What is Oral Cancer?
Oral cancer is cancer that forms on the inside of the mouth, including the back of the throat. Also referred to as oral cavity cancer or mouth cancer, this condition can affect the mouth, gums, lips, and tongue. Cancer at the back of the throat or pharynx is classified as pharyngeal (oropharyngeal) cancer.
Oral cancer is one of the most common forms of head and neck cancer. A projected 54,000 people a year will be diagnosed with oral cancer in the United States. Oral cancer is treatable, especially if caught early, so knowing the symptoms and other risk factors is essential.
Stages of Oral Cancer
The stages of oral cavity cancer are classified based on the tumor size and how far the cancer has spread. They are ranked I-IV and defined as follows:
- Stage I: The oral tumor is 2 cm or less in size, and the cancer has not spread to any other areas
- Stage II: The tumor in the mouth is between 2 and 4 cm, and the cancer has not spread to any other areas in the body
- Stage III: The tumor is larger than 4 cm (around 2 inches), and the cancer may have spread to the lymph nodes but not to other parts of the body
- Stage IV: The tumor is larger than 4 cm, and the cancer has spread to the lymph nodes and spread (metastasized) to other parts of the body
The TNM system may also determine oral cancer stages. T refers to the location and size of the tumor. N is used when oral cancer has spread to the lymph nodes, and M indicates that cancer has metastasized to other parts of the body—a small stage I tumor can be described as: T1, N0, M0.
Types of Oral Cancer
Different subtypes of mouth cancer are classified by where they first occur in the oral cavity. Types of oral cancer can include:
- Gum cancer - Sometimes mistaken for gingivitis, gum cancer can manifest as bleeding, cracking gums with small sores on the lining
- Lip cancer - This is the most common type of mouth cancer, most typically found on the lower lip
- Tongue cancer - Squamous cells can develop on the surface of the tongue
- Hard palate cancer – Develops on the roof of the mouth
- Under the tongue – The floor of the mouth is affected
- Inner cheek cancer – Develops on the inner cheek; also known as Buccal Mucosa cancer
Signs & Symptoms of Oral Cancer
There is a range of mouth cancer symptoms--some of them can resemble symptoms of less serious conditions, such as a toothache, canker sore, or gingivitis. If your oral symptoms continue for over two weeks, consult a doctor or dentist.
The signs of oral cancer can include:
- Sores that bleed easily on the inside of your mouth and don’t go away after two weeks
- Reddish or white patches (or a combo of both colors) on the inside of the mouth
- Swelling bumps or lumps in the mouth area, including the gums, lips, cheek, and tongue
- Unexplained bleeding anywhere in or around the oral cavity
- Crusty spots or rough areas on your gums, lips, or inside your mouth
- Chronic earache
- Trouble swallowing or chewing
- Difficulty moving your tongue/jaw or speaking
- Continued numbness or pain in the face, mouth, or neck
- Unexplained weight loss
- Chronic sore throat or hoarseness or any other changes in the way you speak
Oral cancers are twice more likely to occur in men than in women. This could be due to elevated use of tobacco and alcohol in men vs. women, a contributing risk factor to developing the disease.
What Causes Oral Cancer?
Cancerous cells develop when the DNA of healthy cell tissues mutates, turning abnormal and destroying surrounding cells.
Most mouth cancers are squamous cell carcinoma—flat, thin cells found in the tissue that makes up the skin's surface. Less common oral cancers are oral verrucous carcinoma (a form of squamous cell carcinoma) and oral melanoma.
Oral cancers develop when the DNA in the cells of the lips and inside the mouth mutate into cancer cells. While it is unknown why these mutations in the DNA occur and form oral tumors, there are risk factors that increase the likelihood of developing the condition.
Risk Factors for Oral Cancer
Anyone can develop oral cancers, but there are risk factors associated with the disease, such as:
- Tobacco use, including smoking cigarettes, pipes, cigars, vaping, and chewing tobacco
- Excessive alcohol consumption, especially in combination with smoking
- A family history of cancer - Some inherited genetic mutations increase the chances of developing oral cancer
- Excessive sun exposure - Don’t forget to use lip balm with SPF to protect your lips
- HPV (human papillomavirus) – Although HPV is the main cause of oropharyngeal cancer, its prevalence in oral cancers is relatively low. HPV is a sexually transmitted virus. Vaccines available to prevent HPV, typically recommended for young people and people with high risk.
- Age - Adults over the age of 55 are more likely to develop oral cancer
- Gender – Males are more prone to developing oral cancer than females
- Unhealthy diet - Particularly a diet low in vegetables and fruits
While there’s no fool-proof method for preventing mouth cancer, there are actions you can take to lower your risk of getting it, including:
- Quitting tobacco
- Moderating alcoholic consumption
- Avoiding excessive sun exposure to avoid cancer of the lips. Wear a hat and lip sunscreen
- Visiting the dentist
Trust NewYork-Presbyterian for Oral Cancer Care
The nationally recognized cancer doctors at NewYork-Presbyterian are experts in identifying the symptoms and underlying risk factors for all types of head and neck cancers, including oral cancer, pharyngeal cancer, laryngeal cancer, and cancer of the sinuses and nasal cavity.
If you are at risk for oral cancer and are exhibiting symptoms, our compassionate cancer care teams can render a diagnosis and develop a treatment plan and protocol designed just for you.
Early detection is key. Don’t hesitate to reach out to us for an appointment.