Mouth Cancer 101: Symptoms, Causes, Treatment & Prevention of Oral Cancer

Learn more about mouth cancer, including its signs and symptoms, stages, causes, diagnosis, complications, prevention and treatment.

by Nathasha Lee

Mouth cancer, also known as oral cancer, is the eighth most common cancer worldwide. 300,000 new cases and 145,000 deaths were caused by mouth cancer in 2012 alone. What exactly is mouth cancer, what are its symptoms and what can we do about it? We’ll explain what the different types of mouth cancer are and the ways you can get treatment and receive support.

What is mouth cancer?

Mouth cancer refers to when a tumour grows in any of the areas around the mouth. These can include the lips, tongue, gums, cheek lining, back of the throat and the roof of the mouth. The cancer can spread to other parts of the body around the mouth such as the jawbone, the throat or the lymph nodes in the neck. Mouth cancer that has spread to different parts of the body is known as metastatic oral cancer.

Types of mouth cancer

These are the most common types of mouth cancer:

1. Floor of mouth cancer

The floor of the mouth refers to the area under the tongue where this type of cancer begins. The cells in this area will start to multiply rapidly and form tumours or lesions which can easily be mistaken for canker sores. Floor of mouth cancer has a high chance of being cured if it is diagnosed early.

2. Gum cancer

Mouth cancer typically does not affect the gums, with cancer of the gums accounting for 6% of all diagnosed cases in 2017. Nonetheless, gum cancer can manifest as a swelling and ulcers developing on the gums. It can look similar to gingivitis, another gum-related disease that causes swollen and bleeding gums.

3. Hard palate cancer

Hard palate cancer, also simply referred to as palate cancer, affects the hard area behind the upper row of your teeth that makes up the roof of your mouth. Tumours can grow in the hard palate, making swallowing uncomfortable.

4. Inner cheek cancer

Inner cheek cancer is also known as buccal mucosa cancer and happens when the cells lining the area inside the cheeks multiply rapidly and produce tumours.

5. Lip cancer

Different types of tumours and lesions can develop on the upper and lower lips, with tumours being more common on the upper lip and squamous cell carcinoma being common on the lower lip. While tumours can appear as a pearly-white raised areas of tissue, squamous cell carcinoma appears as firm smooth plaques with ulcers in the centre. People who frequently work outdoors have a higher risk of getting this type of cancer.

6. Tongue cancer

Tongue cancer can develop either on the upper surface of the tongue or the lower surface of the tongue just above the salivary glands. Cancers that develop on the upper surface are considered mouth cancers while cancers that develop at the base of the tongue near the throat are considered pharyngeal cancers.

Risk factors for mouth cancer

Scientists aren’t sure about what exactly causes the DNA of the mouth cells to mutate and become cancerous. However, there are some known factors which can cause or greatly increase your risk of mouth cancer:

  • Chewing betel nuts, with or without added tobacco.
  • Having jagged or broken teeth. Damaged teeth can cause persistent ulcers or wounds on the tongue which over time can increase one’s chance of developing mouth cancer at the affected sites.
  • High alcohol consumption.
  • Human papillomavirus (HPV). HPV refers to a group of viruses which affect the skin and membranes in the body like the cervix, mouth, and throat. You can contract HPV from having sex with an infected person. In some cases, HPV can cause cells to multiply abnormally, causing mouth cancer.
  • Poor oral hygiene.
  • Using products that contain tobacco, like chewing tobacco or smoking tobacco cigarettes.

