Mouth cancer, also known as lip and oral cavity cancer, is a type of cancer that begins in any portion of the mouth. This includes the gums, the lining of the cheeks and lips, oral/mobile tongue (the front two-thirds of the tongue), the floor of the mouth under the tongue, hard palate (the bony roof of the mouth) and the retromolar trigone (area behind the wisdom teeth).
Mouth cancer is more common in males, and is generally diagnosed after the age of 55. However, anyone can develop this disease.
Types of Mouth Cancers
There are several different types of mouth cancers, which are often categorises by the types of cells they develop from in the body and their location.
Squamous Cell Carcinomas (SCC)
Squamous cell carcinomas (SCCs) are cancers that arise from squamous cells, which are thin, flat cells that cover the inside of the mouth, nose, and throat. They are the most common form of mouth cancer. SCCs can be aggressive, but can have a good prognosis when found early.
Salivary Gland Cancers
Salivary gland cancers are malignancies that develop in the salivary glands in the mouth. Salivary glands are responsible for the production of saliva, which is a fluid that aids in digestion, prevents your mouth from becoming too dry and supports healthy teeth. For more information on salivary gland cancers, please refer to the Rare Cancers Australia Salivary Gland Cancer page.
Buccal Mucosa Cancer
Buccal mucosa cancers are rare cancers that develop in the lining of the cheeks and the back of the lips. The most common type of buccal mucosa cancer is squamous cell carcinomas (SCCs). Buccal mucosa cancer is often aggressive and can have high recurrence rates, however they can have a good prognosis when found early.
Rare types of Mouth Cancers
These types of mouth cancers are considered rare:
- Lymphomas.
- Melanomas.
- Sarcomas.
- Basal cell carcinomas.
- Adenoid cystic tumours.
Treatment
If mouth cancer is detected, it will be staged and graded based on size, metastasis (whether the cancer has spread to other parts of the body) and how the cancer cells look under the microscope. Staging and grading helps your doctors determine the best treatment for you.
Treatment is dependent on several factors, including location, stage of disease and overall health. In adult patients, your tumour will be staged and graded to help determine the best treatment option for you. There is currently no standard staging system for children with laryngeal cancer.
The treatment options for adults and children with mouth cancer are similar. These options may include:
- Surgery, potentially including:
- Glossectomy (total or partial removal of the tongue).
- Mandibulectomy (partial removal of the lower jaw known as the mandible).
- Maxillectomy (partial removal of the upper jaw known as the maxilla).
- Mandibulotomy (cutting of the jawbone to allow better access for difficult reach cancers – repaired with titanium plates at the end of the surgery).
- Lymphadenectomy (removal of affected lymph nodes).
- Reconstructive surgery (surgery to reconstruct an area of skin or jaw that was removed to access the cancer).
- Tracheostomy (insertion of a tube in the trachea (windpipe) to assist with breathing).
- Insertion of feeding tubes, such as gastrostomy/PEG tubes and nasogastric tubes.
- Radiation therapy.
- Chemotherapy.
- Clinical trials.
- Palliative care.
For more information on the treatment options, please refer to the Rare Cancers Australia Treatment Options page.
Risk factors
Some of the risk factors for mouth cancer include:
- Excessive alcohol consumption.
- Smoking and/or tobacco usage.
- Poor oral hygiene.
- Being infected with the Human Papillomavirus (HPV).
- Having a family history of mouth cancer.
- Certain conditions, such as Fanconi anaemia, Li-Fraumeni syndrome and/or bloom syndrome.
Not everyone with these risk factors will develop the disease, and some people who have the disease may have none of these risk factors. See your general practitioner (GP) if you are concerned.
Early symptoms
Symptoms of mouth cancer are similar in adults and children. Some of the potential symptoms include:
- Pain in the mouth.
- Difficulty or pain when swallowing.
- Persistent sore throat.
- A persistent sore or swelling in the mouth that doesn’t heal over time.
- Unusual bleeding and/or numbness in the mouth.
- Red and/or white patches on the tongue, lips, mouth or gums.
- Unexplained bad breath.
- Changes and/or difficulties with speech.
- Pain when moving the tongue.
- Unexplained weight loss.
- Loose or ill-fitting dentures.
- Pain in the ear.
- Swelling of the jaw.
Not everyone with the symptoms above will have cancer, but see your GP if you are concerned.
Diagnosis/diagnosing
If your doctor suspects you have mouth cancer, they will order a range of diagnostic tests to confirm the diagnosis, and refer you to a specialist for treatment.
Physical examination
Your doctor will collect your overall medical history, as well as your current symptoms. Following this, they may examine your body to check for any abnormalities. More specifically, they will examine the oral cavity and observe any abnormalities with a small mirror with lights attached.
Imaging & blood tests
The doctor will take images of your body using magnetic resonance imaging (MRI), a computed tomography scan (CT scan), x-ray and/or ultrasound, depending on where it is suspected the cancer is. The doctor may also look at other parts of the body and looks for signs of metastasis. Additionally, a blood test may be taken to assess your overall health and help guide treatment decisions.
Biopsy
Once the location of the cancer has been identified, the doctor will perform a biopsy to remove a section of tissue using a needle. Once a sample has been removed, it will be sent to a lab and analysed for cancer cells.
Prognosis (Certain factors affect the prognosis and treatment options)
While it is not possible to predict the exact course of the disease, your doctor may be able to give you a general idea based on the rate and depth of tumour growth, susceptibility to treatment, age, overall fitness, and medical history. Generally, early-stage mouth cancers have a better prognosis and survival rates. However, if the cancer is advanced and has spread, the prognosis may not be as good and there may be a higher risk of cancer recurrence. It is very important to discuss your individual circumstances with your doctor to better understand your prognosis.
References
Some references are to overseas websites. There may be references to drugs and clinical trials that are not available here in Australia.