Mouth cancer can affect any part of the mouth, including the tongue and lips. The most common symptoms are having a sore or ulcer for more than three weeks. You should see your dentist or doctor if you have any symptoms in your mouth that are unusual. The outlook for people with mouth cancer is very good if it is diagnosed early.
Cancer is a disease of the cells in the body. The body is made up from millions of tiny cells. There are many different types of cell in the body, and there are many different types of cancer which arise from different types of cell. What all types of cancer have in common is that the cancer cells are abnormal and multiply 'out of control'.
A malignant tumour is a lump or growth of tissue made up from cancer cells which continue to multiply. As they grow, malignant tumours invade into nearby tissues and organs, which can cause damage.
Malignant tumours may also spread to other parts of the body. This happens if some cells break off from the first (primary) tumour and are carried in the bloodstream or lymph channels to other parts of the body. These small groups of cells may then multiply to form secondary tumours (metastases) in one or more parts of the body. These secondary tumours may then grow, invade and damage nearby tissues, and spread again.
Some cancers are more serious than others, some are more easily treated than others, some have a better outlook (prognosis) than others.
So, cancer is not just one condition. In each case it is important to know exactly what type of cancer has developed, how large it has become, and whether it has spread. This will enable you to get reliable information on treatment options and outlook. See separate leaflet called Cancer - What are Cancer and Tumours? for further details about cancer in general.
Mouth cancer is a cancer that can develop in any part of the mouth, including the tongue, the gums, the palate (roof of the mouth), under the tongue, the skin lining the mouth or the lips.
Mouth cancer is also sometimes called oral cancer. Although mouth cancer is uncommon in the UK, it seems to be getting more common. There are around 4,700 cases that are diagnosed each year. It is twice as common in men as it is in women and is rare in people aged under 40. Many cases are diagnosed by dentists rather than doctors.
A cancerous tumour starts from one abnormal cell. The exact reason why a cell becomes cancerous is unclear. It is thought that something damages or alters certain genes in the cell. This makes the cell abnormal and multiply out of control. (See separate leaflet called What Causes Cancer? for more details.)
Some people develop mouth cancer for no apparent reason. However, certain risk factors increase the chance that mouth cancer may develop. These include:
Mouth cancer is not hereditary, so does not run in families.
The most common symptoms of mouth cancer are a sore or ulcer in the mouth that does not heal, and pain in the mouth that does not go away.
In many cases, changes are seen in the mouth before the cancer develops. This means that early treatment of these changes will actually prevent a cancer developing.
Other symptoms include:
All of these symptoms can be due to other conditions, so tests are needed to confirm the diagnosis.
Note: any ulcer in the mouth that does not heal after three weeks should be checked by your dentist or doctor.
It is likely that you will need a biopsy. A biopsy is when a small sample of tissue is removed from a part of the body. The sample is then looked at under the microscope to look for abnormal cells. Results of a biopsy can take two weeks.
If you are confirmed to have mouth cancer then further tests may be done. For example, biopsy samples may be taken from the nearby lymph glands by using a fine needle. This is to assess if any cancer cells have spread to the lymph glands.
Other tests may be arranged to see if the cancer has spread to other parts of the body. For example, a CT scan, an MRI scan, or other tests. (The separate leaflets describe each of these tests in more detail.)
This assessment is called staging of the cancer. The aim of staging is to find out:
Treatment options which may be considered include radiotherapy, surgery, and chemotherapy. The treatment advised for each case usually depends on various factors such as the exact site and extent of the cancer, and your general health.
You should have a full discussion with a specialist who knows your case. They will be able to give the pros and cons, likely success rate, possible side-effects, and other details about the possible treatment options for your type of cancer.
You should also discuss with your specialist the aims of treatment. For example:
The most common treatment is surgery. The type of operation depends on the size of the cancer and its site. The operation may be to remove the cancer and some of the surrounding normal tissue.
Sometimes surgery is aimed at curing the cancer by removing it all. Sometimes surgery is used to relieve symptoms if the cancer is at an advanced stage (palliative surgery). The operations are all done whilst you are asleep under a general anaesthetic.
Laser surgery may sometimes be used to remove small mouth cancers. This may be combined with a light-sensitive drug in treatment known as photodynamic therapy (PDT).
Sometimes a special type of surgery called micrographic surgery or Mohs' surgery is used for cancers on the lip. In this surgery, the surgeon removes the cancer in very thin layers and the tissue that has been removed is examined under a microscope during the operation. This technique makes sure that all the cancer cells are removed and only a very small amount of healthy tissue is removed.
Radiotherapy is a treatment which uses high-energy beams of radiation which are focused on cancerous tissue. This kills cancer cells, or stops cancer cells from multiplying. (See separate leaflet called Radiotherapy for more details.)
Two types of radiotherapy are used for mouth cancer: external and internal.
Chemotherapy is a treatment which uses anti-cancer drugs to kill cancer cells, or to stop them from multiplying. Chemotherapy may be used in conjunction with radiotherapy or surgery. Chemotherapy may also be advised if the cancer has spread to other areas of the body. (See separate leaflet called Chemotherapy with Cytotoxic Medicines for more details.)
If a mouth cancer is diagnosed and treated at an early stage then there is a good chance of a cure. A cure is less likely if the cancer has spread.
The treatment of cancer is a developing area of medicine. New treatments continue to be developed and the information on outlook above is very general. The specialist who knows your case can give more accurate information about your particular outlook, and how well your type and stage of cancer is likely to respond to treatment.
Supports people with mouth, throat and other head and neck cancer.
Tel (Helpline): 0808 808 0000 Web: www.macmillan.org.uk
Provides information and support to anyone affected by cancer.
Provides facts about cancer, including treatment choices.
A charity that works in various areas related to facial problems such as oral cancer, facial injuries and facial disfigurement.
See Patient.co.uk Cancer/Leukaemia/Lymphoma support groups.