Mouth cancer, often known as oral cancer or cancer of the oral cavity, is cancer that starts in the region of the mouth. More than 853 people in Victoria are diagnosed with mouth cancer each year – that’s over 16 people diagnosed every week. Mouth cancer starts in the cells lining the mouth. Damaged cells can then grow uncontrollably to form a tumour.
The two main risk factors for mouth cancer are alcohol and tobacco, and the combined effect of drinking and smoking is far greater. Mouth cancer risk increases as you get older, and men are three times more likely than women to develop the disease.
Mouth cancer can be treated if diagnosed at an early stage, so it’s important to see your dentist or doctor immediately if you notice any changes in your mouth.
Symptoms of mouth cancer
The most common sites of mouth cancer are the lips, tongue and floor of the mouth, but it can also develop in the gums, the inside lining of the cheeks, roof of the mouth, hard and soft palate, tonsils and salivary glands.
The symptoms of mouth cancer can include:
- a visible mass or lump that may or may not be painful
- a mouth ulcer that won’t heal
- white or red patches on the mouth, tongue or gums
- loss of sensation anywhere in the mouth
- trouble swallowing
- impaired tongue mobility
- difficulty moving your jaw
- loose teeth or sore gums
- altered taste
- swollen lymph glands.
Having these symptoms does not mean that you have mouth cancer, but if you experience or notice any of these you should speak to your dentist or doctor.
Risk factors for mouth cancer
Tobacco and alcohol are responsible for over 75% of mouth cancers, by exposing your mouth to cancer-causing substances (carcinogens). If you smoke and drink, your risk of developing mouth cancer is significantly higher. Alcohol may enable other carcinogens, including tobacco, to enter and damage cells.
Tobacco use includes cigarettes, cigars, pipes and chewing. If you smoke or chew tobacco, you are twice as likely to develop mouth cancer as a non-smoker. Chewing or smoking areca nut, betel quid, pan or gutka also increases your risk.
Where in the mouth the cancer develops depends on how you use the tobacco product. For example, if you have a habit of chewing tobacco in your left cheek, you may be prone to cancer of that cheek.
Mouth cancer is six times more common in alcohol drinkers than in non-drinkers. The more you drink, the greater the risk.
Other risk factors include:
- being over 40 years of age
- being male – men are three times as likely to develop mouth cancer as women
- sun exposure – ultraviolet (UV) radiation can lead to skin cancer on the lips
- poor oral hygiene
- being overweight or obese.
Diagnosing mouth cancer
Mouth cancer is diagnosed using a number of tests including:
- physical examination of the mouth by your dentist or doctor
- biopsy (taking a sample of tissue for examination in a laboratory)
- CT scan
- MRI (magnetic resonance imaging) scan
- PET (position emission tomography) scan.
Test results can take a few days to come back. It’s natural to feel anxious waiting to get your results. It can help to talk to a close friend or relative about how you’re feeling. You can also contact the Cancer Council on 13 11 20 and speak with a cancer nurse.
How mouth cancer can spread
The membranes of the mouth, nose and throat are lined with flat, firm cells called squamous cells. Most mouth cancers originate in these surface cells. Without treatment, squamous cell carcinoma can spread into deeper tissue, including muscle and bone, or to the throat or lymph glands in the neck. Mouth cancer can also migrate to other parts of the body if it accesses the bloodstream or lymphatic system, so it’s important to diagnose and treat it early.
Treatment for mouth cancer
Treatment depends on the size, type and location of the cancer and whether it has spread, but can include:
- surgery – the tumour is surgically removed, if it is small. The lymph glands on the affected side may also be removed if the tumour extends into these
- radiation therapy – small, precise doses of ionising radiation target and destroy cancer cells. This type of treatment is often all that’s needed for small, localised cancers
- chemotherapy – the use of cancer-killing drugs, often in combination with surgery and/or radiotherapy. Chemotherapy may sometimes be used to shrink a tumour before surgery
- multi-modal treatments – surgery on larger tumours may be followed with radiation therapy. Chemo-radiotherapy may also be used
- long term monitoring – this may include regular oral examinations and occasional x-rays to make sure the cancer hasn’t come back
- ongoing care – this may include speech therapy, dietary advice, regular medical follow-up and counselling.
All treatments have side effects. These will vary depending on the type of treatment you are having. Many side effects are temporary, but some may be permanent. Your doctor will explain all the possible side effects before your treatment begins.
When mouth cancer can’t be cured
If your mouth cancer has spread to other parts of your body and it is not possible to cure it by surgery, your doctor may still recommend treatment.
Treatment for control of cancer may include chemotherapy, radiotherapy, surgery, immunotherapy or pain-relieving medications (or a combination of these). Treatment may help to relieve symptoms, might make you feel better and may allow you to live longer.
You may hear your doctor call your treatment ‘palliative’. This means treatment designed to relieve symptoms rather than cure. The Cancer Council booklet Treatment for advanced cancer may be helpful to read.
Reducing your risk of mouth cancer
Regularly attending the dentist for check-ups and flagging any changes to your mouth is important. You can reduce your risk of mouth cancer by:
- stopping smoking or chewing tobacco – find out more about smoking and oral health
- reducing the amount of alcohol you drink
- eating a healthy diet, including plenty of non-starchy vegetables and fruit (which are thought to help lower the risk of mouth cancer)
- maintaining a healthy body weight
- using sun protection on your lips.
Following this advice doesn’t mean that you will never get mouth cancer, but it can reduce your risk, and has other health benefits too.
Where to get help
This page has been produced in consultation with and approved by:
Dental Health Services Victoria
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