Oral Cancer

Mouth cancer can affect any part of the mouth, including the tongue and lips.

The most common symptom is 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. We endeavour at all times to refer you to professionals if we notice anything suspicious in your mouth or face in general.

FAQs

What is cancer?

Cancer is a disease of the cells in the body. The body is made up of millions of tiny cells. There are many different types of cells in the body, and there are many different types of cancer which arise from different types of cells. 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 of cancer cells which continue to multiply. As they grow, malignant tumours invade 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, and 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.

What causes mouth cancer?

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 multiplies out of control.

Some people develop mouth cancer for no apparent reason. However, certain risk factors increase the chance that mouth cancer may develop.

These include:

• Smoking – Mouth cancer is just one cancer which has a much higher incidence in smokers than in non-smokers.
• Alcohol – Drinking a lot of alcohol can increase your risk of developing mouth cancer.
• Chewing tobacco or the betel leaf.
• The human papillomavirus (HPV) may increase your risk of mouth cancer.
• There are some conditions affecting the mouth, such as Leukoplakia and Erythroplakia, which can increase the risk of cancer developing.

Mouth cancer is not hereditary, so it does not run in families.

What are the symptoms of mouth cancer?

The most common symptoms of mouth cancer are sores or ulcers 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 cancer develops. This means that early treatment of these changes will prevent cancer from developing.

Other symptoms include:

• White patches anywhere in your mouth (Leukoplakia).
• Red patches anywhere in your mouth (Erythroplakia).
• A lump on the lip, tongue or in mouth or throat.
• Unusual bleeding or numbness in the mouth.
• Pain when chewing or swallowing.
• A feeling that something is caught in the throat.
• Loose teeth or dentures feeling uncomfortable and not fitting properly.
• A change in your voice or speech problems.
• Weight loss.
• A lump in the neck.

If cancer spreads to other parts of the body, various other symptoms can develop.  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.

How is mouth cancer diagnosed and assessed?

To confirm the diagnosis 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. The results of a biopsy can take two weeks.

Assessing the extent and spread (Staging)

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 cancer has spread to other parts of the body. For example, a CT scan, an MRI scan, or other tests.

This assessment is called staging of cancer. Staging aims to find out:

• How much the tumour has grown in the mouth.
• Whether cancer has spread to local lymph nodes.
• Whether cancer has spread to other areas of the body (metastasised).

What is the prognosis (Outlook)?

If 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 cancer has spread.

The treatment of cancer is a developing area of medicine. New treatments continue to be developed and the information on the outlook above is very general. The medical doctor who knows your case can give more accurate information about your particular outlook, and how well your type and stage of cancer are likely to respond to treatment.

What are the treatment options for mouth cancer?

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 cancer, and your general health.

You should have a full discussion with a medical doctor 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 doctor, the aims of treatment. For example:

In many cases, treatment aims to cure cancer. There is a good chance of a cure if it is treated in the early stages. Many cases are diagnosed at an early stage. This is because early mouth cancers are more easily detected than cancers deeper inside the body. (Doctors tend to use the word remission rather than the word cured. Remission means there is no evidence of cancer following treatment. If you are in remission, you may be cured. However, in some cases, cancer returns months or years later. This is why doctors are sometimes reluctant to use the word cured.)

In some cases, treatment aims to control cancer. If a cure is not realistic, with treatment it is often possible to limit the growth or spread of cancer so that it progresses less rapidly. This may keep you free of symptoms for some time.

In some cases, treatment aims to ease symptoms. For example, if a cancer is advanced then you may require painkillers or other treatments to help keep you free of pain or other symptoms. Some treatments may be used to reduce the size of cancer, which may ease symptoms such as pain or difficulty with swallowing.

Surgery

The most common treatment is surgery. The type of operation depends on the size of cancer and its site. The operation may be to remove cancer and some of the surrounding normal tissue.

Sometimes surgery is aimed at curing 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 a 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 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 that only a very small amount of healthy tissue is removed.

Radiotherapy

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.

Two types of radiotherapy are used for mouth cancer: external and internal.

External radiotherapy: This is where radiation is targeted on cancer from a machine. (This is the common type of radiotherapy which is used for many types of cancer.)

Internal radiotherapy (brachytherapy): This treatment involves placing small radioactive wires next to the cancer for a short time and then they are removed.

Chemotherapy

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 cancer has spread to other areas of the body.

Further Help And Information

The Mouth Cancer Foundation
Web: www.mouthcancerfoundation.org

Macmillan Cancer Support
Tel (Helpline): 08088 080 000
Web: www.macmillan.org.uk

Provides information and support to anyone affected by cancer.

CancerHelp UK
Web: www.mouthcancerfoundation.org

Saving Faces
Web:www.savingfaces.co.uk

A charity that works in various areas related to facial problems such as oral cancer, facial injuries and facial disfigurement.

For more information regarding this treatment

Contact Us or Call 01501 731 711