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Oral cancer

Cancer - mouth; Mouth cancer; Head and neck cancer - oral; Squamous cell cancer - mouth; Malignant neoplasm - oral; Oropharyngeal cancer - HPV; Carcinoma - mouth

Oral cancer is cancer that starts in the mouth.

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Throat anatomy
Mouth anatomy

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Causes

Oral cancer most commonly involves the lips or the tongue. It may also occur on the:

Most oral cancers are a type called squamous cell carcinoma. These cancers tend to spread quickly.

Smoking and other tobacco use are linked to most cases of oral cancer. Heavy alcohol use also increases the risk for oral cancer.

Human papillomavirus (HPV) infection (the same virus that causes genital warts) account for a larger number of oral cancers than in the past. One type of HPV, type 16 or HPV-16, is much more commonly associated with almost all oral cancers.

Other factors that may increase the risk for oral cancer include:

Some oral cancers begin as a white plaque (leukoplakia) or as a mouth ulcer.

Men develop oral cancer twice as often as women do. It is more common in men older than 40.

Symptoms

Oral cancer can appear as a lump or ulcer in the mouth that may be:

Other symptoms may include:

Exams and Tests

Your doctor or dentist will examine your mouth area. The exam may show:

A biopsy of the sore or ulcer will be done. This tissue will also be tested for HPV.

CT, MRI and PET scans may be done to determine if the cancer has spread.

Treatment

Surgery to remove the tumor is recommended if the tumor is small enough.

If the tumor has spread to more tissue or nearby lymph nodes, a larger surgery is done. The amount of tissue and the number of lymph nodes that are removed depend on how far the cancer has spread.

Surgery may be used together with radiation therapy and chemotherapy for larger tumors.

Depending on what type of treatment you require, supportive treatments that may be needed include:

Support Groups

You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.

Outlook (Prognosis)

About one half of people with oral cancer will live more than 5 years after they are diagnosed and treated. If the cancer is found early, before it has spread to other tissues, the cure rate is nearly 90%. More than half of oral cancers have spread when the cancer is detected. Most have spread to the throat or neck.

It is possible, but not fully proven, that cancers that test positive for HPV may have a better outlook. Also, those who smoked for less than 10 years may do better.

People who require larger doses of radiation along with chemotherapy are more likely to have more severe problems with swallowing.

Oral cancers can recur if tobacco or alcohol use is not stopped.

Possible Complications

Complications of oral cancer may include:

When to Contact a Medical Professional

Oral cancer may be discovered when the dentist does a routine cleaning and examination.

Call your provider if you have a sore in your mouth or lip or a lump in the neck that does not go away within 1 month. Early diagnosis and treatment of oral cancer greatly increases the chance of survival.

Prevention

Oral cancer may be prevented by:

HPV vaccines recommended for children and young adults target HPV sub-types most likely to cause oral cancers. They have been shown to prevent most oral HPV infections. It is not clear yet whether they also are able to prevent oral cancers.

Related Information

Cancer
Alcohol use and safe drinking
Dental care - adult
Leukoplakia
Mouth ulcers
Metastasis
Dry mouth during cancer treatment
Mouth and neck radiation - discharge
Swallowing problems

References

Fakhry C, Gourin CG. Human papillomavirus and the epidemiology of head and neck cancer. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 75.

Little JW, Miller CS, Rhodus NL. Cancer and oral care of patients with cancer. In: Little JW, Miller CS, Rhodus NL, eds. Little and Falace's Dental Management of the Medically Compromised Patient. 9th ed. St Louis, MO: Elsevier; 2018:chap 26.

National Cancer Institute website. Oropharyngeal cancer treatment (adult) (PDQ) - health professional version. www.cancer.gov/types/head-and-neck/hp/adult/oropharyngeal-treatment-pdq#link/_528. Updated January 27, 2020. Accessed March 31, 2020.

Wein RO, Weber RS. Malignant neoplasms of the oral cavity. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 93.

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Review Date: 10/30/2019  

Reviewed By: Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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