Mouth cancer is a type of cancer that can affect any part of the oral cavity. It may develop on the gums, lips, tongue, inner lining of the cheeks, the floor of the mouth (beneath the tongue), or the roof of the mouth. Cancer occurring within the mouth is also known as oral cancer or oral cavity cancer. Mouth cancer falls under the broad category of head and neck cancers, which are generally treated in a similar manner.
By Able Health I Medically reviewed by Dr. Alireza Estedlal
Page last reviewed: February 2024 I Next review due: February 2026
Mouth cancer can present with various signs and symptoms, such as:
Oral cancer develops when cells in the mouth or lips undergo mutations (changes) in their DNA. DNA contains instructions that regulate cell behaviour. Mutations cause cells to grow and divide uncontrollably instead of dying as normal cells would. As these abnormal cells accumulate, they can form a tumour that can spread within the mouth and to other parts of the head, neck, or even beyond over time.
Most oral cancers originate from the thin, flat cells (known as squamous cells) lining the lips and the inner mouth. Many cases of mouth cancer are squamous cell carcinomas.
The exact cause of squamous cell mutations leading to mouth cancer is unclear. However, certain risk factors have been identified that increase the likelihood of developing the condition.
Several factors can increase the risk of mouth cancer:
To diagnose oral cancer, the following tests and procedures may be used:
After diagnosing oral cancer, the dentist will determine its stage or extent. Staging tests may include:
Oral cancer stages are usually denoted with Roman numerals I to IV. A lower stage, such as I, indicates a smaller cancer localized to one area, while a higher stage, such as IV, signifies a larger cancer or one that has spread to other areas of the neck, head, or body.
The stage of your mouth cancer is crucial in determining the appropriate treatment options.
Treatment for mouth cancer depends on factors such as the cancer's stage, location, overall health, and personal preferences. Treatment options may include surgery, radiation therapy, and chemotherapy. It is essential to discuss your options with your doctor to determine the most suitable approach.
Surgical options for oral cancer may include:
Surgery for oral cancer carries risks such as bleeding and infection and can impact appearance and the ability to eat, swallow, and talk. Sometimes, a tube may be required for eating, drinking, and taking medication. The tube may be placed in the stomach through the nose for short-term use or directly into the stomach through the skin for longer-term use. Your doctor might also suggest seeing a professional to help you adapt to these changes.
Radiation therapy uses high-energy beams, such as X-rays and protons, to destroy cancerous cells. External beam radiation is the most common method, delivered from a machine outside the body. Alternatively, radiation therapy can be administered by placing radioactive seeds or wires close to the cancer in a procedure called brachytherapy.
Radiation therapy is often given after surgery but can also be used as the primary treatment for early-stage oral cancer. Sometimes, it is combined with chemotherapy to enhance effectiveness, though this combination can intensify side effects. For advanced cases, radiation therapy can help alleviate symptoms like pain.
Possible side effects of radiation therapy to the mouth include dry mouth, cavities, and damage to the jawbone. Before starting radiation therapy, the doctor may recommend seeing a dentist to ensure your teeth are in good condition. Unhealthy teeth might need treatment or extraction before therapy. Your dentist can also advise on how to care for your teeth during and after treatment to minimise future complications.
Chemotherapy uses powerful chemicals to destroy malignant cells. These drugs can be administered alone, in combination with other chemotherapy agents, or alongside other treatments. When given with radiation therapy, chemotherapy can enhance the effectiveness of radiation.
Side effects of chemotherapy vary depending on the specific drugs used but commonly include nausea, vomiting, and hair loss. Your doctor will inform you of the side effects associated with the chemotherapy drugs prescribed.
Targeted drug therapy for mouth cancer focuses on specific features of cancerous cells that contribute to their growth. These drugs can be used alone or combined with radiation therapy or chemotherapy.
One targeted drug therapy for mouth cancer is Cetuximab (Erbitux), which inhibits a protein found in various cells, though it is more prevalent in certain cancer cells. Side effects of this drug can include skin rash, headache, itchiness, infections, and diarrhoea. Additional targeted drugs may be considered if standard treatments are ineffective.
Immunotherapy uses the immune system to fight cancer cells. Normally, the immune system might fail to recognise cancer cells because they release proteins that hide them from immune cells. Immunotherapy works by disrupting this process.
Generally, immunotherapy is reserved for advanced cases of mouth cancer that do not respond to conventional treatments.
Oral cancers are closely associated with tobacco use, including cigars, cigarettes, pipes, snuff, and chewing tobacco. While not all individuals diagnosed with the condition use tobacco, quitting is crucial if you do, as:
Quitting smoking or chewing tobacco can be challenging, especially during the stress of a cancer diagnosis and treatment. However, your healthcare provider can discuss various options, including medications, nicotine replacement therapies, and counselling.
Alcohol consumption, particularly when combined with tobacco products, significantly increases the risk of oral cancer. Therefore, it is important to stop drinking all forms of alcoholic beverages to reduce the risk of developing a second cancer.
There is no complementary or alternative medicine that can cure mouth cancer. However, these treatments may help manage the disease and alleviate side effects such as fatigue during treatment.
Fatigue is common during cancer treatment. Although your doctor can address the underlying causes, you may still feel persistently worn out. Complementary therapies may help manage fatigue. Discuss the following options with your doctor:
Discussing treatment options for mouth cancer with your doctor can be overwhelming, especially as you are coming to terms with your diagnosis and making decisions about treatment. To manage this uncertainty, consider the following strategies: