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What is mouth cancer?

Mouth cancer, also known as oral cancer or cancer of the oral cavity, is often used to describe a number of cancers that start in the region of the mouth. These most commonly occur on the lips, tongue and floor of the mouth but can also start in the cheeks, gums, roof of the mouth, tonsils and salivary glands. Mouth cancers are generally classified as head and neck cancers. While the term mouth cancer is seldom used in scientific literature nor in Australia's official cancer data collection system, we use it here because it is used in basic information to promote cancer prevention and is easy to understand.



Symptoms of Mouth cancer

Symptoms of mouth cancer can include:

  • a lump in your neck

  • loose teeth

  • swelling or a sore on your lip that won't heel

  • difficult or painful swallowing

  • changes in speech

  • bleeding or numbness in the mouth

  • white or red patches on the mouth, tongue or gums

  • unexplained weight loss



Causes of mouth cancer

The main risk factors for most mouth cancers are tobacco and alcohol consumption. Other risk factors can include:

  • human papillomavirus (HPV)

  • epstein-barr virus (EBV)

  • family history of mouth cancers

  • poor oral hygiene and gum disease

  • exposure to the sun

  • chewing the seed of the areca palm tree (sometimes called areca or betel nut)



Diagnosis of mouth cancer

Signs of mouth cancer are often first detected by your dentist. Your doctor or dentist is likely to examine your mouth, throat, tongue, cheeks, ears and eyes. You may also be referred to a specialist for additional tests, such as:

Endoscopy

In an endoscopy, a flexible tube (endoscope) is used to examine the nose, sinuses, larynx (voice box) and pharynx (throat).

Biopsy

A biopsy is the removal of a small amount of tissue which is sent to a pathologist to determine if cancer cells are present.

X-rays

X-rays of the head and neck can be used to see if cancer cells are present in the jaw, lungs or chest.

Scans

PET, CT and MRI scans to determine the location, stage and spread of cancer cells.



Treatment for mouth cancer

Treatment for mouth cancer depends on the type of cancer, where it is located and how far it has spread.

Staging

Tests such as CT and MRI scans help to determine how far the cancer has spread. Staging helps your doctor decide on the best treatment options for you.

Surgery

A common treatment for mouth cancers is surgery to remove the tumour, particularly in early-stage cancer. The extent of surgery may depend on the size of the tumour and how far the cancer has spread. Surrounding tissue and lymph nodes may also be removed.

Radiation therapy (radiotherapy)

Radiation therapy (also known as radiotherapy) can be used on its own to treat some small mouth cancers. Radiation therapy can also be used in combination with chemotherapy for more advanced cancers. Your doctor may also recommend radiation therapy after surgery.

Chemotherapy

Chemotherapy uses drugs to kill or shrink tumours. It can be used on its own or with radiation therapy. You may have chemotherapy to shrink a tumour before surgery or if cancer has come back after other treatments.

Palliative care

Palliative care aims to improve your quality of life without trying to cure the cancer. It may be recommended by your doctor to alleviate the symptoms of cancer or the side-effects of treatment.

Treatment Team

Depending on your treatment, your treatment team may consist of a number of different health professionals, such as:
  • GP (General Practitioner)- looks after your general health and works with your specialiststo coordinate treatment.
  • Ear, nose and throat (ENT) specialist- treats disorders of the ear, nose and throat
  • Head and neck surgeon- diagnoses and treats cancers of the head and neck.
  • Oral surgeon- treats disorders of the mouth, face and jaws.
  • Reconstructive (plastic) surgeon- performs any complex reconstructive surgery that restores or repairs the body's appearance and function.
  • Dentist- evaluates and treats the mouth and teeth
  • Radiation oncologist- prescribes and coordinates radiation therapy treatment.
  • Medical oncologist- prescribes and coordinates the course of chemotherapy.
  • Cancer nurses- assist with treatment and provide information and support throughout your treatment.
  • Dietitian- recommends an eating plan to follow while you are in treatment and recovery.
  • Speech pathologist- helps with swallowing and communication difficulties during and after treatment.
  • Other allied health professionals- such as social workers, pharmacists and counsellors.


Screening for mouth cancer

There is currently no screening for mouth cancer available in Australia.



Preventing mouth cancer

Around 59% of mouth cancers in Australia are caused by smoking. Around 31% are caused by excess alcohol consumption. So quitting smoking and moderating alcohol consumption will significantly reduce your risk of developing mouth cancer, especially those inside the mouth. Cancers of the lip are commonly associated with UV exposure, so it is also important to protect yourself from the sun when the UV is 3 or above.



Prognosis for mouth cancer

While it is not possible to predict the exact course of a disease, your doctor may give you a prognosis, the likely outcome of your disease based on the type of cancer, your test results and the rate of tumour growth. Other factors include your age, medical history and overall health.

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