11184 Oral Cancer

Overview

Oral cancer is a type of cancer that starts in the mouth, lips, or the back of the throat. It begins when cells in the mouth grow out of control and form a tumour. It can appear as a sore, a lump, or a patch that does not heal.

Oral cancer is not as common as many other cancers, but thousands of people are diagnosed with it every year worldwide. It is less common than lung or breast cancer, but it is still important to be aware of.

Oral cancer can affect anyone, but it is more common in people over 40, in men, and in those who smoke or drink alcohol heavily. It can also affect younger people, especially in connection with HPV infection.

Symptoms

Common symptoms

• A sore in the mouth or lip that does not heal within 3 weeks
• A red or white patch on the gums, tongue, or lining of the mouth
• A lump or thickening in the cheek, jaw, or neck
• Pain or tenderness in the mouth or on the lip
• Difficulty chewing, swallowing, or moving the tongue
• A persistent sore throat or hoarseness
• Numbness in the mouth or lower lip
• Unexplained loose teeth
• Bleeding from the mouth without a clear cause

Symptoms in children

• Oral cancer is very rare in children, but the symptoms are the same as in adults.
• A persistent sore or lump in the mouth that does not heal should always be checked by a doctor.
• Unexplained difficulty eating or speaking may also be a sign.

Symptoms in older adults

• Older adults are at higher risk, especially if they have used tobacco or alcohol for many years.
• Denture wearers should be aware of any new sore spots or changes that do not settle.
• Difficulty eating, swallowing, or a noticeable lump in the neck should be investigated promptly.

Causes

Main causes

• Most oral cancers begin in the flat cells that line the inside of the mouth.
• Damage to the DNA of these cells makes them grow abnormally and form a tumour.
• The exact cause is often not certain, but several lifestyle and health factors are strongly linked.

Risk factors

• Using any form of tobacco, including smoking and chewing tobacco
• Drinking large amounts of alcohol regularly
• Being infected with human papillomavirus (HPV)
• Long-term sun exposure on the lips
• A diet low in fruits and vegetables
• A weakened immune system
• Being over the age of 40
• Being male
• Having had oral cancer before

When to see a doctor

See a doctor urgently if:

• Any sore in your mouth or on your lip that has not healed within 3 weeks
• A red or white patch that feels rough or does not rub off
• A lump or thickening inside your mouth, on your lip, or in your neck
• Difficulty chewing, swallowing, or moving your tongue

Book a routine appointment if:

• If you notice any persistent change in your mouth that concerns you, make an appointment with your GP or dentist.
• Tell them how long you have had the symptom and whether it has changed.

Diagnosis

Your GP or dentist will examine your mouth, lips, and neck, and ask about your symptoms. If they notice anything unusual, they will refer you to a specialist such as an ear, nose, and throat (ENT) doctor or an oral and maxillofacial surgeon for more tests.

Tests that may be done

• A biopsy — taking a small sample of tissue from the area to look at under a microscope
• Imaging scans such as ultrasound, CT, or MRI to see whether cancer has spread
• An endoscopy — using a thin, flexible camera to look at the back of the throat

What to expect at your appointment

The examination is usually quick and not painful. If a biopsy is needed, you will get local anaesthetic so the area is numb. Results can take a week or two. The specialist team will explain what they find and what happens next.

Treatment

Treatment for oral cancer depends on the type, size, and stage of the cancer, as well as your overall health. You will have a team of specialists who work together to plan your care. Common treatments include surgery, radiotherapy, and chemotherapy, often used in combination.

Self-care at home

• Keep your mouth clean and moist by rinsing gently — your care team can advise you on safe rinses.
• Eat soft, nutritious foods that are easy to swallow.
• Drink plenty of fluids to stay hydrated.
• Avoid smoking and alcohol, as they can slow healing and increase side effects.
• Rest as needed and let your body recover between treatments.

Medical treatments

Medical treatment may involve surgery to remove the tumour, radiotherapy using high-energy beams to destroy cancer cells, chemotherapy or other drug therapies to kill cancer cells, and targeted treatments that focus on specific changes in cancer cells. Your specialist team will recommend the best plan and explain the goals and possible side effects. They will never give you specific drug names or doses without discussing them directly with you.

When is surgery considered?

Surgery is often the first treatment for oral cancer. The surgeon removes the tumour and a small margin of healthy tissue around it to ensure all cancer cells are gone. In some cases, lymph nodes in the neck are also removed if there is a risk the cancer has spread.

Living with this condition

After treatment, you will have regular follow-up appointments to check that the cancer has not returned and to manage any side effects. Some people notice changes in eating, speaking, or appearance. Rehabilitation support, such as speech therapy or dietary advice, is available to help you adapt.

Lifestyle tips

• Follow your care team's advice on oral hygiene and rinsing.
• Stay hydrated and use lip balm if your lips are dry.
• Avoid tobacco and limit alcohol use to help reduce the risk of the cancer coming back.
• Keep moving as much as you comfortably can to maintain energy and strength.
• Attend all follow-up appointments and report any new symptoms early.

Diet and exercise

Eating well during and after treatment is important for healing and energy. If chewing or swallowing is difficult, try soft, moist, and protein-rich foods like soups, scrambled eggs, yoghurt, and smoothies. Gentle activity such as walking can improve your mood and stamina, but always follow the advice of your healthcare team.

Mental health and emotional wellbeing

A cancer diagnosis and treatment can bring worry, sadness, or stress. These feelings are completely normal. It is important to talk about them with your care team, family, or a counsellor. If you ever feel that you cannot cope or have thoughts of self-harm, reach out to your local mental health crisis service or your GP immediately.

Prevention

You cannot always prevent oral cancer, but you can greatly reduce your risk. The most important steps are not smoking, limiting alcohol, protecting your lips from the sun, and having the HPV vaccination.

Vaccines

An HPV vaccine is available in many countries. It protects against the types of HPV that can cause oral and other cancers. Ask your healthcare provider or local clinic whether it is recommended for you.

Screening programmes

Regular dental check-ups can help spot early changes in your mouth. Some countries offer screening for people at higher risk. If you are worried about your risk, talk to your dentist or GP about what checks are available.

Complications

If left untreated

• The cancer can grow deeper into the mouth, jaw, throat, or tongue.
• It can spread to lymph nodes in the neck and then to other parts of the body.
• It can cause severe pain, difficulty eating, difficulty speaking, and weight loss.
• In advanced stages, it can block the airway and cause breathing problems.

Long-term outlook

Many oral cancers are treated successfully, especially when found early. The outlook depends on the stage and type of cancer, but treatments are improving all the time. Even for more advanced cancers, there are effective options to control the disease and maintain quality of life. With support, many people continue to live fulfilling lives after treatment.

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