Oral Cancer

Oral cancer refers to a variety of cancers that can affect any part of the mouth including the lips, tongue, gums, cheeks and palate. Most of these cancers are squamous cell carcinomas that attack a specific layer of epithelial cells found in skin and mucous membranes. These tumors can spread quickly once established. Besides growing larger in mass, the cancer may spread (metastasize) to other areas of the body via the lymphatic system. According to the National Cancer Institute, approximately 30,000 Americans are diagnosed with oral cancer every year. Men are about twice as likely as women to develop this disease, and the risk increases with age.

Causes of Oral Cancer

• The use of smokeless tobacco (chaw, dip and snuff) is the greatest risk factor for oral cancer. Individuals who use these products are about 50 times more likely than the general population to develop cancer of the lips, gums, and cheek lining.
• Smokers and people who drink excessively are also much more likely than non-smokers and non-drinkers to experience mouth cancer.
• Sun exposure that increases the risk of skin cancer can also affect the risk of oral cancer on the lips.
• Infection with the HPV virus (that also causes cervical cancer) can lead to mouth cancer. This risk is growing. Viral infection is now thought to be the second most common cause of this cancer.
• A suppressed immune system increases the risk for oral and other cancers.
• Poor oral hygiene leading to disease of the gums (periodontitis) is a known contributing cause of mouth tumors.

It is possible to develop an oral tumor even if you do not have any known risk factors for the disease. This may be due to an undetected genetic risk factor. Everyone should be screened regularly for oral cancer. This is a normal part of a dental exam for most patients. You should also learn to check your mouth at home for any changes — just like you do a regular skin exam to check for skin cancer.

How Is Oral Cancer Detected?

Oral tumors may initially show up as a lesion or sore in the mouth that does not heal within a couple of weeks. These are often white, but can appear as red or darker patches as well. The lesion may feel like a raised bump, or it can appear as a deep crack with hard edges. Often, the lesion resembles a canker sore. A dentist will check visually for these signs as well as unexplained bleeding and swollen lymph nodes. Some dentists also use a lamp called a VELScope to highlight lesions. This fluorescent light can show cell changes that are going on under the surface and can lead to very early detection of cancerous cell activity. Any suspicious areas in the mouth can be biopsied to confirm the diagnosis.

Is Oral Cancer Treatable?

Yes, oral cancer can be successfully treated to reduce, halt or eliminate the tumor and stop the spread of cancer. The cure rate for oral cancer is about 90 percent with early diagnosis. Unfortunately, only 50 percent of patients have this cancer detected before it has spread to other tissues. The five-year survival rate for oral cancer is only 55 percent because delayed diagnosis is so common.

Surgical excision is the most commonly recommended treatment to remove oral tumors. This may be done in conjunction with radiation therapy and/or chemotherapy depending on the stage and extent of the cancer. If the tumor is large, post-treatment reconstruction may require extensive prosthodontic and plastic surgery to repair the damaged area. Early treatment not only prolongs life, it also helps reduce the amount of disfigurement and loss of function associated with surgical intervention. If you have not received an oral cancer screening within the last year, schedule an appointment with your dentist to get your mouth checked.