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Mouth cancer

 

Expert reviewer, Mr Malcolm Cameron, Consultant Head and Neck, Oral and Maxillofacial Surgeon
Next review due, October 2021

Mouth cancer is the result of cells in your mouth growing abnormally and out of control. The medical name for mouth cancer is oral cancer. Around one in 75 men and one in 150 women in the UK will be diagnosed with it at some point in their life.

The earlier mouth cancer is diagnosed, the more effective treatment is likely to be. So it’s important to recognise any symptoms and get them checked out by a dentist or doctor as soon as you can.

About mouth cancer

Mouth cancer can start anywhere in your mouth, including:

  • your cheek lining and inside of your lip
  • the floor of your mouth and undersurface of your tongue
  • the edges of your tongue
  • your gums, including the triangle area of the gum behind your back teeth

Mouth cancer can also be classed depending on the type of cell it starts in. Nine out of 10 mouth cancers grow in the flat, skin-like cells that line the inside of your mouth. These are called squamous cell carcinomas.

Other, rarer types of mouth cancer include:

  • salivary gland cancer, which starts in your salivary gland cells
  • lymphoma, which can start in lymph tissue near the base of your tongue and tonsils
  • melanoma, which can start in skin pigment cells in your mouth or on your lips

Symptoms of mouth cancer

You might not notice any symptoms at first if you have mouth cancer. But as the cancer progresses, you may start to develop different symptoms depending on which part of your mouth is affected. These can include:

  • a lump in your mouth or on your lip that doesn’t go away after a couple of weeks
  • an ulcer in your mouth that isn`t healing
  • a lump in your neck or enlarged lymph nodes in your neck
  • pain in your mouth
  • a sore throat that you’ve had for a long time, and doesn’t seem to be getting better
  • difficult or painful chewing or swallowing
  • unexplained bleeding in your mouth
  • difficulty moving your jaw
  • red or red and white patches in your mouth
  • numbness of your lip or another part of your mouth
  • loose teeth or dentures that no longer fit you properly
  • difficulties with your speech – you may sound hoarse or quieter, or you may slur your words
  • pain in your ear – caused by damage to a nerve near your tongue
  • unexplained weight loss

These symptoms aren't necessarily signs of mouth cancer, but if you have any of them, see your dentist or GP.

Diagnosis of mouth cancer

Your dentist might spot the early signs of mouth cancer during a routine check-up.

If you see your GP or dentist with symptoms of mouth cancer, they’ll ask you some questions about your symptoms and your medical history. They may ask to examine your mouth, as well as feel your neck and face to check for swellings. Depending on what symptoms you have, your GP may refer you to a dentist, who can assess your symptoms further. If your dentist or GP thinks your symptoms could be due to mouth cancer, they will refer you to a doctor specialising in mouth cancer.

The specialist may want to take a biopsy (a small sample of tissue) from the affected area. This will be sent to a laboratory for testing to check if there are any cancerous cells. If the affected area is in a place they can access easily, they may just give you a local anaesthetic to numb the area and gently remove a small piece of tissue. Sometimes, your doctor may need to use a special instrument called a nasoendoscope or laryngoscope to look at the affected area and take a biopsy. These are narrow, flexible tubes that can be passed up your nose and into your throat.

Staging

If you're found to have cancer, you will usually need to have other tests to see how big your cancer is and whether it’s spread. This is called staging. Staging can help doctors estimate how your cancer is likely to progress, and what’s the best course of treatment for you.

The tests may include the following.

  • Scans, to check the location, size and extent of the cancer. You may have a computer tomography (CT) scan, a magnetic resonance imaging (MRI) scan or a PET-CT scan. A PET-CT scan uses a CT scan with a radioactive dye to show up cancer cells.
  • Biopsies of lymph nodes in your neck. Lymph nodes are part of your lymphatic system, which carries fluid called lymph around your body. If your mouth cancer has started to spread, there may be cancer cells in these lymph nodes. Your doctor will usually use a fine needle and a syringe to take a sample of cells from lymph nodes in your neck.
  • Triple endoscopy. Your doctor will use an endoscope to look at the inside of your mouth and throat, as well as your oesophagus and windpipe, to check for other cancers. An endoscope is a narrow, flexible, tube-like telescopic camera.

