Oral Cancer: Risks, Symptoms, and Prevention

Oral cancer appears as a growth or sore in the mouth that does not go away. About 50,000 people in the U.S. get oral cancer each year, 70% of them men. Oral cancer includes cancers of the lips, tongue, cheeks, floor of the mouth, hard and soft palate, sinuses, and pharynx (throat. It can be life-threatening if not diagnosed and treated early.

When it is caught early, oral cancer is much easier for doctors to treat. Yet most people get a diagnosis when their condition is too advanced to treat effectively. If you see your dentist or doctor regularly and learn how to spot suspicious changes, you’ll have a much better shot at an early diagnosis.

What Are the Symptoms of Oral Cancer?

The most common symptoms of oral cancer include:

• Swellings/thickenings, lumps or bumps, rough spots/crusts/or eroded areas on the lips, gums, cheek, or other areas inside the mouth
• Velvety white, red, or speckled (white and red) patches in the mouth
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• Unexplained bleeding in the mouth
• Unexplained numbness, loss of feeling, or pain/tenderness in any area of the face, mouth, or neck
• Persistent sores on the face, neck, or mouth that bleed easily and do not heal within 2 weeks
• A soreness or feeling that something is caught in the back of the throat
• Difficulty chewing or swallowing, speaking, or moving the jaw or tongue
• Hoarseness, chronic sore throat, or change in voice
• Ear pain
• Swelling or pain in your jaw. If you wear dentures, they might be uncomfortable or hard to put in.
• A change in the way your teeth or dentures fit together
• Dramatic weight loss

If you notice any of these changes, contact your dentist or health care professional immediately.

Who Gets Oral Cancer?

According to the American Cancer Society, men face twice the risk of developing oral cancer as women. Men who are over age 50 face the greatest risk. It's estimated that over 50,000 people in the U.S. received a diagnosis of oral cancer in 2019.

Risk factors for the development of oral cancer include:

• Smoking. Cigarette, cigar, or pipe smokers are six times more likely than nonsmokers to develop oral cancers.
• Smokeless tobacco use. Users of dip, snuff, or chewing tobacco products are 50 times more likely to develop cancers of the cheek, gums, and lining of the lips.
• Excessive consumption of alcohol. Oral cancers are about six times more common in drinkers than in nondrinkers. Using alcohol and tobacco together increases your chances even more.
• Family history of cancer.
• Excessive sun exposure, especially at a young age. Ultraviolet radiation from the sun can cause lip cancers.
• Human papillomavirus (HPV). Certain HPV strains are etiologic risk factors for Oropharyngeal Squamous Cell Carcinoma (OSCC). Almost everyone who’s sexually active will get HPV at some point in life. A specific type of this virus is causing a growing number of otherwise healthy men under 50 to get cancers in the back of their mouths and throats from oral sex. The more people you and your partners have sex with, the bigger your risk.
• Age. Oral cancers can take years to grow. Most people find they have it after age 55. But more younger men are getting cancers linked to HPV.
• Gender. Men are at least twice as likely as women to get oral cancer. It could be because men drink and smoke more than women do.
• Poor diet. Studies have found a link between oral cancer and not eating enough vegetables and fruits.

It is important to note that over 25% of all oral cancers occur in people who do not smoke and who only drink alcohol occasionally.

What Is the Outlook for People With Oral Cancer?

The overall 5-year survival rate for patients with an early diagnosis of oral cavity and pharynx cancers is 84%. If the cancer has spread to nearby tissues, organs, or lymph nodes, the 5-year survival rate drops to 65%.

How Is Oral Cancer Diagnosed?

As part of your routine dental exam, your dentist will conduct an oral cancer screening exam. Your dentist knows what a healthy mouth should look like and probably has the best chance of spotting any cancer. Experts recommend getting checked every year starting at age 18, and sooner if you start smoking or having sex.

More specifically, your dentist will feel for any lumps or irregular tissue changes in your neck, head, face, and oral cavity. When examining your mouth, your dentist will look for any sores or discolored tissue as well as check for any signs and symptoms mentioned above.

A biopsy may be needed to determine the makeup of a suspicious-looking area. There are different types of biopsies and your doctor can determine which one is best. Many doctors don’t use brush biopsies because while they're very easy, they still need a scalpel biopsy to confirm the results if the brush biopsy is positive. Also there are different types of scalpel biopsies, incisional and excisional, depending whether only a piece or the whole area is needed to determine what the nature of the problem is. Some doctors perform these biopsies with lasers.

How Is Oral Cancer Treated?

Oral cancer is treated the same way many other cancers are treated -- with surgery to remove the cancerous growth, followed by radiation therapy and/or chemotherapy (drug treatments) to destroy any remaining cancer cells.

What Can You Do to Prevent Oral Cancer?

Scientists think that oral cancer starts when the DNA in the cells inside your mouth gets damaged. But some things, including your health habits, can make you more likely to get it. To prevent oral cancer:

• Don't smoke or use any tobacco products and drink alcohol in moderation (and refrain from binge drinking).
• Eat a well-balanced diet.
• Limit your exposure to the sun. Repeated exposure increases the risk of cancer on the lip, especially the lower lip. When in the sun, use UV-A/B-blocking sun protective lotions on your skin, as well as your lips.

You can take an active role in detecting oral cancer early, should it occur, by doing the following:

• Conduct a self-exam at least once a month. Using a bright light and a mirror, look and feel your lips and front of your gums. Tilt your head back and look at and feel the roof of your mouth. Pull your checks out to view the inside of your mouth, the lining of your cheeks, and the back gums. Pull out your tongue and look at all surfaces; examine the floor of your mouth. Look at the back of your throat. Feel for lumps or enlarged lymph nodes in both sides of your neck and under your lower jaw. Call your dentist's office immediately if you notice any changes in the appearance of your mouth or any of the signs and symptoms mentioned above.
• See your dentist on a regular schedule. Even though you may be conducting frequent self-exams, sometimes dangerous spots or sores in the mouth can be very tiny and difficult to see on your own. The American Cancer Society recommends oral cancer screening exams every 3 years for persons over age 20 and annually for those over age 40. During your next dental appointment, ask your dentist to perform an oral exam. Early detection can improve the chance of successful treatment.

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