Oral Cancer: Spotting the Signs, Understanding the Risks, and Why Early Detection Saves Lives

Oral cancer, also known as mouth cancer, is a serious condition that arises in the tissues of the oral cavity. This includes the lips, tongue, gums, inner cheeks, and the roof or floor of the mouth. In some instances, it can also affect the oropharynx, which is the area at the back of the throat.

Often, oral cancer begins as a painless sore or patch, which can easily be overlooked in its initial stages. This underscores the importance of regular dental checkups and self-examinations for early diagnosis. While anyone can be affected, certain lifestyle choices, such as tobacco and alcohol use, significantly elevate the risk.

Early detection and prompt treatment are crucial for improving outcomes and survival rates. Read on to learn more about the signs, symptoms, and prevention strategies for oral cancer.

Understanding Oral Cancer

Oral cancer is a type of head and neck cancer that develops in the tissues of the oral cavity, including the lips, tongue, cheeks, gums, and the floor and roof of the mouth. Sometimes, it can also affect the oropharynx, the part of the throat at the back of the mouth.

It typically manifests as a persistent sore, patch, or lump that doesn't heal and can initially be mistaken for a minor issue.

If left untreated, oral cancer can spread to nearby structures, including lymph nodes and other parts of the head and neck, and in advanced cases, even to distant organs. Despite its potentially deadly nature, oral cancer is highly treatable when diagnosed early.

Who is Most at Risk?

While oral cancer primarily affects individuals aged 60 and older, it can also occur in younger people. Men are statistically twice as likely to develop it compared to women. Among different racial groups, white men have a higher incidence rate than Black men. Approximately 11 out of 100,000 people will be diagnosed with oral cancer in their lifetime.

One of the concerning aspects of this cancer is that many of its early symptoms are painless and subtle, leading to delays in diagnosis and treatment.

Recognizing Oral Cancer Symptoms

Oral cancer often presents as persistent changes in the mouth that do not resolve. These can include:

Visible Signs:

• White, red, or mixed patches (leukoplakia, erythroplakia, or erythroleukoplakia)
• Sores or ulcers that bleed easily and do not heal within 2 weeks
• Thickening or lumps in the cheek, gums, or tongue
• Crusty or rough areas on the lips or inside the mouth

Sensory and Functional Symptoms:

• Numbness or unexplained pain in the mouth or neck
• Difficulty or pain when chewing, swallowing, or speaking
• Unintentional weight loss
• Chronic earache or sore throat
• Persistent bad breath

It's important to note that these symptoms can mimic other conditions, such as infections or ulcers. However, their persistence should prompt concern and a visit to a healthcare professional.

Self-Examination: A Key to Early Detection

Performing a monthly self-exam can help identify unusual changes early:

• Examine your lips, gums, tongue, cheeks, and roof/floor of the mouth.
• Look for patches, sores, lumps, or discolored areas.
• Feel your neck and jaw for lumps or swelling.
• Use a bright light and a mirror to get a full view.

If you notice anything unusual, consult a healthcare professional immediately.

How Oral Cancer Impacts the Body

Oral cancer can significantly impair a person's ability to speak, chew, swallow, and even breathe, depending on the location and extent of the tumor. When it affects the oropharynx, it may lead to oropharyngeal cancer, impacting the base of the tongue, soft palate, tonsils, and the back of the throat.

The oral cavity, where oral cancer typically starts, includes:

• Lips
• Gums
• Inner cheeks
• Front two-thirds of the tongue
• Floor of the mouth (under the tongue)
• Hard palate (roof of the mouth)
• Area near the wisdom teeth

Causes and Risk Factors

Oral cancer begins in squamous cells, which are thin, flat cells lining the inside of the mouth. When these cells undergo mutations, usually due to prolonged exposure to carcinogens, they start to multiply uncontrollably and form tumors.

Major risk factors include:

• Tobacco use: Smoking or chewing tobacco is responsible for the majority of oral cancer cases.
• Excessive alcohol consumption: Alcohol irritates mucous membranes and increases cancer risk, especially when combined with tobacco use.
• HPV infection: Human papillomavirus, particularly strain HPV-16, has been linked to oropharyngeal cancers.
• Excessive sun exposure: Can cause lip cancer if lips are not protected with SPF.
• Poor oral hygiene and chronic irritation from broken teeth or ill-fitting dentures.
• Family history of cancer or genetic predispositions.

According to Healthline reports, approximately 25% of oral cancer cases occur in individuals without any of the above risk factors, which underscores the importance of regular oral screenings.

Diagnosing Oral Cancer

Diagnosis typically begins during routine dental or medical exams. Dentists often play a key role in early detection.

Diagnostic methods include visual and physical exams, brush biopsies, incisional biopsies, and laryngoscopy or pharyngoscopy. Once a lesion is confirmed as cancerous, additional tests are done to determine staging, which influences treatment options.

Stages of Oral Cancer

Oral cancer is staged using the TNM system:

• T (Tumor size):
  • T1: ≤2 cm
  • T2: >2 cm but ≤4 cm
  • T3: >4 cm
• N (Lymph nodes): Indicates if cancer has spread to lymph nodes.
• M (Metastasis): Shows whether the cancer has spread to other organs.

Staging helps doctors determine the most effective treatment and estimate the patient's prognosis.

Preventing Oral Cancer

While not all cases can be prevented, the risk can be significantly reduced through:

• Avoiding tobacco and limiting alcohol use
• Using SPF lip balms and sun protection
• Eating a healthy diet rich in fruits and vegetables
• Getting the HPV vaccine
• Maintaining good oral hygiene
• Regular dental screenings every 1–3 years (depending on age)

Life After Treatment

Life after oral cancer treatment varies. Some patients experience minor changes, while others face long-term impacts on speaking, chewing, and appearance. Support from reconstructive surgery, physical therapy, speech therapy, and mental health counseling may be needed. Ongoing check-ups are essential, as recurrence or secondary cancers are possible.