Squamous Cell Cancer of the Oral Cavity - Oral Cancer

Oral cancer is a group of abnormal cells that involves the mouth or the oropharynx. The oropharynx is the part of the throat at the back of the mouth.

What is going on in the body?

Oral cancer occurs in the top layer of cells lining the mouth and oropharynx. The abnormal cells may be found in the lips, tongue, or inside of the cheeks. The tumor may also involve the floor or roof of the mouth, the tonsils, or the oropharynx. Oral cancer may start as a sore that is not yet cancerous. Over time, probably years, it can develop into oral cancer.

Oral cancers can grow outward as a wart-like mass. Or they can be ulcers that invade inwardly. The longer that oral cancers grow untreated, the more likely they are to metastasize, or spread throughout the body.

What are the causes and risks of the disease?

Oral cancer can occur at any age, but is most common in people older than the age of 45. Some of the factors that increase a person's risk for oral cancer are as follows:

The herpes simplex and the human papillomavirus are being investigated as possible causes of oral cancer.

What are the signs and symptoms of the disease?

Following are some of the symptoms of oral cancer:

How is the disease diagnosed?

Diagnosis of oral cancer begins with a medical history and physical exam. A biopsy, or sample, may be taken from suspicious masses. If cancer is found, the healthcare provider will order tests to see the extent of the cancer. These may include X-rays of the chest and jaw. The provider may also order a CT scan, ultrasound, or MRI.

Oral cancers are graded as poorly or well differentiated, a process that looks at the types of cancer cells in the skin lesions. The following factors are also taken into account:

What can be done to prevent the disease?

Lifestyle changes can be highly effective in preventing oral cancer. A person who uses tobacco in any form should stop. Alcohol use should be avoided, or strictly limited. Lip balms and other methods should be used to avoid sun exposure. It's important to eat a healthy diet, following the food guide pyramid. Good oral hygiene and regular dental care are also important.

What are the long-term effects of the disease?

Oral cancer can be completely cured if it is treated in the early stages. Many people remain free of the cancer after effective treatment. Others, however, are at risk for a second episode unless they make lifestyle changes to lower their risk factors. Oral cancer that spreads to aggressive local neck disease can cause death. Rarely, death occurs from tumors that have developed in distant parts of the body.

What are the risks to others?

Oral cancer is not contagious and poses no risk to others.

What are the treatments for the disease?

Treatment options for oral cancer vary, depending on a number of factors, such as:

The healthcare provider may also recommend a complete dental exam before treatment is started. Oral cancer treatment may make the person's mouth more sensitive and prone to infection. The provider may recommend that dental problems be treated before the person starts cancer therapy.

Some of the treatment options for oral cancer are as follows:

Two or more treatment options may be combined to kill as many cancer cells as possible.

What are the side effects of the treatments?

Surgeons try to minimize deformity and loss of function. Sometimes, in an effort to cure a person, it is difficult to achieve these goals. Surgeons need to remove about 1 to 2 centimeters of cancer-free tissue around the sore in people who may be cured. This can result in lip deformity, scarring, loss of tongue function, and difficulty swallowing.

Radiation therapy may cause the following:

People who receive neck and throat radiation need to have all of their teeth removed. Teeth cannot survive this treatment and dentures are required.

Chemotherapy may cause the following problems:

What happens after treatment for the disease?

People who have had oral cancer must be closely followed to make sure the cancer does not return. The person should also be monitored to make sure no new oral cancers occur. If the cancer has spread to other body organs, additional treatment may be needed.

How is the disease monitored?

The person will also need frequent mouth exams to ensure that oral cancer does not return. This person will remain at risk for developing other cancers. Chest X-rays and CT scans may be done to determine whether cancer has spread or developed in other parts of the body. Any new or worsening symptoms should be reported to the healthcare provider.

Author:Thomas Fisher, MD
Date Written:
Editor:Ballenberg, Sally, BS
Edit Date:09/30/01
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:09/10/01