Causes

Oral cancer most commonly involves the lips or the tongue. It may also occur on the:

• Cheek lining
• Floor of the mouth
• Gums (gingiva)
• Roof of the mouth (palate)

Most oral cancers are a type called squamous cell carcinomas. These tend to spread quickly.

Smoking and other tobacco use are linked to most cases of oral cancer. Heavy alcohol use also increases your risk for oral cancer.

Other factors that may increase the risk for oral cancer include:

• Chronic irritation (such as from rough teeth, dentures, or fillings)
• Human papilloma virus (HPV) infection
• Taking medications that weaken the immune system (immunosuppressants)
• Poor dental and oral hygiene

Some oral cancers begin as a white plaque (leukoplakia) or as a mouth ulcer.

Men get oral cancer twice as often as women do, particularly men older than 40.

Symptoms

Sore, lump, or ulcer in the mouth:

• May be a deep, hard-edged crack in the tissue
• Most often pale colored, but may be dark or discolored
• On the tongue, lip, or other area of the mouth
• Usually painless at first (may develop a burning sensation or pain when the tumor is advanced)

Other symptoms that may occur with oral cancer include:

• Chewing problems
• Mouth sores
• Pain with swallowing
• Speech difficulties
• Swallowing difficulty
• Swollen lymph nodes in the neck
• Tongue problems
• Weight loss

Exams and Tests

Your doctor or dentist will examine your mouth area. The exam may show:

• A sore on the lip, tongue, or other area of the mouth
• An ulcer or bleeding

Tests used to confirm oral cancer include:

• Gum biopsy
• Tongue biopsy

X-rays and CT scans may be done to determine if the cancer has spread.

Treatment

Surgery to remove the tumor is usually recommended if the tumor is small enough. Surgery may be used together with radiation therapy and chemotherapy for larger tumors. Surgery is not commonly done if the cancer has spread to lymph nodes in the neck.

Other treatments may include speech therapy or other therapy to improve movement, chewing, swallowing, and speech.

Support Groups

You can ease the stress of illness by joining a support group of people who share common experiences and problems. See cancer - support group.

Outlook (Prognosis)

Approximately half of people with oral cancer will live more than 5 years after they are diagnosed and treated. If the cancer is found early, before it has spread to other tissues, the cure rate is nearly 90%. However, more than half of oral cancers have already spread when the cancer is detected. Most have spread to the throat or neck.

About 1 in 4 persons with oral cancer die because of delayed diagnosis and treatment.

Possible Complications

• Complications of radiation therapy, including dry mouth and difficulty swallowing
• Disfigurement of the face, head, and neck after surgery
• Other spread (metastasis) of the cancer

When to Contact a Medical Professional

Oral cancer may be discovered when the dentist performs a routine cleaning and examination.

Call for an appointment with your health care provider if you have a sore in your mouth or lip or a lump in the neck that does not go away within 1 month. Early diagnosis and treatment of oral cancer greatly increases the chances of survival.

Prevention

• Avoid smoking or other tobacco use
• Have dental problems corrected
• Limit or avoid alcohol use
• Practice good oral hygiene

Alternative Names

Cancer - mouth; Mouth cancer; Head and neck cancer; Squamous cell cancer - mouth

References

National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Head and Neck Cancers. National Comprehensive Cancer Network; 2009. Version 2.2009.

Posner M. Head and neck cancer. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 200.

Wein RO, Malone JP, Weber RS. Malignant neoplasms of the oral cavity. In: Flint PW, Haughey BH, Lund VJ, et al, eds. Cummings Otolaryngology Head and Neck Surgery. 5th ed. St. Louis, Mo: Mosby Elsevier; 2010:chap 96.

Update Date: 2/28/2012

Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Seth Schwartz, MD, MPH, Otolaryngologist, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.