Oral cancer, also known as mouth cancer, describes different tumours which affect different parts
of the mouth. Tumours may arise in the tongue, the floor of mouth, the lining of the cheeks,
the roof of the mouth, the soft panitch, as well as the lips. Tumours may also arise in
glands producing saliva. These include the parotid glands on the sides of the face - these
extend into the neck, as well as the submandibular glands and sublingual glands. Mouth cancers
may present in different ways as either lumps or ulcers. Overall, if an area is present
in the mouth and hasn't healed after a period of two weeks, these ought to be examined
more closely.
One of the most important causes of cancer of the mouth is smoking. Smoking and tobacco
use in its various forms are strongly associated with cancers of the mouth. And these include
using cigars and tobacco in the form of betel nuts or areca nuts. There is no safe quantity in
terms of cigarette smoking and the evidence for using e-cigarettes has not yet been
proven. Alcohol is also strongly associated with developing mouth cancer. And in particular,
smoking and alcohol have an enormous doubling effect increasing the risk greater than the
general population. Recently, studies have demonstrated an association of human papillomavirus
with cancers of the throat in particular. HPV is a virus that is known to cause genital
warts. There is much interest in this area in relation to prognosis and improvement of outcomes.
The symptoms of mouth cancer are variable. In particular, if you develop an ulcer which
fails to heal after a period of two weeks, this ought to be investigated more closely.
Lumps which develop in the mouth without a reasonable explanation which don't disappear
again after two weeks should be investigated further. Persistent lumps in the neck, these
may be painful or painless, which do not disappear after a period of two to three weeks should
also be examined carefully. If your teeth become loose without an obvious cause or if
you have had a tooth extracted recently by your dentist and the socket has failed to heal,
these may be signs which warrant further investigation for mouth cancer. If you are a denture wearer
and you found that your dentures are now ill-fitting, it's important to have a specialist examine
the areas under the denture for a potential cause. Any numbness that you experience in
the face. For example, in the lower lip or upper face under the eye, also needs to be
examined carefully. You may notice red or white patches inside the mouth. The majority
of these are potentially cancerous and that these can be excluded with some very simple
investigations. If you find that your speech has changed and you are lisping for example,
this may well be a sign that warrants further investigation by a specialist.
Approximately 7,000 people are diagnosed with mouth cancer every year in the United Kingdom.
This represents approximately 2% of all cancers diagnosed. These cancers are more common in
the older age group age 50 to 74 and about one in eight individuals under 50 years old
will be diagnosed with mouth cancer. This group of individuals are thought to have HPV
associated mouth cancer. Overall, men are more commonly diagnosed with mouth cancer
than women. And this is thought to be due to the fact that men consume more alcohol
than women.
Probably the most important thing you can do is not to smoke cigarettes or utilise tobacco
in any of its various forms. It's also important to consume less than 14 units of alcohol per
week and that alcohol should be spread out over the week rather than being concentrated
over the weekend. A healthy balanced Mediterranean style diet is helpful. And this needs to be
rich particularly in tomatoes, citrus fruits, and vegetables as well as olive oils and fish.
Regular checkups with your dentist are also important as your dentist is trained in spotting
the early signs of mouth cancer.
The first step in diagnosing mouth cancer is to obtain a biopsy. A small sample of tissue
is taken and examined under the microscope. This will confirm that the diagnosis and the
cancer type. We use a variety of imaging to help understand whether the cancer has spread
to other parts of the body. In particularly into the neck or chest. A combination of ultrasound
scans, with or without a needle test to obtain fluid from a lump in the neck for example,
a CT scan, or MRI scanning may be used. Occasionally, advanced imaging such as PET CT scanning will
also be required. Once all the investigations are completed, your cancer will be staged.
This occurs in a multidisciplinary team meeting with a variety of cancer specialists including
radio therapists and other surgical specialities. From this point onwards, you will have a treatment
plan prior to proceeding to surgery in most cases.