Mouth Cancer: Symptoms, Causes, and Treatment Options

Mouth cancer is a serious health condition that affects thousands of people worldwide. It is part of a group of cancers collectively referred to as head and neck cancers. This article aims to provide an overview of the key symptoms, underlying causes, and various treatment options available for those diagnosed with mouth cancer. Understanding these aspects is crucial for early detection, effective treatment, and improving patient outcomes. Join us as we delve into the essential information that can help in recognizing and addressing this critical health issue. Let’s start with some basics. 

What is Mouth Cancer?

Mouth cancer, also known as oral cancer, refers to the abnormal growth of cells in any part of the mouth, including the lips, tongue, cheeks, floor of the mouth, hard and soft palates, sinuses, and throat. If not detected, diagnosed and treated at an early stage, it can prove to be life-threatening. 

What are the Types of Mouth Cancer?

Mouth cancer is categorised based on the type of cells where the cancer originates. Here are the main types:

Squamous Cell Carcinoma

Squamous Cell Carcinoma is the most common type of mouth cancer, accounting for over 90% of all oral cancers. It originates in the squamous cells, which are flat, thin cells that line the lips, mouth, tongue, and throat.

Verrucous Carcinoma

This is a rare type of squamous cell carcinoma that grows slowly and is usually not aggressive. It appears as a wart-like growth and often affects the gums and the buccal mucosa (inner cheek).

Minor Salivary Gland Carcinomas

Salivary Gland Carcinomas originate in the salivary glands located throughout the mouth and throat. It’s subtypes include:

• Adenocarcinoma: A type of cancer that forms in mucus-secreting glands.
• Adenoid Cystic Carcinoma: Known for its slow growth and tendency to spread along nerves.
• Mucoepidermoid Carcinoma: The most common type of salivary gland cancer, consisting of mucus-secreting and squamous cells.

Lymphoma

These are the cancers that begin in the lymphoid tissues of the tonsils or the base of the tongue. These are rare in the oral cavity but can occur.

Melanoma

Although rare, melanomas can develop in the oral cavity, typically originating in the pigment-producing cells called melanocytes.

Sarcomas

These cancers develop in the bone, cartilage, or muscle of the oral cavity. Examples include osteosarcoma (bone) and rhabdomyosarcoma (muscle).

Understanding the different types of mouth cancer can aid in recognizing symptoms and seeking appropriate treatment. 

Mouth Cancer Signs and Symptoms

The signs and symptoms of mouth cancer include:

• Persistent sores: A sore or ulcer in the mouth that does not heal within two weeks.
• Unexplained bleeding: Bleeding in the mouth without an apparent cause.
• Lumps or thickening: A lump, thickening, or rough spot on the gums, lips, or inside of the mouth.
• White or red patches: White (leukoplakia) or red (erythroplakia) patches that do not go away.
• Pain or difficulty swallowing: Persistent pain in the mouth, throat, or ear, or difficulty swallowing (dysphagia).
• Numbness: Unexplained numbness or loss of feeling in any area of the face, mouth, or neck.
• Loose teeth: Teeth becoming loose or dentures that no longer fit properly.
• Changes in voice: A chronic sore throat or a change in voice, such as hoarseness.
• Unexplained weight loss: Unintentional weight loss accompanying other symptoms.

What are the Risk Factors for Mouth Cancer?

Mouth cancer can develop due to several risk factors. Understanding these can help in prevention and early detection.

• Tobacco use: Smoking cigarettes, cigars, pipes, and using smokeless tobacco (chewing tobacco, snuff) are the most significant risk factors for mouth cancer. Tobacco contains carcinogens that can damage the cells in the mouth.
• Alcohol consumption: Heavy alcohol use increases the risk of mouth cancer. When combined with tobacco use, the risk is significantly higher.
• Human Papillomavirus (HPV) infection: Certain strains of HPV, particularly HPV16, are linked to oropharyngeal cancers, which include cancers of the back of the mouth.
• Excessive sun exposure: Prolonged exposure to the sun can increase the risk of lip cancer.
• Age: The risk of mouth cancer increases with age, most commonly occurring in individuals over 40 years old.
• Gender: Men are more likely to develop mouth cancer than women, possibly due to higher rates of tobacco and alcohol use among men.
• Diet: A diet low in fruits and vegetables may increase the risk of mouth cancer. These foods contain essential vitamins and antioxidants that help protect cells from damage.
• Family history: A family history of cancer can increase the risk, suggesting a possible genetic predisposition.
• Weakened immune system: Conditions or medications that weaken the immune system can increase the risk of mouth cancer.
• Previous cancer: Individuals who have had cancer, particularly in the head and neck region, are at a higher risk of developing mouth cancer.
• Poor oral hygiene: Chronic irritation from rough teeth, ill-fitting dentures, or other dental issues may increase the risk.

