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Oral Cancer: Symptoms, causes, types, and treatment

Dr. Rashmi ByakodiJun 23, 2024

According to the National Centre for Biotechnology Information, Oral Cancer in India is a prime public health concern. It ranks among the top three types of cancers in India. Most people affected by Oral Cancer belong to the country’s lower income groups. Oral Cancer is a fast-growing concern, and the key to survival is early detection. To create more awareness about this disease, the following sections highlight the meaning of Oral Cancer along with its symptoms, causes, types, and treatment methods.

Contents

What is Oral Cancer?
Symptoms of Oral Cancer
Causes of Oral Cancer
Types of Oral Cancer
Oral Cancer treatment
How to prevent Oral Cancer
Frequently Asked Questions

What is Oral Cancer?

Oral Cancer is the cancer of the oral cavity that consists of the lips, tongue, gums, roof of the mouth, inner lining of the cheeks, under area of the tongue, hard and soft palate, sinuses, and pharynx. It occurs when the malignant cells develop in the oral cavity and multiply uncontrollably. Oral Cancers start as tiny tumours (lesions) inside the lining of the mouth or on its surface. Some Oral Cancers begin as harmless leukoplakias or patches. These lesions become malignant over time, developing into squamous cell carcinomas. If not treated before time, Oral Cancer can be life-threatening.

Human papillomavirus 16 (HPV16) is known to cause most cases of Oropharyngeal Cancer, specifically on the back of the tongue and tonsils.

Symptoms of Oral Cancer

Oral Cancer has several symptoms that may be mistaken for common mouth problems. The common symptoms of Oral Cancer are listed below.

Sore on the mouth or lip that does not go away
A red or white patch on the tongue, tonsil/s, gums, or lining of the oral cavity
A swelling or a lump on the cheek, jaw, lips, mouth, neck, or back of the throat
Pain or discomfort inside the mouth and jaw that does not heal
A sore or blocked throat
Difficulty in swallowing or chewing
Lack of feeling or numbness in the tongue and other associated areas
Trouble in moving the tongue or jaw
Pain around teeth
Change in voice or hoarseness
Ear pain
Unintended weight loss
Loss of appetite

Causes of Oral Cancer

The primary cause of Oral Cancer is the mutation of the squamous cells, which become cancerous when their DNA changes and they grow uncontrollably. The reason why this happens in only some squamous cells is unclear. But as per healthcare professionals, here are some causes that may lead to Oral Cancer.

Use of tobacco: Tobacco use accounts for about two-thirds of cases of Oral Cancer, according to the National Cancer Institute (NCI). Using different forms of tobacco like zarda, gutka, khaini, kharra, mawa etc., increases the risk of cancer in the cheeks, gums, and lips by at least two times.
Smoking: Cigarette, cigar, or pipe smoking may elevate the risk of Oral Cancer up to six times than that of non-smokers.
Excessive alcohol consumption: As per National Cancer Institute, people who drink excessively are at five times more risk of developing Oral Cancer than non-drinkers. The risk even goes up if tobacco and alcohol are consumed together.
Family history: If a parent or sibling has the disease, your chances of inheriting it increase.
Human Papilloma Virus (HPV): The sexually transmitted HPV infection, especially HPV16, can cause Oral Cancer. It usually occurs in men under 50 who are sexually active. Since this disease can spread through oral sex, people who have had multiple partners are more likely to get caught by HPV infection. Even if a person has only one partner, the risk of HPV infection still prevails if their companion has been exposed to HPV.
Exposure to sun: Prolonged exposure to the sun can cause cancer on lips because of ultraviolet radiation, particularly at a young age.
Gender: Males are at twice the risk of Oral Cancer than females.
Lack of adequate nutrition in diet: A diet lacking fruits and vegetables could promote the risk of Oral Cancer. This may be due to the deficiency of adequate vitamins and minerals.
Oral Hygiene: According to the National Centre for Biotechnology Information, poor oral hygiene increases the risk of Oral Cancer. It supports the cancer-causing potential of other carcinogens, such as tobacco and alcohol.

Types of Oral Cancer

Here are the types of Oral Cancer.

Squamous Cell Carcinoma: It is the most common type of Oral Cancer that accounts for 90% of cases. Squamous cells are the flat, thin cells that lie in line with the lips and inside the mouth. Any minor changes to the squamous cell DNA make the cells grow uncontrollably.

