Symptoms

The most common symptom of oral cancer is a sore in the mouth that does not heal. Other symptoms include:

  • A lump in the mouth or throat or on the lip
  • A white or red patch on the gums, tongue, or the lining of the mouth
  • Bleeding, pain, or numbness in the mouth
  • A sore throat that does not go away
  • Difficulty or pain when chewing
  • Difficulty or pain when swallowing
  • Swelling of the jaw
  • Loosening of the teeth
  • A lump in the neck
  • Unexplained weight loss
  • A change (hoarseness) in the voice
  • Pain in the ear.
  • Numbness of the tongue or other areas in the mouth

SEEK THE ADVICE FROM A HEALTHCARE PROFESSIONAL IF ANY OF THESE SYMPTOMS PERSISTS FOR TWO (2) WEEKS OR MORE!

Healthcare Professionals who can perform an Oral Cancer Screening Examination:

1.    Dentists

2.    Dental Hygienists

3.    Nurse Practitioners

4.    Physician Assistants

5.    Primary Care or Family Physicians

6.    Urgent Care Physicians

7.    Otolaryngologists (ENT)

8.    Head and Neck Surgeon

9.    Gastroenterologists

Cancer Cells

Cancer begins in cells, the building blocks that make up tissues. Tissues make up the organs of the body.

Normal cells grow and divide to form new cells as the body needs them. When normal cells grow old or get damaged, they die, and new cells take their place.

Sometimes, this process goes wrong. New cells form when the body doesn't need them, and old or damaged cells don't die as they should. The buildup of extra cells often forms a mass of tissue called a growth or tumor.

Tumors in the mouth or throat can be benign (not cancer) or malignant (cancer). Benign tumors are not as harmful as malignant tumors:

Benign tumors:

  • are rarely a threat to life
  • can be removed and usually don't grow back
  • don't invade the tissues around them
  • don't spread to other parts of the body

Malignant tumors:

  • may be a threat to life
  • can grow back after they are removed
  • can invade and damage nearby tissues and organs
  • can spread to other parts of the body

Almost all oral cancers begin in the flat cells (squamous cells) that cover the surfaces of the mouth, tongue, and lips. These cancers are called squamous cell carcinomas.

Oral cancer cells can spread by breaking away from the original tumor. They enter blood vessels or lymph vessels, which branch into all the tissues of the body. The cancer cells often appear first in nearby lymph nodes in the neck. The cancer cells may attach to other tissues and grow to form new tumors that may damage those tissues.

The spread of cancer is called metastasis. See the Staging section for information about oral cancer that has spread.

Diagnosis

People who smoke or drink heavily should be examined for head and neck cancer at least once a year with an Oral Cancer Screening.

An Oral Cancer Screening is a simple procedure that includes looking in the nose, mouth, and throat; examining the skin in the head and neck region; and feeling for lumps in the neck.

If cancer or suspicious lesion is suspected, the doctor may use mirrors and a lighted tube to examine hard-to-see areas as well as perform a biopsy.  A biopsy is when a piece of tissue will be removed with a scalpel or needle.  The specimen is sent to a pathologist who will examine it for signs of cancer.  Your doctor may also suggest other tests or scans.

If you need a biopsy, you may want to ask the doctor or dentist some of the following questions:

  • Why do I need a biopsy?
  • How much tissue do you expect to remove?
  • How long will it take? Will I be awake? Will it hurt?
  • How soon will I know the results?
  • Are there any risks? What are the chances of infection or bleeding after the biopsy?
  • How should I care for the biopsy site afterward? How long will it take to heal?
  • Will I be able to eat and drink normally after the biopsy?
  • If I do have cancer, who will talk with me about treatment? When?

STAGING OF ORAL CANCER

If oral cancer is diagnosed, your doctor needs to learn the extent (stage) of the disease to help you choose the best treatment. When oral cancer spreads, cancer cells may be found in the lymph nodes in the neck or in other tissues of the neck. Cancer cells can also spread to the lungs, liver, bones, and other parts of the body.

When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells as the primary (original) tumor. For example, if oral cancer spreads to the lungs, the cancer cells in the lungs are actually oral cancer cells. The disease is called metastatic oral cancer, not lung cancer. It's treated as oral cancer, not lung cancer. Doctors sometimes call the new tumor "distant" or metastatic disease.

Your doctor may order one or more of the following tests:

  • X-rays: An x-ray of your entire mouth can show whether cancer has spread to the jaw. Images of your chest and lungs can show whether cancer has spread to these areas.
  • CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your body. You may receive an injection of dye. Tumors in your mouth, throat, neck, lungs, or elsewhere in the body can show up on the CT scan.
  • MRI: A powerful magnet linked to a computer is used to make detailed pictures of your body. An MRI can show whether oral cancer has spread.
  • Endoscopy: The doctor uses a thin, lighted tube (endoscope) to check your throat, windpipe, and lungs. The doctor inserts the endoscope through your nose or mouth. Local anesthesia is used to ease your discomfort and prevent you from gagging. Some people also may be given a mild sedative. Sometimes the doctor uses general anesthesia to put a person to sleep. This exam may be done in a doctor's office, an outpatient clinic, or a hospital.
  • PET scan: You receive an injection of a small amount of radioactive sugar. The radioactive sugar gives off signals that the PET scanner picks up. The PET scanner makes a picture of the places in your body where the sugar is being taken up. Cancer cells show up brighter in the picture because they take up sugar faster than normal cells do. A PET scan shows whether oral cancer may have spread.

Doctors describe the stage of oral cancer based on the size of the tumor, whether it has invaded nearby tissues, and whether it has spread to the lymph nodes or other tissues:

  • Early cancer: Stage I or II oral cancer is usually a small tumor (smaller than a walnut), and no cancer cells are found in the lymph nodes.
  • Advanced cancer: Stage III or IV oral cancer is usually a large tumor (as big as a lime). The cancer may have invaded nearby tissues or spread to lymph nodes or other parts of the body