Oral Cancer: Know the Warning Signs, Risk Factors, and Why Early Detection is Key to Survival

Oral cancer, also known as mouth cancer, is a serious condition that develops 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, the area at the back of the throat. Often beginning as a painless sore or patch, it can easily go unnoticed in its early stages. Regular dental checkups and self-examinations are therefore crucial 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 vital for improving outcomes and survival rates.

What is Oral Cancer?

Oral cancer is a type of head and neck cancer that originates in the tissues of the mouth. This encompasses areas such as the lips, tongue, cheeks, gums, the floor and roof of the mouth, and sometimes the oropharynx. It typically manifests as a persistent sore, patch, or lump that does not heal and can be mistaken for a minor issue initially. 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, to distant organs. Despite its potential severity, oral cancer is highly treatable when diagnosed early.

Who is Most Affected?

While oral cancer commonly 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 racial groups, white men have a higher incidence rate than Black men. Approximately 11 in 100,000 people will be diagnosed with oral cancer during their lifetime. The concerning aspect of this cancer is that many early symptoms are painless and subtle, often leading to delayed diagnosis and treatment.

Oral Cancer Symptoms

Oral cancer often presents with 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

These symptoms may resemble other conditions like infections or ulcers, but their persistence should warrant concern.

Oral Cancer: Self-Exam Tips for Early Detection

Performing a monthly self-exam can aid in identifying 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 find 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, which impacts the base of the tongue, soft palate, tonsils, and the back of the throat.

The oral cavity, where oral cancer typically begins, 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

Oral Cancer: Causes and Risk Factors

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

Major risk factors:

• Tobacco use: Smoking or chewing tobacco accounts 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, especially 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, underscoring the importance of regular oral screenings.

How Oral Cancer is Diagnosed

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

Diagnostic methods include visual and physical exams, brush biopsies, incisional biopsies, laryngoscopy, or pharyngoscopy. Once a lesion is confirmed as cancerous, additional tests are performed 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.

How to Prevent 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 oral hygiene
• Regular dental screenings every 1–3 years (depending on age)

Oral Cancer: 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 necessary. Ongoing check-ups are essential, as recurrence or secondary cancers are possible.