Understanding these risk factors can aid in taking preventive measures and seeking early diagnosis, which is crucial for better outcomes in mouth cancer treatment.

Diagnosis of Mouth Cancer

Diagnosing mouth cancer involves several steps and tests to confirm the presence and extent of the disease. Here are the common methods used:

• Physical examination: The doctor will examine the mouth, throat, and neck for lumps, lesions, or other abnormalities. This may include a visual inspection and palpation to feel for any unusual growths.
• Endoscopy: A thin, flexible tube with a light and camera (endoscope) is used to look inside the mouth, throat, and other areas. This allows the doctor to see areas that are not visible during a regular examination.
• Biopsy: If a suspicious area is found, a biopsy will be performed. This involves removing a small sample of tissue from the affected area and examining it under a microscope to check for cancer cells.
• Imaging tests: Various imaging techniques may be used to get a clearer picture of the cancer and determine if it has spread. These tests can include:
• X-rays: To check for spread to the jaw or chest.
• CT Scan: Provides detailed cross-sectional images of the body to locate tumours.
• MRI: Uses magnetic fields and radio waves to produce detailed images of soft tissues.
• PET scan: Involves injecting a small amount of radioactive sugar to highlight cancer cells.
• Fine Needle Aspiration (FNA): A type of biopsy where a thin needle is used to remove cells or fluid from a lump or mass. This is often used if there is a lump in the neck that needs to be evaluated.
• Oral brush biopsy: A less invasive biopsy method where cells are collected by brushing them from the surface of a suspicious area in the mouth.
• Blood tests: While not used to diagnose mouth cancer directly, blood tests can help assess overall health and detect any abnormalities that might suggest the presence of cancer.

These diagnostic tools help healthcare providers determine the presence, stage, and spread of mouth cancer, allowing for the development of an appropriate treatment plan. 

Management and Treatment for Mouth Cancer

Effective management and treatment of mouth cancer depend on the stage of the cancer, the patient's overall health, and personal preferences. Here are the primary methods used:

Staging

Staging mouth cancer involves determining the extent of cancer spread. This is crucial for planning treatment and predicting outcomes. The stages are:

• Stage 0 (Carcinoma in situ): Abnormal cells are found only in the outer layer of the mouth lining.
• Stage I: The tumour is 2 cm or smaller and hasn't spread to lymph nodes.
• Stage II: The tumour is larger than 2 cm but not larger than 4 cm and hasn't spread to lymph nodes.
• Stage III: The tumour is larger than 4 cm or has spread to one lymph node but not to other parts of the body.
• Stage IV: The tumour may be any size, has spread to nearby tissues, lymph nodes, or distant parts of the body.

Surgery

Surgery is often the first line of treatment for mouth cancer, especially in its early stages. Surgical options include:

• Tumour resection: Removal of the tumour and some surrounding healthy tissue.
• Glossectomy: Partial or complete removal of the tongue if the cancer is located there.
• Mandibulectomy: Removal of part or all of the jawbone if the cancer has spread there.
• Maxillectomy: Removal of part of the roof of the mouth if affected.
• Neck dissection: Removal of lymph nodes in the neck if cancer has spread there.
• Reconstructive surgery: Post-tumor removal surgery to restore appearance and function, often involving grafts and prosthetics.

Radiation Therapy (Radiotherapy)

Radiation therapy uses high-energy beams to kill cancer cells. It can be used alone or in combination with surgery and chemotherapy.

• External beam radiation: Directs radiation from outside the body to the cancerous area.
• Brachytherapy: Places radioactive material inside or near the tumour.
• Intensity-Modulated Radiation Therapy (IMRT): Advanced form of radiation that targets the tumour more precisely, minimising damage to surrounding healthy tissue.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells and is often used in combination with radiation therapy (chemoradiation) or as palliative treatment.

• Neoadjuvant chemotherapy: Given before surgery to shrink the tumour.
• Adjuvant chemotherapy: Given after surgery to kill any remaining cancer cells.
• Palliative chemotherapy: Aims to relieve symptoms and improve quality of life in advanced cancer stages.

Palliative Care

Palliative care focuses on providing relief from symptoms and improving the quality of life for patients with advanced mouth cancer.

