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Oral Cancer: Signs, Diagnosis & Treatment

According to the American Cancer Society, more than 28,000 cases of oral cancer are diagnosed annually, with more than 7,000 of these cases resulting in death. Oral cancer may occur on the mouth, lips, tongue, gums, salivary glands, and throat (oropharyngeal).

What are the Signs?

Since oral cancer often begins with an asymptomatic stage during which symptoms may not be obvious, it is often painless initially and therefore difficult to detect.

Although the following signs do not necessarily signify cancer, are not all-inclusive, and may signify other dental conditions, they may be associated with early signs of cancer. Any abnormal change in the mouth, gums, tongue, or surrounding area should be evaluated by a dental professional immediately.

The signs of oral cancer may include:

  • Continuous pain in the mouth
  • Sores and bumps inside the mouth, including ragged, ulcerous lesions
  • Difficulty moving the mouth and jaw
  • Difficulty swallowing and chewing
  • Soreness in the throat
  • Bump in the neck
  • Pronounced pain in one ear
  • Undiagnosed bleeding from the tongue, gums or cheeks
  • Numbness in a specific area of the mouth or jaw

Diagnosis

For a definitive oral cancer diagnosis, you must see a dentist and a doctor (your dentist may refer you to an oncologist if cancer is expected). Your doctor and dentist will examine your mouth and evaluate your medical history to formulate an initial diagnostic impression and treatment plan. If the resulting treatment plan does not effectively resolve the dental condition within two weeks, a biopsy of the affected area will be performed to test for cancer.

It is diagnosed through a confirmed malignant biopsy and a clinical evaluation to identify the stage and grade of the cancer. Cancer is present when the basement membrane of the epithelium is broken. It may eventually spread to other areas of the mouth and body, resulting in secondary cancers that may yield even more serious consequences.

In order to determine the “path” of the cancer, the doctor may perform additional tests, including an X-ray, CT scan (computerized tomography) or MRI Scan (magnetic resonance imaging).

Ultrasounds may be used to establish the contour, consistency and composition of the cancerous mass or masses. In the end, your doctor and dentist will develop an oral cancer treatment plan based on supporting diagnostic tests.

Oral Cancer Treatment and Prevention

To treat oral cancer, doctors may administer one or more of three primary treatment modalities: surgery, radiation therapy or chemotherapy.

If surgery is the chosen treatment, the extent of the surgery depends upon the stage and grade of the cancer. In some progressive cases, surgery may involve removal of tumors in the jaw or roof of the mouth bone tissue. If the cancer has spread to other parts of the body (such as the lymph nodes) then the tumors in those areas may be removed as well. The doctor may remove tumors in the neck area by performing neck dissection.

If surgery is not an option or is not otherwise necessary, doctors may opt to use radiation therapy (a form of X-ray) or chemotherapy (intravenous or oral drugs). Multimodal treatments may incorporate one or more of the aforementioned modalities. For example, radiation therapy or chemotherapy may be used to destroy any remaining cancer that surgery was unable to remove.

Following extensive cancer treatment, patients may need to undergo plastic reconstructive surgery and speech therapy to improve the appearance and functionality of the affected area. Some patients require the use of devices to speak properly.

If you have cancer, it is important to learn as much about your disease as possible. Whether you suffer from a common cancer like nonmelanoma skin cancer or an extremely rare cancer like mesothelioma, you can access a great deal of helpful information online or by contacting The National Cancer Institute at (800) 4-CANCER or (800) 422-6237 or contacting the American Cancer Society at (800) ACS-2345 or (800) 227-2345.

Prevention

Any irritation of the mouth, gums or tongue may increase the risk of oral cancer. You are advised to perform periodic self-examinations of your mouth, gums, tongue and cheeks to check for the presence of any abnormalities.

Self-examination recommendations begin with an oral examination of the mouth, including checking the:

  • Teeth
  • Gums
  • Cheeks
  • Tongue (above and below)
  • Throat
  • Roof of the mouth
  • Turning the lips up and down to view the inner tissue surfaces

However, since symptoms associated with oral cancer may be confused with other medical conditions, self examinations should not replace seeing a dentist and dental hygienist for oral care maintenance at least twice a year. When used in conjunction, periodic self-examination and regular dental hygiene visits can help promote early-stage detection of oral cancer. And remember, it is always best to see both a doctor and dentist to properly evaluate symptoms.