What is Mouth Cancer

Mouth cancer, or oral cancer, is a subtype of head and neck cancer that occurs in the oral cavity. About 90% of oral cancers are squamous cell carcinomas, which originate in the tissues lining the mouth and lips. It most commonly affects the tongue.

Mouth Cancer Causes

Smoking and Drinking

Smoking and drinking contain carcinogenic substances that can damage cell DNA, leading to cancer. The risk of mouth cancer is significantly higher in heavy smokers and drinkers. For example, someone who smokes 40 cigarettes daily and drinks 30 pints of beer weekly is 38 times more likely to develop oral cancer than others.

Betel nuts

Betel nuts, mildly addictive seeds from the betel palm tree, have a stimulating effect similar to coffee. They are carcinogenic and can increase the risk of mouth cancer. Consequently, mouth cancer rates are high in regions where betel nuts are traditionally used.

Smokeless tobacco

Asbestos can cause various lung diseases, including lung cancer and pleural cancer. Smoking and asbestos together significantly increase lung cancer risk. Mesothelioma, an aggressive cancer of the pleura, can affect the lungs, heart, or abdomen.

Human Papilloma Virus (HPV)

HPV is a family of viruses affecting the skin and moist membranes lining the cervix, anus, mouth, and throat. It spreads through close skin-to-skin contact, not just sexual intercourse. Some HPV types can cause abnormal tissue growth and cell changes, potentially leading to cervical cancer.

Diet

There is evidence that a diet rich in red meat, processed foods and fried foods can increase your risk of developing mouth cancer.

GERD (gastro-oesophageal reflux disease)

People with acid reflux, where stomach acid backs up into the esophagus, have an increased risk of oral cancer. Exposure to certain minerals and chemicals, such as asbestos, sulfuric acid, and formaldehyde, also increases the risk of mouth cancer.

Poor oral hygiene

There is evidence that poor oral hygiene, such as having cavities, gum disease, not brushing your teeth regularly, and having ill-fitting dentures (dentures) can increase your risk of mouth cancer.

Mouth Cancer Symptoms

Early-stage oral cancer symptoms are difficult to detect. Smokers and heavy drinkers should regularly visit their dentist for checkups. When symptoms do appear, they may include the following:

Diagnosis of Mouth Cancer

To determine if a lesion is cancerous, a doctor will perform a biopsy by removing a small tissue sample to check for cancer cells. The three main biopsy methods for suspected mouth cancer are:

Punch biopsy

A punch biopsy is used for accessible areas like the tongue or inside the mouth. After numbing the area with a local anesthetic, the doctor removes a small tissue section with forceps. The procedure is not painful.

Fine Needle Aspiration (FNA)

A fine-needle aspiration (FNA) biopsy is used if neck swelling is suspected to be from mouth cancer. The doctor inserts a needle into the lump to remove a small tissue and fluid sample, which is then tested for cancer cells.

Panendoscopy

A panendoscopy is performed to biopsy suspected tissue in the back of the throat or nasal cavities. Using a panendoscope, which includes a camera and light, the doctor guides it through the nose to remove a tissue sample for biopsy and to check for cancer.

Other tests

If the biopsy results are positive, further tests will need to be done to check how far along it is and how far it has spread. These tests will include any of the following:

MRI scan

MRI is a radiology technique that provides detailed internal body structure visualization. It offers more detailed images than X-rays and doesn't use ionizing radiation. Patients are placed inside a large magnet, aligning atomic nuclei in the body. Radiofrequency magnetic fields are then applied to create rotating magnetic fields detectable by the scanner. This information builds images of the scanned area, producing 2D or 3D volumes. MRI's contrast between soft tissues is particularly useful for imaging the brain, muscles, heart, and cancers compared to CT or X-rays.

CT scan

A CT scanner emits narrow beams through the body as it moves in an arc, unlike X-ray machines. CT scans produce more detailed images than X-rays, with an X-ray detector capturing hundreds of density levels. The data is sent to a computer, which creates a 3D cross-section displayed on a screen. Contrast may be used for clearer images, and in some cases, patients drink a barium meal for abdomen scans or receive a barium enema for lower body imaging.

PET scan

PET scanning is a nuclear imaging technique that produces 3D images of functional processes in the body. It detects pairs of gamma rays emitted by a positron-emitting tracer, which is introduced into the body as a biologically active molecule. Computer analysis builds up the concentration of the tracer within the body.

Mouth Cancer Treatment

Depending on the stage of mouth cancer, the doctor will recommend any of the following methods to treat cancer cells:

Surgery

The most common treatment for mouth cancer is surgery, tailored to the cancer's size and location. Surgery aims to remove the cancer entirely or alleviate symptoms in advanced stages (palliative surgery). Laser surgery may remove small mouth cancers and can be combined with photodynamic therapy (PDT).

Radiotherapy

Radiation therapy, also known as radiation therapy, is a treatment that uses high-energy radiation beams that are focused on cancerous tissue. This kills the cancer cells or stops the cancer cells from multiplying.

Chemotherapy

Chemotherapy employs anticancer drugs to kill or halt the multiplication of cancer cells. It can be used alongside surgery or radiation therapy and may be recommended for cancer that has spread. Treatment for oral cancer depends on factors like tumor location, size, type, and stage of the disease, and may include surgery, radiation therapy, or a combination.