Treatment of mouth cancer

What treatment you’re offered will depend on what type of mouth cancer you have, where it is and how far it’s spread. Your doctor will discuss your treatment options with you. If you smoke, they will encourage you to stop before you start any treatment. This is because smoking can increase your risk of complications and reduce the chance that treatment will work.

You will usually be offered surgery or radiotherapy first. Your doctor may also suggest other non-surgical treatments, such as chemotherapy and biological therapy.

Surgery

The aim of surgery is to remove all of the cancer. Exactly what type of surgery you’ll need will depend on where your cancer is, how big it is and whether it’s spread. Your surgeon will explain what they’re planning and what to expect afterwards.

You may need to have reconstructive surgery to repair the bones and soft tissues of your mouth and face. This will depend on what tissues your surgeon has had to remove to take the tumour away. It’s possible that the surgery may affect how you chew, swallow or talk, as well as your appearance. This is more likely the larger your tumour is. Your surgeon will talk to you about these risks before you have any surgery, and what support will be available afterwards to help you.

Radiotherapy

You may have radiotherapy instead of surgery to treat a small cancer, or after surgery to make sure all of the cancer cells have been destroyed.

Radiotherapy can be given as a beam of radiation, directed at the cancerous cells or as a radioactive implant that gives out radiotherapy inside your body (brachytherapy). If you’re having external radiotherapy, you may need treatment for several days a week, over a period of several weeks. Implants are permanent, but the radiation they give off gradually decreases over a period of a few weeks.

Radiotherapy won’t affect your voice and ability to swallow, like surgery might do. But you may still notice some side-effects, such as a sore or dry mouth, or changes in how you taste foods. Most side-effects will start to improve within a few weeks following your treatment.

Chemotherapy

Chemotherapy is a treatment for cancer that uses medicines to destroy cancer cells. You may be offered chemotherapy alongside radiotherapy as an alternative to surgery, to destroy advanced cancer that hasn’t spread beyond your mouth. You may also have it to relieve symptoms of advanced cancer that’s spread to other parts of your body, and to slow down its growth.

Chemotherapy is associated with several side-effects, including sickness and being more susceptible to infections. The team treating you will talk to you about what to look out for and how to manage this.

Biological therapy

If you’re unable to tolerate surgery or chemotherapy, your doctor may suggest treatment with a drug called cetuximab. Cetuximab is a type of biological therapy. These are drugs that change how cancer cells grow and spread. It works by binding to the cancer cells and stopping them from growing. You’ll have cetuximab as an injection, usually alongside radiotherapy.

Causes of mouth cancer

The most common causes of mouth cancer are smoking and drinking more alcohol than recommended. Smoking or chewing tobacco in any form, and chewing betel nuts (which is common in some developing countries), can increase your risk.

Infection with human papillomavirus (HPV) is also thought to cause cancer of the mouth in some people. You’re at greater risk of HPV-associated mouth cancer the more sexual partners you have, especially if you have oral sex.

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Prevention of mouth cancer

Making some simple lifestyle changes can reduce your risk of mouth cancer. These include the following.

  • If you smoke or chew tobacco, try to stop. Visit your local Stop Smoking Service for support (see Other helpful websites below).
  • If you drink alcohol, stop or cut down. Current advice is that both men and women shouldn’t drink more than 14 units of alcohol a week.
  • Look after your teeth and visit your dentist for regular check-ups.
  • Make sure you are following a healthy, balanced diet, with plenty of fruit and vegetables.

Help and support

Being diagnosed with mouth cancer can come as a shock. An important part of cancer treatment is getting the support you need to deal with the emotional aspects as well as the physical symptoms.

Talk to your doctor or nurse about the services available to you. Support services can offer both practical and emotional support.

