Oral cancer is a cancer that begins in the mouth or the throat at the back of the mouth, called the oropharynx. (Cancer that begins in the back of the mouth is also called oropharyngeal cancer.) About 90 percent of the cancers in the oral cavity and the oropharynx are squamous cell carcinomas.
An oral or oropharyngeal cancer can appear anywhere in the oral cavity, including the lips, the lining of the mouth, under the tongue, the tongue, the gums, the area behind the wisdom teeth, the back of the throat, the tonsils, and the roof of the mouth.
Using tobacco and drinking alcohol greatly increases your risk of developing an oral cancer, especially if you use chewing tobacco or snuff. People who both smoke and drink have an even higher risk of developing a cancer in the mouth.
Other risk factors include prolonged sun exposure (for cancer of the lip) and human papillomavirus infection. Some studies show that infection with some subtypes of HPV increases the risk of oral cancer, in particular oropharyngeal cancer.
HPV and oral cancers
The human papillomavirus (HPV) has been linked to oral cancers in new research. This is the same virus that is now known to be linked to cervical cancer in women.
There are about 50,000 cases of oral cancers diagnosed in the United States every year. The most common risk factor for these diseases is excessive alcohol use and cigarette smoking. But there is a new demographic emerging in people in their 30s, 40s, and 50s who don’t have these habits but have oral cancers, especially in males, often linked to HPV.
“The natural history of the HPV virus in the throat is unknown,” says Eduardo Méndez, MD, associate professor of head and neck surgery at UW Medicine. It is a cancer that is hard to detect and difficult to see because it doesn’t cause a white plaque. HPV-positive cancers form in the back of the throat. The positive thing about these cancers is that they respond very well to treatment, better in fact than oral cancers that are not HPV-positive.
The most common symptom of oral cancer is a sore in the mouth that does not heal. Other symptoms include:
- A lump in the mouth or throat or on the lip
- A white or red patch on the gums, tongue, or the lining of the mouth
- Bleeding, pain, or numbness in the mouth
- A sore throat that does not go away
- Difficulty or pain when chewing or swallowing
- Swelling of the jaw
- A change (hoarseness) in the voice
- Pain in the ear.
People who smoke or drink heavily should be examined for head and neck cancer at least once a year. This is a simple 10-minute procedure that includes looking in the nose, mouth, and throat; examining the skin in the head and neck region; and feeling for lumps in the neck.
If cancer is suspected, the doctor may use mirrors and a lighted tube to examine hard-to-see areas. Your doctor may also suggest other tests or scans. If a suspicious area is found, the doctor may do a biopsy, in which a piece of tissue will be removed with either a scalpel or a needle and then examined by a pathologist for signs of cancer.