Mouth cancer symptoms

Most people begin seeking treatment for mouth cancer only when they experience pain in their mouth, but by then your cancer might have progressed to a more advanced stage and spread to other parts of the body. Here are some symptoms of mouth cancer:

  •   A lump in the neck
  •   Difficulty moving your jaw
  •   Loose teeth
  •   Red or white patches in the mouth
  •   Pain in the ears
  •   Soreness inside the throat
  •   Swellings inside the mouth that do not go away despite antibiotic treatment
  •   Ulcers and sores in the mouth that keep on growing
  •   Unexplained bleeding in the mouth

Mouth cancer diagnosis

Signs of mouth cancer could be detected in a dental exam when your dentist examines the inside of your mouth. To check if the ulcer or patch in your mouth is cancerous, your doctor will need to do a biopsy, where a small tissue sample is taken from the area and examined under a microscope.

A complete head and neck exam may be done by a specialist like an ear, nose, and throat (ENT) specialist. They will feel the areas around your face and neck, including your lymph nodes, for any abnormalities. Special scopes may be used to look at areas further inside the mouth. To make sure that there are no cancers in other parts of the body, different types of scopes may also be used to examine areas like the voice box, esophagus (gullet), and the trachea (windpipe).

Mouth cancer treatment

Treatment often involves the removal of a tumour done by a head and neck surgeon. In most cases only the tumour would need to be removed, but if the cancer has progressed to an advanced stage, you may also require surgery on the jawbone. If the cancer has spread to surrounding tissue or the lymph nodes, those parts of the body might have to be removed as well.

Reconstruction surgery may also be done to restore normal mouth function if areas around the mouth need to be removed to prevent the cancer from spreading. This might be necessary as sometimes after surgery to remove tumours and cancerous tissue, one might have difficulty with tasks like chewing and speaking and experience fluids leaking from the mouth.

After successful treatment your cancer can go into remission, but there is a chance that it could come back. You will require an endoscopy (a scope to view the inside of the body) every four to six months in the first year after your cancer has gone into remission, though the frequency will decrease over time. Blood tests and dental examinations may also be needed to check for side effects of radiation treatment on your thyroid function and dental health. Scheduling regular follow-ups with your doctor and a schedule of future tests for early detection can help you discover early signs of returning cancer and nip potential problems in the bud. Having a healthy diet and exercising regularly can prevent your cancer from returning.

Mouth cancer prevention

Here are three of the best ways you can prevent mouth cancer:

1. Cut back on smoking

Tobacco consumption is a strong risk factor for mouth cancer. Tobacco causes increased amounts of nitric oxide and nitrites in the mouth which can increase your risk of mouth and lung cancers. Stopping smoking completely cuts your risk for mouth cancer and other mouth and lung disease. If you have early-stage mouth cancer, quitting smoking will prevent the cancer from advancing into a more dangerous form. If you find it difficult to quit smoking, you can begin by trying to reduce the number of packs that you smoke each day.

2. Drink less alcohol

Excessive alcohol consumption can cause free radicals to develop in the body. Saliva and other fluids in the mouth can cause the ethanol in alcohol to be converted to aldehyde which is a cancer-causing chemical. The recommended number of alcoholic drinks to take in a day is not more than two standard drinks for an adult male and not more than one standard drink for an adult female.

3. Practice good oral hygiene

Studies have found that people with good oral hygiene significantly reduces the risk of developing mouth cancers. Keeping your teeth and gums clean is vital to maintaining the health of the gums and mouth. Brushing your teeth twice a day with a proper toothbrush and toothpaste is essential to maintaining basic oral hygiene. Remember to floss your teeth regularly to remove food particles and bacteria from your mouth. Avoid chewing betel nut as it contains cancer-causing chemicals that have negative impacts on the health of your teeth and gums.

Mouth cancer support groups

If you have been diagnosed with mouth cancer or a caregiver of someone who has, the journey can feel long and lonely. Thankfully, there are support groups you can join to find a network of people with similar experiences and gain the knowledge and support you need to keep going.

The oneHeart Support group is a group run by the National University Cancer Institute of Singapore that provides support for people who have had cancers of the head and neck, including mouth cancer. oneHeart aims to provide knowledge and psychological support to patients and caregivers. To achieve this, it organises various activities including talks by health professionals for members to understand the side effects of cancer treatment and a befriender programme to help people diagnosed with cancer get in touch with and learn from survivors. You can give the support group a call at the numbers given on their website. If you are eligible, you will be matched with a volunteer cancer survivor or caregiver.