Local cancer support groups can be a good source of help and information. Ask your doctor or nurse about local groups, or look on cancer charity websites. See our Other helpful websites section below for some suggestions.

Palliative care nurses can help care for you in your own home, or in a hospice, if you have more advanced cancer.

Frequently asked questions

  • Mouth ulcers are very common. They are usually caused by something simple, like biting your cheek, or eating hot food, and go away on their own after a few days. Ulcers in your mouth can also be caused by skin problems, allergies and conditions affecting your immune system. A common cause of recurrent mouth ulcers is a condition called aphthous stomatitis. This is thought to affect up to one in four people.

    If you’ve just noticed an ulcer in your mouth and you don’t have any other symptoms, wait to see if it goes away on its own. If it hasn’t gone within three weeks, or you have any other concerns, book an appointment to see your dentist. Dentists are specially trained to check your mouth for signs of cancer. They will be able to tell if your ulcer might be due to cancer and refer you to a specialist if necessary. Your dentist will usually carry out an oral health check when you go for your routine dental appointments, which will include looking at any ulcers.

  • You may do. There are various side-effects associated with treatments for mouth cancer that can affect your ability to eat and drink. Your doctor and nurse can advise you on ways to help ease your symptoms and get the food and fluids you need.

    More information

    After surgery or radiotherapy for mouth cancer, you may find it difficult to chew and swallow food. Your doctor will be able to prescribe painkillers to help relieve any pain and reduce swelling. They may also give you a mouthwash or gel that can help to protect your mouth. You may find it better to stick to a soft diet until you recover – with things like soups, casseroles, pasta and scrambled egg.

    Radiotherapy can affect your taste and smell, as well as causing a dry mouth, which may make eating uncomfortable. Ask your doctor about artificial saliva substitutes, and keep some water with you, to keep your mouth moist. Choose foods with stronger flavours than you normally would if you have found your taste has changed, such as garlic, herbs, spices and lemon juice. Try adding sauces, pickles, or relish for flavour.

    If you can’t eat at all during treatments such as radiotherapy, you may need to have a feeding tube for some time. The feeding tube may go up your nose and into your stomach, or it might go directly through the skin of your abdomen (tummy), into your stomach. It’s a simple procedure and will make sure you get all the food and nutrition you need. The feeding tube can be removed when you’re able to eat again.

    Treatments for mouth cancer can also make you more likely to develop tooth decay. Your dentist will talk to you about maintaining good dental hygiene in the long term. They may suggest you use a high-fluoride toothpaste or special mouth wash, to help prevent decay.

  • Whether your speech is affected and how much, depends on where your cancer is, how big it is and the type of treatment you have. You’re more likely to have problems with your speech if you have surgery for cancer affecting your tongue or soft palate.

    Your voice may sound different or you may find it more difficult to talk. Your voice may be quieter or huskier, or you may slur some of your words. Sometimes these problems may only be temporary – for instance, they might get better once any swelling from surgery has gone down. With help from a speech and language therapist, any changes to your speech will usually improve over time.

  • Sometimes, radiotherapy can damage your salivary glands, which means you’ll produce less or no saliva. This can make your mouth feel dry and uncomfortable to chew or swallow. It can take several months to get back to normal, but occasionally, a dry mouth can be permanent.

    There are several things you can do to make your mouth feel more comfortable. These include:

    • chewing sugar-free chewing gum
    • taking regular sips of water, especially when you're eating
    • eating moist foods with sauces or gravy
    • sucking ice chips
    • using artificial saliva, mouthwashes, lozenges or toothpaste (your doctor may be able to prescribe these)
    • using moist cotton wool, or a soft toothbrush to clean your tongue

    You should have regular check-ups with your dentist, as you’re more likely to develop mouth infections and tooth decay after radiotherapy. Ask your doctor or dentist for more information and advice.


