Mouth cancer

Mouth cancer

Mouth cancer, often known as oral cancer or cancer of the oral cavity, is used to describe cancer that starts in the region of the mouth. More than 853 people in Victoria are diagnosed with mouth cancer each year – that’s over 16 people diagnosed every week. Mouth cancer starts in the cells lining the mouth. Damaged cells can then grow uncontrollably to form a tumour.

The two main risk factors for mouth cancer are alcohol and tobacco, and the combined effect of drinking and smoking is far greater. Mouth cancer risk increases as you get older, and men are three times more likely as women to develop the disease. Mouth cancer can be treated if diagnosed at an early stage, so it’s important to see your dentist or doctor immediately if you notice any changes in your mouth.

Symptoms of mouth cancer

The most common sites of mouth cancer are the lips, tongue and floor of the mouth, but it can also develop in the gums, the inside lining of the cheeks, roof of the mouth, hard and soft palate, tonsils and salivary glands. The symptoms of mouth cancer can include:

A visible mass or lump that may or may not be painful

An

ulcer

that won’t heal

White or red patches on the

mouth

,

tongue

or

gums

Loss of sensation anywhere in the mouth

Trouble swallowing

Impaired tongue mobility

Difficulty moving your jaw

Loose teeth or sore gums

Altered taste

Swollen

lymph glands

Having these symptoms does not mean that you have mouth cancer, but if you experience or notice any of these you should speak to your dentist or doctor.

Risk factors for mouth cancer

Tobacco

and

alcohol

are responsible for over 75% of mouth cancers, by exposing your mouth to cancer-causing substances (carcinogens). If you smoke and drink, your risk of developing mouth cancer is much higher. Alcohol may enable other carcinogens, including tobacco, to enter and damage cells.

Tobacco use includes cigarettes, cigars, pipes and chewing. If you smoke or chew tobacco or ‘Paan’, you are twice as likely to develop mouth cancer than a non-smoker. Chewing or smoking areca nut, betel quid, pan or gutka also increases your risk. The location of the cancer depends on the usage of the tobacco product – for example, if you have a habit of chewing tobacco in your left cheek, you may be prone to cancer of that cheek.

Mouth cancer is six times more common in alcohol drinkers than in non-drinkers. The more you drink, the greater the risk.

Other risk factors include:

Being over 40 years of age

Men are three times as likely to develop mouth cancer as women

Sun exposure - ultraviolet (UV) radiation can lead to skin cancer on the lips

Being overweight or obese

Diagnosing mouth cancer

Mouth cancer is diagnosed using a number of tests including:

Physical examination of the mouth by your

dentist

or

doctor

Biopsy

(taking a sample of skin of the mouth for examination in a laboratory)

X-ray

Ultrasound

CT scan

MRI

(magnetic resonance imaging) scan

PET

(position emission tomography) scan

Test results can take a few days to come back. It is natural to feel anxious waiting to get your results. It can help to talk to a close friend or relative about how you’re feeling. You can also contact the

Cancer

Council

External Link

on Tel:

13 11 20

and speak with a cancer nurse.

How mouth cancer can spread

The skin of the mouth, nose and throat are lined with flat, firm cells called squamous cells. Most mouth cancers originate in these surface cells. Without treatment, squamous cell carcinoma can spread deeper, including muscle and bone, or to the throat or lymph glands in the neck. Mouth cancer can also spread to other parts of the body if it accesses the bloodstream or lymphatic system, so it’s important to diagnose and treat it early.

Treatment for mouth cancer

Treatment depends on the size, type and location of the cancer and whether it has spread, but can include:

Surgery

• the tumour is surgically removed, if small. The lymph glands on the affected side may also be removed if the tumour extends into these.

Radiation therapy

• small, precise doses of ionising radiation target and destroy cancer cells. This type of treatment is often all that’s needed for small, localised cancers.

Chemotherapy

• the use of cancer-killing drugs, often in combination with surgery and/or radiotherapy. Chemotherapy may sometimes be used to shrink a tumour before surgery.

Multi-modal treatments

• Surgery on larger tumours may be followed with radiation therapy. Chemo-radiotherapy may also be used.

Long term monitoring

– this may include regular oral examinations and occasional X-rays to make sure the cancer hasn’t come back.

Ongoing care

– this may include speech therapy, dietary advice, regular medical follow-up and counselling.

All treatments have side effects. These will vary depending on the type of treatment you are having. Many side effects are temporary, but some may be permanent. Your doctor will explain all the possible side effects before your treatment begins.

When mouth cancer can’t be cured

If your mouth cancer has spread to other parts of the body and it is not possible to cure it by surgery, your doctor may still recommend treatment. Treatment for control of cancer may include chemotherapy, radiotherapy, surgery, immunotherapy or pain-relieving medications (or a combination of these). Treatment may help to relieve symptoms, might make you feel better and may allow you to live longer. You may hear your doctor call your treatment ‘palliative’. This means treatment designed to relieve symptoms rather than cure. The

Cancer Council booklet Treatment for advanced

cancer

External Link

may be helpful to read.

Reducing your risk of mouth cancer

Having regular check-ups with your oral health professional and notifying them of any changes to your mouth is important, especially if you have had a lump or mouth ulcer for more than two weeks.

These are ways you can reduce your risk of mouth cancer:

Stop smoking or chewing tobacco

Reduce the amount of

alcohol

you drink

Eat a healthy diet, including plenty of non-starchy

vegetables and fruit

(which are thought to help lower the risk of mouth cancer)

Keep a healthy body weight

Use sun protection on your lips

Following this advice doesn’t mean that you will never get mouth cancer, but it can reduce your risk and has other health benefits too.

Where to get help

Your

oral health professional

or

doctor

Dental Health Services

Victoria

External Link

provides public dental services through the

Royal Dental Hospital

Melbourne

External Link

and community dental clinics, for eligible people. For more information about public dental services Tel.

(03) 9341 1000

, or

1800 833 039

outside Melbourne metro

Australian Dental

Association

External Link

‘Find a Dentist’ search function or Tel. (03) 8825 4600

Cancer Council

Victoria

External Link

, Cancer Information and Support Service Tel.

13 11 20

Peter MacCallum Cancer

Centre

External Link

, Appointments and Enquiries Tel.

(03) 9656 1111

Victorian Comprehensive Cancer

Centre

External Link

, Tel.

(03) 8559 7160

Speech Pathology

Australia

External Link

, Tel.

(03) 9462 4899

Head and Neck Cancer

Australia

External Link