Oral cancer, also known as mouth cancer or oral cavity cancer, is most frequently found in the tongue, the lips, and the floor of the mouth. It can also develop in the gums, the minor salivary glands, the lining of the lips and cheeks, the roof of the mouth, or the area behind the wisdom teeth.
The majority of oral cancers originate in the squamous cells that line the mouth, tongue, gums, and lips; these are classified as squamous cell carcinomas. Salivary gland cancers, however, are a different type, developing deeper in the tissue, and most commonly form from mucoepidermoid cells, which line the minor salivary glands.
It is important to note that not all growths or tumours found in the mouth are cancerous. Some are benign (non-cancerous), while others may be precancerous, meaning they have the potential to develop into cancer but are not yet malignant.
A risk factor is any element that increases an individual's chance of developing cancer. Many oral cancer cases are linked to specific risk factors, though some patients develop the disease without any known cause. The primary risk factors for oral cancer include:
A significant number of people diagnosed with oral cancer use tobacco in some form, including cigarettes, cigars, pipes, and chewing tobacco. The risk increases with both the duration and amount of tobacco use. The form of tobacco can influence the location of the cancer; for instance, chewing tobacco or snuff is often linked to cancer of the gums, cheek, and lips. Exposure to passive or secondhand smoke may also increase risk.
Heavy alcohol consumption (more than 21 alcoholic drinks per week) is a risk factor. The combination of heavy drinking and tobacco use is particularly dangerous, dramatically increasing the likelihood of developing oral cancer compared to those who abstain from both.
Many cases of oral cancer can be prevented. Steps to minimise the risk include:
Early diagnosis offers the best chance of successful treatment, which is why specialised clinics, such as the Oral Cancer Prevention Clinic, provide a dedicated setting for the diagnosis, monitoring, and treatment of precancerous lesions.
Oral cancer symptoms vary among individuals. As early detection is crucial for successful treatment, it is important to consult a doctor or dentist if you notice any abnormal areas in your mouth.
A persistent white patch or spot in the oral cavity. In a small number of cases, the patch may appear as a mix of red and white. Approximately 25% of leukoplakias are found to be cancerous or precancerous.
A persistent red, raised area or spot in the oral cavity that may bleed if scraped. About 90% of erythroplakias are classified as cancerous or precancerous.
It is important to remember that these symptoms are not exclusively linked to cancer and can be caused by other health issues. However, discussing any new or persistent signs with your doctor is essential for a prompt and accurate diagnosis.
Since early diagnosis dramatically improves the chances of successful treatment, it is vital for both oral cancers and precancerous lesions to be detected as early as possible. SSCHRC utilises advanced techniques and technology to accurately determine if a tumour is benign, precancerous, or malignant. Additionally, SSCHRC is working on new, less-invasive optical techniques to assist in the early detection of oral cancers.
If your doctor suspects oral cancer, they will thoroughly examine the inside of your cheeks and lips, the floor and roof of the mouth, the tongue, and the lymph nodes in your neck. They will also ask about your health history, past illnesses, and any dental problems. It is crucial to inform your doctor or dentist if you currently use, or have previously used, any form of tobacco.
One or more of the following tests may be used to confirm the presence of cancer and determine if it has spread:
A biopsy is the only definitive way to diagnose oral cancer. This involves removing a small tissue sample for microscopic examination for cancer cells. Depending on the tumour's location, some biopsies are performed in an outpatient setting with only local anaesthesia, while others may require a surgical procedure under general anaesthesia. Types of biopsy procedures include:
Imaging exams help in the diagnosis by showing if the cancer is present and whether it has spread. These may include:
Several tests are unique to oral cancer. If these tests yield a positive result, a biopsy will subsequently be performed:
Autofluorescence Imaging: A specialised device emits a blue light into the mouth. Healthy tissue will fluoresce in response, while tissue that appears less bright or dark may indicate abnormal cells.
Treatment for oral cancer is highly individualised and depends on the tumour's stage, grade, location, and the patient's overall health. Treatment plans typically involve a multidisciplinary team of specialists, including surgeons, medical oncologists, and radiation oncologists. Common treatment modalities often involve surgery, radiation therapy, and chemotherapy, which may be used alone or in combination. Newer therapies, such as targeted therapy and immunotherapy, are also playing an increasing role in patient care. SSCHRC is committed to providing comprehensive, customised treatment to achieve the best possible outcomes for all our patients.