Mouth Cancer

Overview

Mouth cancer, also called oral cancer, happens when abnormal cells in the lips, tongue, gums, inner cheeks, roof, or floor of the mouth grow out of control. These cells can form a lump, a sore, or a patch that does not heal.

Mouth cancer is not one of the most common cancers, but it is not rare. Thousands of people are diagnosed each year in the UK and around the world.

Mouth cancer can happen at any age, but it is most often diagnosed in people over 40. It is more common in men than in women. Young people can also get it, sometimes linked to HPV infection.

Symptoms

Common symptoms

• A sore in the mouth that does not heal within three weeks
• A red or white patch inside the mouth
• A lump or thickening in the cheek, tongue, or gums
• Pain when swallowing or chewing
• A feeling that something is stuck in the throat
• Persistent hoarseness or a change in your voice
• Numbness in the tongue or mouth
• Teeth feeling loose or dentures not fitting well
• Swelling in the jaw or neck

Symptoms in children

• Mouth cancer is very rare in children, but any lump, sore, or swelling in the mouth that does not go away should be checked by a doctor.

Symptoms in older adults

• Symptoms are the same as in younger adults, but they can sometimes be mistaken for normal dental problems. Regular dental check-ups are especially important as you get older.

Causes

Main causes

• The exact cause of mouth cancer is not known, but it starts when cells in the mouth get damaged DNA. Over time, these damaged cells multiply out of control and form a tumour.
• In many cases, the damage is linked to tobacco, alcohol, or HPV infection.

Risk factors

• Smoking or chewing tobacco
• Heavy alcohol use
• Infection with certain types of HPV, especially HPV type 16
• Being over the age of 40
• Prolonged sun exposure on the lips
• A diet low in fruits and vegetables
• A weakened immune system
• A history of oral cancer or precancerous white patches (leukoplakia)

When to see a doctor

See a doctor urgently if:

• See a doctor or dentist as soon as possible if you have a mouth ulcer or sore that lasts longer than three weeks.
• See a doctor promptly if you notice a lump, swelling, or persistent red or white patch in your mouth or neck.
• If you have difficulty swallowing, pain, or numbness that is not going away, do not wait for a routine appointment – get it checked.

Book a routine appointment if:

• For minor mouth problems like occasional pain, bleeding gums, or a bitten cheek, book a routine appointment with your dentist or GP.
• If you are unsure, it is always better to be seen and reassured.

Diagnosis

A doctor or dentist will start by looking and feeling inside your mouth, including your tongue, gums, and the sides of your cheeks. They will also feel your neck for swollen glands. If they see anything suspicious, they will refer you to a specialist for more tests.

Tests that may be done

• Biopsy – a small piece of tissue is removed and looked at under a microscope to check for cancer cells.
• Panendoscopy – a thin, flexible tube with a camera is used to examine the mouth, throat, and food pipe.
• Imaging scans – such as MRI, CT, or PET scans – to check the size of the tumour and see if it has spread.

What to expect at your appointment

Most people who are referred for tests do not end up having mouth cancer. The biopsy is the only way to know for sure. Waiting for results can be stressful, but your clinical team will explain each step and support you through the process.

Treatment

Treatment for mouth cancer depends on the type, size, location, and stage of the cancer, as well as your overall health. The main treatment approaches are surgery, radiotherapy, and chemotherapy or targeted therapy. You may have one treatment or a combination of them.

Self-care at home

• Keep your mouth clean by gently rinsing with salt water or the mouthwash your team recommends.
• Stay hydrated and try to eat soft, nutritious foods like soups, smoothies, and mashed vegetables.
• Follow your healthcare team's advice for caring for your mouth after any procedure.
• Stop smoking and limit alcohol to help your body heal and reduce the risk of the cancer coming back.

Medical treatments

Radiotherapy uses high-energy beams to destroy cancer cells. Chemotherapy and targeted therapy use medicines to shrink or kill cancer cells. These treatments are planned by a specialist team, and your doctor will explain the exact plan for you. You will not need to remember specific drug names – your team will guide you.

When is surgery considered?

Surgery is often the first treatment for early-stage mouth cancer. It involves removing the tumour and a small margin of healthy tissue around it. In some cases, reconstructive surgery is needed to rebuild the mouth or face. Your surgeon will explain the details before you agree to any procedure.

Living with this condition

Living with mouth cancer and its treatment can be challenging. You may need help with eating, speaking, or swallowing. Your healthcare team will include specialists such as dietitians, speech therapists, and nurses who can support your day-to-day recovery.

Lifestyle tips

• Quit smoking, as it can slow healing and increase the risk of recurrence.
• Limit alcohol, especially during treatment.
• Eat a balanced diet with plenty of fruits and vegetables.
• Protect your lips with SPF lip balm when in the sun.
• Go to all follow-up appointments and report any new or changing symptoms.

Diet and exercise

If chewing or swallowing hurts, choose soft, moist foods like porridge, mashed potatoes, and yogurt. Gentle exercise, such as a short walk, can help you keep your strength and improve your mood. Speak to your team before starting new exercise.

Mental health and emotional wellbeing

A cancer diagnosis can bring anxiety, sadness, or fear. These feelings are normal. Talking to a counsellor, joining a support group, or simply opening up to friends and family can help. If you feel overwhelmed, tell your healthcare team – they can provide extra support.

Prevention

You cannot always prevent mouth cancer, but you can greatly lower your risk. The most effective steps are avoiding all forms of tobacco, limiting alcohol, and protecting your lips from the sun. Eating a healthy diet rich in fruits and vegetables may also help.

Vaccines

There is no vaccine that prevents mouth cancer directly, but vaccination against human papillomavirus (HPV) can prevent the types of HPV that are linked to mouth cancer. Ask your doctor if HPV vaccination is right for you.

Screening programmes

There is no national screening programme for mouth cancer, but regular dental check-ups can help detect abnormal changes early. Dentists are trained to spot signs of mouth cancer during routine examinations.

Complications

If left untreated

• The cancer can grow deeper into the tongue, jaw, or other nearby tissues.
• Cancer cells can spread to lymph nodes in the neck and then to other parts of the body.
• Without treatment, the cancer may cause severe pain, difficulty eating and speaking, and can become life-threatening.

Long-term outlook

The outlook for mouth cancer is generally good if it is found early. Most people with early-stage mouth cancer are cured. Treatment may be hard, but many people return to a full and active life. Your healthcare team will give you a clear and honest picture based on your own situation.

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