Oral cancer—also known as “mouth cancer”—is one of the least obvious malignancies, and yet it can be one of the deadliest. On average, it kills one person every hour of the day in the US. Around 45,000 people are diagnosed annually, but it’s often diagnosed at a late stage, making it harder to treat. So, what causes oral cancer, what are the symptoms, and how can we best protect ourselves against it?
Different kinds of oral cancer
Oral cancer involves malignant cells forming on the surface of the tongue, mouth, lips, and gums. In over 90% of cases, it’s the squamous cells that are affected, but rarer kinds include oral malignant melanoma (affecting the pigmentation cells), and adenocarcinoma, which occurs in the saliva glands.
What are the symptoms?
Early symptoms of oral cancer are very unobtrusive. You might have a small lump, or you may find small white or red patches on the surface of your mouth or tongue. Another early symptom is a mouth ulcer that doesn’t heal up within a few days. None of these is especially painful, and if they’re in an area you don’t normally see (such as the base of the tongue or the back of the throat), they can go unnoticed for a long time. If you have any of these symptoms for longer than 21 days, you should get checked out by a doctor or dentist.
What are the risk factors?
Using tobacco products—including smoking or sucking tobacco pouches—is a significant risk factor for oral cancer. Excessive alcohol consumption is another common risk factor, so people who smoke and drink heavily are far more susceptible. Recently, scientists have also discovered that the HPV16 virus (which is linked to genital warts and cervical cancer) can also cause oral cancer. This last factor is less well-known, so experts believe greater awareness could help patients get diagnosed sooner. Occasionally, there seems to be a genetic predisposition towards oral cancer.
What if oral cancer is not diagnosed early?
If oral cancer is not diagnosed early (perhaps because the signs haven’t yet been spotted), the malignant cells will be sending out secondaries into the rest of the body. It’s very common for the lymph nodes to be affected, and once cancer cells enter the lymphatic system, they can be easily spread around the body. Also, carcinomas in the mouth can become deeply embedded and grow into surrounding areas, such as the larynx, thyroid gland, and tonsils.
Removal of oral cancer tumors can be much harder if they’re well established, and the process can sometimes cause significant damage to surrounding tissues—including the face, jaw, larynx, and esophagus. Speaking and swallowing can become very difficult, the voice can change, and aspirating food into the lungs can set up ongoing health issues (such as pneumonia infection).
How is oral cancer treated?
Like other cancers, the treatment for oral cancer has a three-pronged approach—doctors may recommend any or all treatments, depending on your exact circumstances. Removal of the tumor is usually the first step, and this is relatively simple if it’s diagnosed early and it’s conveniently located, e.g. on the tip of the tongue. Surgery is generally followed up with radiotherapy and perhaps chemotherapy to tackle any remaining cancer cells.
What is the prognosis for oral cancer patients?
Much depends on how early the cancer is discovered, and one where it’s located. Early diagnosis increases the likelihood that the cancer is contained and hasn’t spread elsewhere in the body. If the tumor is spotted quickly and can be easily removed, this significantly improves the prognosis. However, the issues with the late diagnosis do affect the overall survival rates, with only 57% likely to be alive five years later.
How can I help prevent oral cancer?
As noted above, smoking and excessive drinking are two key factors, so you can help yourself enormously by drinking within government guidelines and quitting smoking entirely. Further, be aware of the impact of the HPV virus, get examined regularly, and always have regular dental checkups—your dentist can look at areas of your mouth that you can’t see. Dentists are often the first to spot the warning signs. Eating a healthy diet that’s rich in fresh produce and low in saturated fats may also help you ward off oral cancer.