Some less common Oral Cancers include the following.

Adenocarcinoma: A type of cancer that affects the salivary glands.
Sarcoma: It develops from abnormalities in bones, soft tissue, cartilage, and muscles. However, the occurrence of Oral Sarcoma is minimal. Oral sarcoma accounts for about 1% of all Oral Cancers.
Lymphoma: A type of Oral Cancer that develops in the lymph nodes of the oral cavity. It often affects the gum, soft palate, and the base of the tongue.
Oral Malignant Melanoma: It is a rare type of cancer that occurs in the mucosal tissues of the mouth. Most Oral Melanoma grows in the upper jaw mucosa and roof of the mouth. However, it can occur on the gums, tongue, or lips as well.

Oral Cancer treatment

If Oral Cancer is detected early, it is usually treated with surgery and radiation therapy. But if it is detected in an advanced stage, then doctors may use a combination of treatments.

Oral Cancer treatment may vary depending upon the type, stage, and location of cancer, the patient’s health, and personal preferences. The most recommended treatment options are mentioned below.

1. Surgery

Oral Cancers in the early stage may be treated with surgery involving removing the tumour and the malignant lymph nodes. In addition to that, some tissues near the mouth and neck may also be removed. Here’s a list of some common Oral cancer surgeries.

Primary Tumour Surgery: It includes the removal of the tumour.
Glossectomy: It is the process of total or partial removal of the tongue.
Mandibulectomy: A surgery in which a small or large part of the lower jaw bone is removed.
Maxillectomy: A cancer surgery that includes the removal of part of the upper jaw.
Neck Dissection: This is a surgery for the removal of the lymph nodes from the neck.

2. Radiation therapy

Radiation therapy is a line of treatment that uses high-energy x-ray beams or radiation beams to destroy the DNA in the malignant cells and the surrounding tissues.

3. Chemotherapy

Chemotherapy uses powerful anti-cancer drugs that kill cancer cells and weakens the cells’ ability to multiply and spread. Chemotherapy is either given in an intravenous line or via oral pills through the mouth.

4. Targeted therapy

In targeted therapy, the drug that is used targets the proteins of the cancer cells that help them develop, multiply and spread. However, it does not hurt normal cells. It can be used to treat Oral Cancers by destroying malignant cells.

How to prevent Oral Cancer

Although Oral Cancer is tough to prevent, the risk of developing Oral Cancer can be minimised up to a great extent if the following steps are adopted.

Avoid tobacco and its products: Since tobacco use contributes majorly to Oral Cancer, you should avoid using tobacco and its products. Quitting tobacco and tobacco products even after many years of use reduces the risk of Oral Cancer up to a large extent.
Cut Down on alcohol consumption: If you are a regular drinker, you should minimise your alcohol consumption in order to prevent the risk of Oral Cancer.
Avoid excess sun exposure: To avoid the risk of Oral Cancer, you must reduce your exposure to the sun. Always ensure to use good quality sunscreen when you are going outside during the daytime.
Get vaccinated for HPV: To protect yourself from human papillomavirus infection, you must get vaccinated with the HPV vaccine.
Eat a balanced diet: Eating a balanced diet that includes fruits, vegetables, proteins, good fats, and whole grains can reduce your risk of Oral Cancer.
Dental Check-Ups at Regular Intervals: It is important to get your dental check-ups done at regular intervals. It will help you to identify early signs of leukoplakia or erythroplakia. It's recommended that people between the ages of 20 and 40 have their Oral Cancer screened once every three years and annually after the age of 40.

Frequently Asked Questions

Here’s a list of some common queries and their resolutions related to Oral Cancer.

What causes Oral Cancer?

Chewing of tobacco, excess alcohol consumption, and infection due to the human papillomavirus are the leading causes of Oral Cancer.

What is the most common type of Oral Cancer?

Squamous Cell Carcinoma is the most common type of Oral Cancer that accounts for 90% of the cases.

What is the survival rate of Oral Cancer?

The approximate 5-year survival rate for Oral Cancer is 60% (the percentage of people who can survive with this type of cancer for five years).

Sources

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on several secondary sources on the internet. As this content piece is not vetted by a medical professional, please consult a doctor before making any health-related decisions.