 Women who have mouth cancer can also join the Bishana Ladies’ Group organised under the Singapore Cancer Society (SCS). The Bishana Ladies’ Group provides a platform for women who have been diagnosed with cancer to share their experiences, learn from and support one another, and develop relationships through workshops and recreational activities. Members can enjoy various enrichment programmes like baking workshops, yoga and Zumba classes, ukulele lessons and costume jewellery workshops. The group meets every third Friday from 6.30 p.m. to 9.00 p.m. and every third Saturday from 10.00 a.m. to 12.30 p.m. If you are a woman who has been diagnosed with cancer, you can join the Bishana Ladies’ Group by filling out a simple application form on the SCS website.

Going through the journey of treatment or recovery from cancer can bring about large changes in your emotional state and physical capabilities. Homage can help you if you are grappling with the side effects of cancer treatment, or if you are a caregiver who is worn out from round-the-clock care for a family member with cancer. Our trained nurses can provide respite care so that you can take a break from caregiving and recharge mentally. We also provide medical escorts to help you or your loved one go to appointments, night care when doctors are not available at late hours, and even rehabilitation therapy from the comfort of your home. All you need to do to gain an extra helping hand in your recovery journey is to make an appointment with us on the Homage mobile application.

References
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  2. Bishana Ladies Group. (n.d.). Singapore Cancer Society. Retrieved July 24, 2021, from https://www.singaporecancersociety.org.sg/get-help/cancer-survivor/join-a-support-group/bishana-ladies-group.html
  3. Facts about moderate drinking | CDC. (n.d.). Centres for Disease Control and Prevention. Retrieved July 23, 2021, from https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm
  4. Fighting Oral Cancer with Drool. (n.d.). National Dental Centre Singapore. Retrieved July 22, 2021, from https://www.ndcs.com.sg/giving/fighting-oral-cancer-with-drool
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  6. Floor of Mouth Cancer. (n.d.). Memorial Sloan Kettering Cancer Center. Retrieved July 22, 2021, from https://www.mskcc.org/cancer-care/types/mouth/types-mouth/floor-mouth
  7. Inner Cheek Cancer (Buccal Mucosa Cancer). (n.d.). Memorial Sloan Kettering Cancer Center. Retrieved July 23, 2021, from https://www.mskcc.org/cancer-care/types/mouth/types-mouth/inner-cheek-cancer-buccal-mucosa
  8. Mathur, R., Singhavi, H. R., Malik, A., Nair, S., & Chaturvedi, P. (2019). Role of Poor Oral Hygiene in Causation of Oral Cancer-a Review of Literature. Indian journal of surgical oncology, 10(1), 184–195. https://doi.org/10.1007/s13193-018-0836-5
  9. NHS. (2019, October 18). Causes. Nhs choices. https://www.nhs.uk/conditions/mouth-cancer/causes/
  10. Ramesh, R., & Sadasivan, A. (2017). Oral squamous cell carcinoma masquerading as gingival overgrowth. European journal of dentistry, 11(3), 390–394. https://doi.org/10.4103/ejd.ejd_261_16
  11.  oneHeart Support Group – NCIS | National University Cancer Institute, Singapore. (n.d.). National University Cancer Institute. Retrieved July 22, 2021, from https://www.ncis.com.sg/Our-Services/Patient-Support-Groups/Pages/NPC-oneHeart-Support-Group.aspx
About the Writer
Nathasha Lee
Nathasha Lee is a final-year Anthropology major at Yale-NUS College. She hopes her writing can make a positive difference in the lives of readers, no matter how small. In her spare time, she enjoys making art, listening to podcasts, and drinking lots of tea.
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