Cancers of the mouth and back of the throat are referred to as oral cancers. With about 49,700 new cases each year, oral cancer accounts for 3% of all diagnosed cancers in the United States.
Those over the age of 40 are at a higher risk for oral cancer, and it affects 2x more men than women. Other risk factors include tobacco and alcohol use, sun exposure and diet.
Because oral cancer can spread quickly, early diagnosis gives patients the best chance of a full recovery.
Symptoms
Anyone with symptoms of oral cancer should see a medical professional as soon as possible. Similarly, your dentist may notice signs before you do at one of your semi-annual visits.
Some symptoms may include:
- A sore, thick or discolored patch in your mouth, lip or throat
- Ulcerations, particularly on the side of the tongue or under the tongue
- Difficulty chewing or swallowing
- Swelling of the jaw
- Pain in one ear
- Numbness in your tongue or elsewhere in your mouth
Diagnosis
Diagnosing oral cancer is comprised of two basic steps:
First is a physical exam. During the exam, patients will usually be asked to give a detailed medical and family history. This is also when a doctor or dentist will examine the mouth for signs of cancerous tissue. If abnormal tissue is found, a sample of cells is biopsied and tested. The cells are usually removed with a scalpel or another surgical tool, but it won’t cause too much discomfort.
While analyzing these cells, medical professionals are looking for either cancer or precancerous changes, indicating an especially high risk for cancer in the future.
Image tests are also commonly used. This could include an X-ray, MRI, CT scan or PET scan.
Staging
When cancer is detected, the doctor will need to determine how severe the cancer is.
While the staging process varies, one common method is American Joint Committee on Cancer (AJCC) TNM system.
- The extent of the tumor (T): How large is the main (primary) tumor and which, if any, tissues of the oral cavity or oropharynx it has spread to?
- The spread to nearby lymph nodes (N): Has the cancer spread to nearby lymph nodes?
- The spread (metastasis) to distant sites (M): Has the cancer spread to distant organs such as the lungs?
Numbers or letters after T, N, and M provide more details about each of these factors. Higher numbers mean the cancer is more advanced. Once a person’s T, N, and M categories have been determined, this information is combined in a process called stage grouping to assign an overall stage.
Staging provides insights that help medical professionals formulate the best course of treatment.
Treatment
The most common treatments for oral cancer include surgery, radiation therapy, chemotherapy, and targeted drug therapy.
The stage and location of cancer will determine which specialist you’re referred to. It could be:
- An ear, nose and throat doctor
- An oncologist
- A dentist who specializes in oral surgery
- A head/neck surgeon
Anyone concerned about oral health should consult with a trusted medical professional in their area.