
KIMS
’s radiation oncologists specialize in head and neck cancers. They have extensive knowledge in knowing which approach will provide you with the most benefit.

KIMS
’s radiation therapy team has access to every modern form of radiation available. They will customize a treatment plan so precise that it factors in the size and shape of your tumor to the millimeter. Your team’s goal is twofold: to eliminate tumor cells and to prevent the side effects of treatment by keeping the healthy cells around the tumor safe.

Here you will find more in-depth information about the different approaches to mouth cancer radiation therapy.

Intensity-Modulated Radiation Therapy (IMRT)

Read more

KIMS
’s radiation oncologists work hard to minimize the side effects of treatment. They will explain to you in detail what to expect and when side effects are likely to occur.

The most common side effects of radiation to the oral cavity include:

  • changes in your skin that look like a sunburn
  • hoarseness
  • changes in taste
  • dryness of the mouth
  • weakening of teeth
  • pain, sores, or redness in the mouth

Our dental oncology team is available to support you with any problems that may arise with your teeth. They may also fit you with a custom mouth guard to protect your teeth during treatment.

Our rehabilitation team has extensive experience in helping people address the side effects of radiation therapy. A speech and swallowing specialist will meet with you before treatment to discuss any possible changes in your speech, voice, or swallowing. During and after treatment, they will provide you with exercises to prevent side effects. They will look out for any problems you are having with swallowing and make sure you are maintaining the range of motion in your tongue, jaw, and neck.

We offer comprehensive follow-up care tailored to the unique needs of head and neck cancer survivors. In addition to monitoring for signs that the mouth cancer has come back, we focus on identifying, preventing, and controlling any long-term and late effects associated with mouth cancer and its treatment

Rehabilitation

Speech and swallowing therapists are key members of the head and neck rehabilitation team. In addition, physical and occupational therapists help you improve your mobility after surgery or other treatments.

Our experts help you manage any changes in your speech and pronunciation, tongue or jaw range of motion, voice, or swallowing. They may also recommend

other tests to better assess your speech, voice, or swallow function. Your speech and swallowing therapist is involved in your care early after your diagnosis and works with you as long as you need, throughout treatment, recovery, and beyond.

 

Supportive care And Pain Management:

Our specialists in supportive care can help you cope with the side effects of therapy. These include pain, nausea, and fatigue. We can also help with the emotional and spiritual needs that often come up during and after cancer treatment.

If you are in pain during your treatments or even after they’re over, we have pain specialists who can help. We will build a plan that makes sense for you and your needs. Our experts can work with your doctor and pharmacists to give you solutions for both acute physical pain, which comes on suddenly, as well as chronic pain, which can linger. Our goal is to keep you as comfortable as possible.

Nutrition

Many people with mouth cancer have questions about diet and nutrition. Our food and nutrition team is trained in helping you understand and cope with a variety of conditions relating to cancer treatment.

Our expert dietitians provide medical nutrition therapy that can help you manage problems with swallowing, or changes in taste, your weight, and other issues. They work closely with your treatment team to customize a dietary plan that fits your own specific needs.