By Dr Ananya Mandal, MD
Mouth cancer or oral cancer occurs when there is an abnormal proliferation of tumor or cancer cells over the tongue, mouth, lips or gums and less commonly over tonsils, back of the throat (pharynx) and salivary glands.
Oral cancer forms part of the head and neck group of cancers. About two-thirds of oral cancers occur in the mouth and about one-third are found in the pharynx. 1-5
Common symptoms of mouth cancer
The hallmark symptoms of this condition include:
one or more painful or painless mouth ulcers that refuses to heal,
white or red patches over the inside linings of the mouth or tongue
a swelling within the mouth that refuses to go away even after three weeks
Causes of mouth cancer
The exact cause of mouth cancer is not known. The underlying cause is usually when some of the mouth cells change and their life cycle are altered. These cells grow and reproduce in an uncontrollable and dangerous fashion and are the cancer cells.
What causes this change is unclear. However, there are several risk factors that may increase the chances of getting mouth cancer. These include:
drinking alcohol in excess
infection with certain viruses like human papilloma virus (HPV) (a virus that also causes genital warts and cervical cancer in women)
excessive exposure to the harmful UV rays of the sun
consuming a diet devoid of fruits and vegetables and excess of red meat and fried food
Frequency of mouth cancer
Oral cancer is relatively uncommon in the United Kingdom and is the sixth most common cancer in the UK. About one-third of those diagnosed with the cancer will die because of the condition. It accounts for 1 in 50 of all cases of cancer.
In 2009 there were 6,200 new cases of mouth cancer. In 2007, for example, in the UK 7.6 cases of oral cancers were seen per 100,000 population (males 10.9; females 4.6).
Other classes were 2.3 cases of mouth cancers (males 3.0; females 1.6), 2.3 cases of tongue (males 3.2; females 1.5) and 0.3 cases of lip cancer (males 0.5; females 0.2) were seen per 100,000 population.
In India the incidence rate approaches half of all cancers (male incidence rates up to 6.5 per 100,000 per year).
In Europe the incidence is low and it forms only 5% of all cancers. However, rates are high in France (male incidence rates up to 8 per 100,000 per annum) where it is the third most common cancer in males and the second most common cause of death from cancer.
Oral cancer is diagnosed in an estimated 35,000 Americans a year and causes approximately 7,500 deaths.
Who does mouth cancer affect?
Most cases are seen in adults over the age of 60. In younger people infection with HPV may be responsible for most cases.
Mouth cancer is more common in men than women. This could be because men tend to drink more alcohol than women.
Treatment of mouth cancer
There are three main options for treating mouth cancer. These include surgical removal of the tumor. This is usually followed by chemotherapy or anti-cancer medications that are taken as pills or as injections and radiation therapy.
Radiation therapy involves the use of radiation beams that are high energy X-rays which kill cancerous cells. These treatments are often used in combination.
Measures to reduce the risk of mouth cancers include:
adhering to recommended weekly limits for alcohol consumption (21 units for men, 14 units for women)
eating a ‘Mediterranean-style diet,’ high in fresh vegetables and fruits
Regular dental checkups are also important for early detection of any abnormalities as dentists can often spot the early stages of mouth cancer.
If detected at an early stage a complete cure is often possible using a combination of chemotherapy, radiotherapy and surgery.
An estimated 4 out of 5 people with early-stage mouth cancer survive at least five years after diagnosis.
If diagnosed at an advanced stage, when the cancer has spread beyond the mouth the outcome is poor with only 1 in 5 people surviving for at least five years after their diagnosis.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)