What is oral cancer?

Cancer starts when cells change (mutate) and grow out of control. The changed (abnormal) cells often grow to form a lump or mass called a tumor. Cancer cells can also grow into (invade) nearby areas. They can spread to other parts of the body, too. This is called metastasis.

Oral cancer is part of a group of cancers called head and neck cancers. It starts in cells that make up the inside of the mouth or the lips. Oral cancer is fairly common. It can be cured if found and treated at an early stage (when it's small and has not spread). A healthcare provider or dentist often finds oral cancer in its early stages because the mouth and lips are easy to examine.

Almost all oral cancers are squamous cell carcinomas. This means they start in the cells that make the lining of the mouth. There are other, much less common types.

Who is at risk for oral cancer?

A risk factor is anything that may increase your chance of having a disease. The exact cause of someone’s cancer may not be known. But risk factors can make it more likely for a person to have cancer. Some risk factors may not be in your control. But others may be things you can change.

Oral cancer is twice as common in men as it is in women. Other factors that increase risk include:

• Past or current use of any form of tobacco

• Heavy alcohol use

• A lot of natural or artificial sun exposure (can cause lip cancer)

• Fair skin

• HPV (human papillomavirus) infection

• Lack of fruits and vegetables in your diet

• Being very overweight

• Using betel quid or gutka chewing tobacco products

• Some inherited syndromes, like Fanconi anemia

• Weakened immune system

• Poor oral hygiene

• Not getting regular dental care

Talk with your healthcare provider about your risk factors for oral cancer and what you can do about them.

Can oral cancer be prevented?

There is no sure way to prevent all mouth and throat cancers. But you can control some risk factors to help reduce your risk:

• Quit using all types of tobacco

• Limit or don’t drink alcohol

• Protect yourself from ultraviolet light exposure

• Prevent HPV infection

• Eat lots of fruits and vegetables

• Get to or stay at a healthy weight

• Take care of your mouth and teeth

• Get regular dental care

What are the symptoms of oral cancer?

Oral cancer is often found because a person notices changes in their mouth. It's also easy for a dentist or other healthcare provider to look for changes in the mouth. The symptoms of oral cancer include:

• A sore on your lip or in your mouth that won’t heal

• A lump on your lip, in your mouth, or in your throat

• A white or red patch on your gums, tongue, or lining of your mouth

• Abnormal bleeding, pain, or numbness in your mouth

• Feeling like something is caught in your throat

• Numbness in your mouth or tongue

• Trouble chewing or swallowing

• Pain when you chew or swallow

• Swelling around your jaw

• Loose or painful teeth

• A lump, swelling, or mass in your throat or neck that doesn’t go away

• Unexpected weight loss

• A change in your voice

• Pain in your ear or jaw

• Change in how your dentures fit

• Ongoing bad breath

Many of these may be caused by other health problems. Still, it's important to see your healthcare provider if you have these symptoms. Only a healthcare provider can tell if you have cancer.

How is oral cancer diagnosed?

Oral cancer is often found during routine dental exams. Your healthcare provider may check for signs of oral cancer during your regular physicals, too. You should see a healthcare provider if you have any changes in your mouth.

If your provider thinks you may have oral cancer, you'll need exams and tests to be sure. Your provider will ask you about your health history, your symptoms, risk factors, and family history of disease. An oral exam will be done. This includes looking at your head and neck and checking inside your mouth. Your provider may also look at the back of your mouth and throat with small mirrors or with a thin, flexible, lighted tube (called a laryngoscope or a pharyngoscope). Based on the results, your healthcare provider may decide you need a biopsy to check for cancer.

A biopsy is the only way to tell for sure if you have cancer. Small pieces of tissue are taken out and tested for cancer cells. Your results will come back in about 1 week.

After a diagnosis of oral cancer, you’ll need more tests. These help your healthcare providers learn more about your overall health and the cancer. They're used to find out the stage of the cancer. The stage is how much cancer there is and how far it has spread (metastasized) in your body. It's one of the most important things to know when deciding how to treat the cancer.

Once your cancer is staged, your provider will talk with you about what this means for your treatment. Be sure to ask your provider to explain the details of your cancer to you in a way you can understand. 

How is oral cancer treated?

Your treatment choices depend on the type of oral cancer you have, test results, and the stage of the cancer. The goal of treatment may be to cure you, control the cancer, or help ease problems caused by the cancer. Talk with your healthcare team about your treatment choices, the goals of treatment, and what the risks and side effects may be. Other things to think about are if the cancer can be removed with surgery, how your body will look and work after treatment, and your overall health.

Types of treatment for cancer are either local or systemic. Local treatments remove, destroy, or control cancer cells in one area. Surgery and radiation are local treatments. Surgery is a common treatment for oral cancer. Systemic treatment is used to destroy or control cancer cells that may have traveled around your body. When taken by pill, infusion, or injection, chemotherapy, immunotherapy, and targeted therapy are systemic treatments.

You may have just one treatment or a combination of treatments. Tests will be done during treatment to see how well it's working.

Oral cancer may be treated with:

• Surgery

• Radiation therapy

• Chemotherapy

• Targeted therapy

• Immunotherapy

• Supportive care

Talk with your healthcare providers about your treatment options. Make a list of questions. Think about the benefits and possible side effects of each option. Talk about your concerns with your healthcare provider before making a decision.

What are treatment side effects?

Cancer treatments like chemotherapy and radiation can damage normal cells. This can cause side effects like hair loss, mouth sores, and vomiting. Talk with your healthcare provider about side effects linked with your treatment. There are often ways to manage them. There may be things you can do and medicines you can take to help prevent or control many treatment side effects.

After surgery for oral cancer, you may need extra care to adjust to new ways of eating, drinking, speaking, and breathing. The types of changes you have depend on the type of surgery that was done.

Coping with oral cancer

Many people feel worried, depressed, and stressed when dealing with cancer. Getting treatment for cancer can be hard on your mind and body. Keep talking with your healthcare team about any problems or concerns you have. Work together to ease the effect of cancer and its symptoms on your daily life.

Here are some tips:

• Talk with your family or friends.

• Ask your healthcare team or social worker for help.

• Speak with a counselor.

• Talk with a spiritual advisor, such as a minister or rabbi.

• Ask your healthcare team about medicines for depression or anxiety.

• Keep socially active.

• Join a cancer support group.

Cancer treatment is also hard on the body. To help yourself stay healthier, try to:

• Eat a healthy diet, with a focus on high-protein foods.

• Drink plenty of water, fruit juices, and other liquids.

• Keep physically active.

• Rest as much as needed.

• Talk with your healthcare team about ways to manage treatment side effects.

• Take your medicines as directed by your team.

A key part of oral cancer care is quitting tobacco. Smoking can slow recovery and delay healing. It can also increase the risk of the cancer coming back after treatment. Talk to your cancer treatment team to get help quitting.

When should I call my healthcare provider?

Your healthcare provider will talk with you about when to call. You may be told to call if you have any of the below:

• New symptoms or symptoms that get worse

• Signs of an infection, such as a fever

• Side effects of treatment that affect your daily function or don't get better with treatment

Ask your healthcare provider what signs to watch for and when to call. Know how to get help after office hours and on weekends and holidays.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.