Introduction

Mouth cancer, also known as oral cancer, is where a tumour develops in the lining of the mouth. It may beon the surface of the tongue, the insides of the cheeks, the roof of the mouth (palate), or thelips or gums.

Tumourscan also develop in the glands that produce saliva, the tonsils at the back of the mouth,and thepart of the throat connecting your mouth to your windpipe (pharynx). However, these are less common.

This page covers:

Oral cancer

Types

Causes

Who's affected

Treatment

Complications

Prevention

Outlook

Symptoms of mouth cancer

Symptoms of mouth cancer include:

• sore mouth ulcers that don't heal within several weeks
• unexplained, persistent lumps in the mouth that don't go away
• unexplained, persistent lumps in the neck that don't go away
• unexplained looseness of teeth, or sockets that don't heal after extractions
• unexplained, persistent numbness or an odd feeling on the lip or tongue
• sometimes, white orred patches on the lining of themouth or tongue these can be early signsof cancer, so theyshouldalso be investigated
• changes in speech, such as a lisp

See your GP or dentist if these symptomsdon't heal within three weeks, particularly if you drink or smoke heavily.

Types of mouth cancer

Mouth canceris categorised by the type of cell the cancer(carcinoma) starts in.

Squamous cell carcinoma is the most common type of mouth cancer, accounting for9 out of 10 cases.

Squamous cells are found in many places around the body, including the inside of the mouth and the skin.

Less common types of mouth cancer include:

• adenocarcinomas cancers that develop inside the salivary glands
• sarcomas these grow from abnormalities in thebone, cartilage, muscle or other body tissue
• oral malignant melanomas where the cancer starts in melanocytes, the cells that produce skin pigment; they appear as very dark, mottled swellings that often bleed
• lymphomas these grow from cells normally found in lymph glands, but can also develop in the mouth

What causes mouth cancer?

Things that increase your risk of developing mouth cancer include:

• smoking or usingother forms of tobacco
• drinking alcohol people who drink and smoke heavily have a much higher risk comparedwith the population at large
• infection with the human papilloma virus (HPV) HPV is the virus that causes genital warts

Only one in eight (12.5%) cases affect people younger than 50.

Mouth cancer can occur in younger adults. HPV infection is thought to be associated with the majority of cases that occur in younger people.

Cancer of the mouth is also more common in men than in women. This may be because, on average, men tend to drink more alcohol than women.

Treating mouth cancer

There are three main treatment options for mouth cancer:

• surgery where the cancerous cells are surgically removed, along with a tiny bit of the surrounding normal tissue or cells to ensure the cancer is completely removed
• radiotherapy where high-energy X-rays are used to kill cancerous cells
• chemotherapy where powerful medications are used to kill cancerous cells

These treatments are often used in combination. For example, surgery may be followed by a course of radiotherapy to help prevent the cancer returning.

As well as trying to cure the cancer, treatment will focus on important functions of the mouth, such as breathing, speaking and eating. Maintaining the appearance of your mouth will also be given high priority.

It can affect the appearance of your mouth and make speaking and swallowing difficult (dysphagia) .

Dysphagia can be a potentially serious problem. If small pieces of food enter your airways and become lodged in your lungs, it could trigger a chest infection, known as aspiration pneumonia .

If you drink as much as 14 units a week, it's best to spread it evenly over three or more days.

In cases where the cancer is larger, there's still quite a good chance of a cure, but surgery should be followed by radiotherapy or a combination of radiotherapy and chemotherapy to give the best chance.

Advances in surgery, radiotherapy and chemotherapy have resulted in much improved cure rates.

Overall, around 60% of people with mouth cancer will live at least five years after their diagnosis, and many will live much longer without the cancer returning.