Learn what doctors and dentists look for when diagnosing mouth cancer. Find out about oral cancer treatments, including surgery, chemotherapy and radiation.
Mouth cancer refers to cancer that develops in any of the parts that make up the mouth (oral cavity). Mouth cancer can occur on the:
Cancer that occurs on the inside of the mouth is sometimes called oral cancer or oral cavity cancer.
Mouth cancer is one of several types of cancers grouped in a category called head and neck cancers. Mouth cancer and other head and neck cancers are often treated similarly.
Signs and symptoms of mouth cancer may include:
Make an appointment with your doctor or dentist if you have any persistent signs and symptoms that bother you and last more than two weeks. Your doctor will likely investigate other more common causes for your signs and symptoms first, such as an infection.
Mouth cancers form when cells on the lips or in the mouth develop changes (mutations) in their DNA. A cell's DNA contains the instructions that tell a cell what to do. The mutations changes tell the cells to continue growing and dividing when healthy cells would die. The accumulating abnormal mouth cancer cells can form a tumor. With time they may spread inside the mouth and on to other areas of the head and neck or other parts of the body.
Mouth cancers most commonly begin in the flat, thin cells (squamous cells) that line your lips and the inside of your mouth. Most oral cancers are squamous cell carcinomas.
It's not clear what causes the mutations in squamous cells that lead to mouth cancer. But doctors have identified factors that may increase the risk of mouth cancer.
Factors that can increase your risk of mouth cancer include:
There's no proven way to prevent mouth cancer. However, you can reduce your risk of mouth cancer if you:
Tests and procedures used to diagnose mouth cancer include:
Once mouth cancer is diagnosed, your doctor works to determine the extent (stage) of your cancer. Mouth cancer staging tests may include:
Mouth cancer stages are indicated using Roman numerals I through IV. A lower stage, such as stage I, indicates a smaller cancer confined to one area. A higher stage, such as stage IV, indicates a larger cancer, or that cancer has spread to other areas of the head or neck or to other areas of the body. Your cancer's stage helps your doctor determine your treatment options.
Treatment for mouth cancer depends on your cancer's location and stage, as well as your overall health and personal preferences. You may have just one type of treatment, or you may undergo a combination of cancer treatments. Treatment options include surgery, radiation and chemotherapy. Discuss your options with your doctor.
Surgery for mouth cancer may include:
Surgery carries a risk of bleeding and infection. Surgery for mouth cancer often affects your appearance, as well as your ability to speak, eat and swallow.
You may need a tube to help you eat, drink and take medicine. For short-term use, the tube may be inserted through your nose and into your stomach. Longer term, a tube may be inserted through your skin and into your stomach.
Your doctor may refer you to specialists who can help you cope with these changes.
Radiation therapy uses high-energy beams, such as X-rays and protons, to kill cancer cells. Radiation therapy is most often delivered from a machine outside of your body (external beam radiation), though it can also come from radioactive seeds and wires placed near your cancer (brachytherapy).
Radiation therapy is often used after surgery. But sometimes it might be used alone if you have an early-stage mouth cancer. In other situations, radiation therapy may be combined with chemotherapy. This combination increases the effectiveness of radiation therapy, but it also increases the side effects you may experience. In cases of advanced mouth cancer, radiation therapy may help relieve signs and symptoms caused by the cancer, such as pain.
The side effects of radiation therapy to your mouth may include dry mouth, tooth decay and damage to your jawbone.
Your doctor will recommend that you visit a dentist before beginning radiation therapy to be sure your teeth are as healthy as possible. Any unhealthy teeth may need treatment or removal. A dentist can also help you understand how best to care for your teeth during and after radiation therapy to reduce your risk of complications.
Chemotherapy is a treatment that uses chemicals to kill cancer cells. Chemotherapy drugs can be given alone, in combination with other chemotherapy drugs or in combination with other cancer treatments. Chemotherapy may increase the effectiveness of radiation therapy, so the two are often combined.
The side effects of chemotherapy depend on which drugs you receive. Common side effects include nausea, vomiting and hair loss. Ask your doctor which side effects are likely for the chemotherapy drugs you'll receive.
Targeted drugs treat mouth cancer by altering specific aspects of cancer cells that fuel their growth. Targeted drugs can be used alone or in combination with chemotherapy or radiation therapy.
Cetuximab (Erbitux) is one targeted therapy used to treat mouth cancer in certain situations. Cetuximab stops the action of a protein that's found in many types of healthy cells, but is more prevalent in certain types of cancer cells. Side effects include skin rash, itching, headache, diarrhea and infections.
Other targeted drugs might be an option if standard treatments aren't working.
Immunotherapy uses your immune system to fight cancer. Your body's disease-fighting immune system may not attack your cancer because the cancer cells produce proteins that blind the immune system cells. Immunotherapy works by interfering with that process.
Immunotherapy treatments are generally reserved for people with advanced mouth cancer that's not responding to standard treatments.
Mouth cancers are closely linked to tobacco use, including cigarettes, cigars, pipes, chewing tobacco and snuff, among others. Not everyone who is diagnosed with mouth cancer uses tobacco. But if you do, now is the time to stop because:
Quitting smoking or chewing can be very difficult. And it's that much harder when you're trying to cope with a stressful situation, such as a cancer diagnosis and treatment. Your doctor can discuss all of your options, including medications, nicotine replacement products and counseling.
Alcohol, particularly when combined with tobacco use, greatly increases the risk of mouth cancer. If you drink alcohol, stop drinking all types of alcohol. This may help reduce your risk of a second cancer.
No complementary or alternative medicine treatments can cure mouth cancer. But complementary and alternative medicine treatments may help you cope with mouth cancer and the side effects of cancer treatment, such as fatigue.
Many people undergoing cancer treatment experience fatigue. Your doctor can treat underlying causes of fatigue, but the feeling of being utterly worn out may persist despite treatments. Complementary therapies can help you cope with fatigue.
Ask your doctor about trying:
As you discuss your mouth cancer treatment options with your doctor, you may feel overwhelmed. It can be a confusing time, as you're trying to come to terms with your new diagnosis, and also being pressed to make treatment decisions. Cope with this uncertainty by taking control of what you can. For instance, try to:
Make an appointment with your doctor or dentist if you have signs or symptoms that worry you.
If your doctor or dentist feels you may have mouth cancer, you may be referred to a dentist who specializes in diseases of the gums and related tissue in the mouth (periodontist) or to a doctor who specializes in diseases that affect the ears, nose and throat (otolaryngologist).
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well-prepared. Here's some information to help you get ready, and what to expect from your doctor.
Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For mouth cancer, some basic questions to ask include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions that occur to you.
Your doctor is likely to ask you a number of questions. Being ready to answer them may allow more time later to cover points you want to address. Your doctor may ask:
Avoid doing things that worsen your signs and symptoms. If you have pain in your mouth, avoid foods that are spicy, hard or acidic and that may cause further irritation. If you're having trouble eating because of pain, consider drinking nutritional supplement beverages. These can give you the nutrition you need until you can meet with your doctor or your dentist.
May 4th, 2021