Mouth cancer also called oral cancer, can occur anywhere in the oral cavity. It can occur on the surface of the tongue, in the roof and floor of the mouth, the lips, inside the cheek, in the gums, in the tonsils, and in the salivary glands. Oral cancer mostly happens after the age of 40, but can occur in other age groups as well. The risk of developing oral cancer is twice more likely in men than women. We will see further in this article about oral cancer symptoms, types, causes and treatment options in detail.
Tobacco abuse, smoking, eating spicy food or constant irritation from a broken tooth or denture can bring about dysplastic changes in the tissue. If not treated in time they carry a risk of progressing into cancer. Leukoplakia and erythroplakia are the early signs of dysplastic changes.
Most leukoplakia is benign, less than 25 percent of cases of leukoplakia are either cancerous or become precancerous. Erythroplakia is usually more severe, with about 70 about of cases cancerous either at the time of diagnosis or later.
Once established, chemotherapy and radiation is the treatment offered, and in most cancers, surgery is also indicated.
Oral cancer symptoms
Oral cancer can occur in any part of the mouth, including the lips, tongue, cheek, and throat. It can also involve the salivary glands, pharynx, larynx, and sinuses. Early detection is crucial in overcoming oral cancer. If any of the oral cancer symptoms persist for over two weeks, check with a healthcare professional.
- Areas of red or white lesions in your mouth or lips
- Sores, swellings, lumps or thick patches anywhere in or around your mouth or throat
- Numbness, pain or tenderness anywhere in your mouth (1)
- Trouble moving your jaw or tongue
- Problems with chewing, swallowing or speaking
- A lingering sore throat or hoarseness
- The feeling of a lump stuck in your throat
- Pain in one of your ears but without any loss of hearing
- Loose teeth with no apparent dental cause (2)
- Swellings that make wearing dentures uncomfortable
Early precancerous signs in the mouth and oropharynx
The following medical conditions are harmless, to begin with, but if left untreated can turn into cancer in certain individuals. These conditions are called precancerous lesions. These abnormal cells are called dysplastic cells. If left untreated, they might go on to develop into cancer. They are –
Leukoplakia appears as a white patch in the mouth. About 5 out of 100 people diagnosed with leukoplakia have cancerous or precancerous changes (3).
Erythroplakia appears as a red area, flat or slightly raised, that often bleeds when scraped (4). About 50 out of 100 people diagnosed with erythroplakia lesions can have cancerous changes.
What causes precancerous lesions?
The most common cause of leukoplakia and erythroplakia is smoking or chewing tobacco (5). Betel nut, areca nut, sharp edges of a broken tooth acting as an irritant can also cause dysplasia of the cells (6).
A precancerous condition can also develop due to poorly fitting dentures that continuously irritate the gums or the inside of the mouth or tongue.
Treatment for precancerous lesions
If stopping smoking and alcohol and tobacco consumption does not make the lesion disappear or if the lesion shows early signs of cancer, If you have dysplasia, there is a risk that you might develop mouth cancer. If your doctor removes the dysplasia, your risk of mouth cancer usually disappears.
Beta-carotene is an antioxidant that is converted to vitamin a in your body. Research studies have shown that beta-carotene along with vitamin E might be an effective treatment for leukoplakia patches (7).
When these conditions occur, a biopsy or other test is done to determine whether the cells are cancerous. A grading is established for the same (8).
The pathologist examines the cancer cells under a microscope from the biopsy sample to find out the grade of cancer. The grade of cancer helps determine the advancement of the disease and also the treatment desired.
There are four grades of mouth and oropharyngeal cancer –
Grade 1 (low grade)
The dysplastic cells look very much like the regular mouth or oropharyngeal cells.
Grade 2 (intermediate grade)
The dysplastic cells look slightly different to regular mouth or oropharyngeal cells.
Grade 3 (high grade)
The dysplastic cells look very abnormal and not much like healthy cells.
Grade 4 (high grade)
The dysplastic cells appear profoundly different to regular mouth or oropharyngeal cells.
Types of oral cancer
Squamous cell carcinoma
More than 90 percent of carcinomas that occur in the oral cavity and oropharynx are squamous cell carcinoma (9). The throat and mouth are mostly lined with squamous cells, which are flat and arranged in a scale-like way.
Squamous cell carcinoma means that some squamous cells are turning dysplastic and proliferating abnormally.
About 5 percent of oral cavity tumors are a verrucous carcinoma. They are slow-growing cancer compromising of squamous cells (10). This cancer infrequently spreads to other parts of the body but can invade and involve the tissue surrounding the site of origin.
Minor salivary gland carcinomas
This category includes oral cancer that can develop in the minor salivary glands. Minor salivary glands are found throughout the lining of the mouth and throat.
These types include adenoid cystic carcinoma, mucoepidermoid carcinoma, and polymorphous low-grade adenocarcinoma.
They develop in lymph tissue and are known as lymphomas. The lymphatic system, a part of the immune system, is affected by this disease.
The tonsils and base of the tongue both contain lymphoid tissue. Hodgkin lymphoma and non-Hodgkin lymphoma are related to lymphomas in the oral cavity.
The benign oral cavity and oropharyngeal tumors: several types of non-cancerous tumors and tumor-like conditions can arise in the oral cavity and oropharynx.
Sometimes, these conditions may develop into cancer. For this reason, benign tumors, which usually don’t recur, are often surgically removed.
The types of benign lesions include –
- Eosinophilic granuloma
- Granular cell tumor
- Condyloma acuminatum
- Verruciform xanthoma
- Pyogenic granuloma
- Odontogenic tumors
Oral health effects of cancer treatment
Chemotherapy and radiation, the regular cancer treatment, are the treatment of choice. If cancer has progressed, surgery may be required. Cancer treatment affects the patient’s dental health.
Post-radiation symptoms include dry mouth; a burning feeling in the mouth or throat, tooth decay due to radiation caries, difficulty chewing, swallowing, tasting or speaking, mouth sores and susceptibility to infections in the mouth.
Final words on oral cancer symptoms
Be regular with your dentist. If you see any white or red patches in your mouth consult your healthcare practitioner for receiving a diagnosis. You never if they are the early signs of oral cancer symptoms. If correct measures are taken on time, and any dysplastic changes are identified, it can help curb the cancer growth.
Ragged or broken tooth can irritate the tongue or cheek and produce dysplastic changes. Chronic infection from a tooth can also prove harmful in the more extended run.
Cancer of oral cavity effects and hampers a person lifestyle in many ways. So avoid smoking and tobacco and control on the intake of spicy food.