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Related information

    • About mouth and oropharyngeal cancer. Cancer Research UK. www.cancerresearchuk.org, last reviewed 10 May 2018
    • Survival. Mouth and oropharyngeal cancer. Cancer Research UK. www.cancerresearchuk.org, last reviewed 15 June 2018
    • Cancers of the oral cavity. PatientPlus. www.patient.info, last checked 27 July 2015
    • Oropharyngeal cancer. BMJ Best Practice. bestpractice.bmj.com, last reviewed June 2018
    • Types and grades. Mouth and oropharyngeal cancer. Cancer Research UK. www.cancerresearchuk.org, last reviewed 2 October 2014
    • Suspected cancer: recognition and referral. National Institute for Health and Care Excellence (NICE), June 2015. www.nice.org.uk
    • Head and neck cancers. Oxford handbook of oncology. Oxford Medicine Online. oxfordmedicine.com, published September 2015
    • Seeing your GP. Mouth and oropharyngeal cancer. Cancer Research UK. www.cancerresearchuk.org, last reviewed 8 May 2018
    • Biopsy. Mouth and oropharyngeal cancer. Cancer Research UK. www.cancerresearchuk.org, last reviewed 8 May 2018
    • Mehanna H, Evans M, Beasley M, et al. Oropharyngeal cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol 2016; 130(S2):S90–96
    • PET-CT scan. Mouth and oropharyngeal cancer. Cancer Research UK. www.cancerresearchuk.org, last reviewed 9 May 2018
    • Lymph node biopsy. Mouth and oropharyngeal cancer. Cancer Research UK. www.cancerresearchuk.org, reviewed 9 May 2018
    • About surgery. Mouth and oropharyngeal cancer. Cancer Research UK. www.cancerresearchuk.org, last reviewed 14 October 2014
    • Clarke P, Radford K, Coffey M, et al. Speech and swallow rehabilitation in head and neck cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol 2016; 130(S2):S176–S180
    • External radiotherapy. Mouth and oropharyngeal cancer. Cancer Research UK. www.cancerresearchuk.org, last reviewed 30 September 2014
    • Internal radiotherapy. Mouth and oropharyngeal cancer. Cancer Research UK. www.cancerresearchuk.org, last reviewed 14 October 2014
    • Side-effects of radiotherapy. Mouth and oropharyngeal cancer. Cancer Research UK. www.cancerresearchuk.org, last reviewed 8 June 2018
    • About chemotherapy. Mouth and oropharyngeal cancer. Cancer Research UK. www.cancerresearchuk.org, last reviewed 14 October 2014
    • Biological therapy. Mouth and oropharyngeal cancer. Cancer Research UK. www.cancerresearchuk.org, last reviewed 14 October 2014
    • UK Chief Medical Officers’ low risk drinking guidelines. Department of Health, August 2016. ww.gov.uk
    • Support at home for you and your family. Mouth and oropharyngeal cancer. Cancer Research UK. www.cancerresearchuk.org, last reviewed 11 May 2018
    • Assessment of oral ulceration. BMJ Best Practice. bestpractice.bmj.com, last reviewed June 2018
    • History and examination. Oxford handbook of clinical dentistry. Oxford Medicine Online. oxfordmedicine.com, published online August 2014
    • Eating. Mouth and oropharyngeal cancer. Cancer Research UK. www.cancerresearchuk.org, last reviewed 11 May 2018
    • Tips for diet problems. Coping with cancer. Cancer Research UK. www.cancerresearchuk.org, last reviewed 12 October 2017
    • Butterworth C, McCaul L, Barclay C. Restorative dentistry and oral rehabilitation: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol 2016; 130(S2): S41–S44
    • Changes in your speech. Mouth and oropharyngeal cancer. Cancer Research UK. www.cancerresearchuk.org, last reviewed 11 May 2018
    • Mouth and teeth after head and neck radiotherapy. Cancer Research UK. www.cancerresearchuk.org, last reviewed 14 March 2016
  • Reviewed by Pippa Coulter, Freelance Health Editor, October 2018
    Expert reviewer Mr Malcolm Cameron, Consultant Head and Neck, Oral and Maxillofacial Surgeon
    Next review due October 2021



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