• Pain management: Using medications and other techniques to control pain.
• Nutritional support: Ensuring the patient receives adequate nutrition, which may involve feeding tubes or dietary adjustments.
• Speech therapy: Helping patients regain speech and swallowing abilities post-surgery or treatment.
• Emotional and psychological support: Offering counselling and support groups to help patients and their families cope with the emotional aspects of cancer.

Preventing Mouth Cancer

Taking proactive steps can significantly reduce the risk of developing mouth cancer. Here are key preventive measures:

Stop Using Tobacco or Don't Start

Tobacco use is the leading cause of mouth cancer. It includes smoking cigarettes, cigars, pipes, and using smokeless tobacco (chewing tobacco, snuff). The carcinogens in tobacco can damage the cells in the mouth and throat, leading to cancer. It is therefore important to quit smoking and avoid all forms of tobacco, if you do. For this you can seek support through cessation programs, medications, and counselling.

Drink Alcohol Only in Moderation

Excessive alcohol consumption is a major risk factor for mouth cancer. Alcohol can irritate the cells in the mouth, increasing the risk, especially when combined with tobacco use. It is, therefore, important to limit alcohol intake to moderate levels - typically, up to one drink per day for women and up to two drinks per day for men.

Avoid Excessive Sun Exposure to Your Lips

Prolonged exposure to ultraviolet (UV) rays from the sun can cause lip cancer. Protect your lips by using a lip balm with SPF, wearing a wide-brimmed hat, and avoiding excessive sun exposure, especially during peak hours.

See Your Dentist Regularly

Regular dental check-ups can help detect early signs of mouth cancer. Dentists can identify abnormal changes in the mouth and refer you for further examination if necessary. It is, therefore, advisable to visit your dentist at least twice a year, and report any unusual symptoms or changes in your mouth.

Additional Preventive Measures

• Maintain a healthy diet: Eat a balanced diet rich in fruits and vegetables. These foods contain essential vitamins and antioxidants that can help protect against cancer.
• Practise good oral hygiene: Brush and floss daily to maintain good oral health and reduce the risk of infections that can contribute to cancer development.
• Get vaccinated: Consider getting vaccinated against human papillomavirus (HPV), which is linked to oropharyngeal cancers.
• Avoid risky behaviours: Avoid risky behaviours such as sharing needles or engaging in unprotected sex, which can increase the risk of HPV and other infections associated with mouth cancer.

By incorporating these preventive measures into daily life, individuals can significantly lower their risk of developing mouth cancer and maintain better overall oral health. Regular monitoring and lifestyle changes are key components of effective prevention.

Prognosis for Mouth Cancer

The prognosis for mouth cancer depends on several factors, such as the stage at which it is diagnosed, the type and location of the cancer, the patient's overall health, and the treatment plan. Here is an overview of the prognosis for mouth cancer based on different influencing factors:

Stage of Cancer

• Early stage (I or II): When detected early, mouth cancer has a better prognosis. The five-year survival rate for early-stage oral cancer can be around 70-90%.
• Advanced stage (III or IV): Advanced stages of mouth cancer have a lower survival rate. The five-year survival rate for stage III can be around 50%, and for stage IV, it may drop to around 30%.

Type of Cancer

• Squamous cell carcinoma: This is the most common type of mouth cancer. Its prognosis depends heavily on early detection and treatment.
• Other types of mouth cancer: Less common types of mouth cancer may have different prognosis.

Location of Cancer

• Tongue, floor of mouth, and other specific areas: The location of the cancer within the mouth can influence treatment outcomes. For example, cancers on the lip often have a better prognosis compared to those on the tongue or floor of the mouth.

In addition to the aforementioned, the prognosis for mouth cancer also depends on how well the patient responds to the recommended treatment and how diligently they follow the treatment recommendations. For an individual prognosis, the patient must consult with their doctor, who can provide personalised information based on the specific circumstances of the case.

Final Words

Mouth cancer is a serious condition that requires prompt and specialised medical attention. Early detection and treatment significantly improve the prognosis, highlighting the importance of regular check-ups and being aware of the symptoms. If you or a loved one are experiencing any signs of mouth cancer or have concerns about oral health, consulting a specialist is crucial. Max Hospitals, with its team of experienced oncologists and state-of-the-art facilities, is dedicated to providing comprehensive care and support. Don’t hesitate to seek expert advice and take proactive steps towards better health by booking a consultation at Max Hospitals today.