Oral cancer

The oral cavity includes the lips and all areas of the mouth. Any type of cancer that develops in the oral cavity is considered an oral cancer. Oral pharyngeal cancer affects the oral cavity and also the throat area, including the back of the tongue, the tonsils or the back of the throat. Oral cancers can affect various bodily functions, such as talking, breathing and eating. They may also be disfiguring to the face. Men are twice as likely as women to develop oral cancer, and it's more common in people over age 50.


Causes
According to the National Cancer Institute, smoking and chewing tobacco are the main causes of oral cancer. In fact, 85 percent of oral cancers are linked to tobacco use. People who smoke or chew tobacco regularly are 35 times more likely to get oral cancer than people who do neither. In some cases, the risk for pipe and cigar smokers may be greater than cigarette smokers. Inhaling snuff or drinking excessive amounts of alcohol also raises the risk. Some studies have shown that people who have chronic mouth irritation or sores, including either white or red patches, also have a greater chance of developing this type of cancer. Environmental factors, such as chronic exposure to asbestos or wood dust, or infection with the human papilloma virus (HPV, the virus that causes genital warts) may also play a role.
The disease usually affects tissue irritated by jagged teeth, poor oral hygiene, ill-fitting dentures and habitual chewing on the inside of the mouth. Iron deficiency is linked to tongue cancer in some women, and excessive exposure to sunlight causes some types of lip cancer. Pipe smokers have a higher risk of lip cancer.


Symptoms
Symptoms of various types of oral cancer may include:
a sore on the lip or in the mouth that does not heal
a lump on the lip or in the mouth or throat
a white or red patch on the gums, tongue or lining of the mouth
unusual bleeding, pain or numbness in the mouth
a sore throat that does not go away, or a feeling that something is caught in the throat
difficulty or pain with chewing or swallowing
swelling of the jaw that causes dentures to fit poorly or become uncomfortable
a change in the voice
pain in the ear or other areas of the head or neck that does not respond to treatment

Diagnosis
To diagnose oral cancer, the doctor will generally do a biopsy by taking a small tissue sample from your mouth. The sample will be sent to a lab for examination under a microscope. The doctor may also do X-rays or other imaging tests to identify tumors, such as a computed tomography scan or magnetic resonance imaging.

Treatment
The health care team that treats oral cancer might include a head and neck surgeon, a radiologist, an oncologist and a dentist.
Small oral cancers often respond to surgery or radiation therapy. Laser surgery or cryosurgery (freezing cells with liquid nitrogen) can also destroy small tumors. If more extensive surgery is needed, facial disfigurement may lead to the need for reconstructive surgery. You may also need rehabilitation therapy to help you regain your ability to chew, swallow and speak.

When oral cancer is found and treated early, the outlook is good. Three-fourths of cases are cured with early detection, and more than half the people with oral cancer survive for more than five years after treatment. In part, success depends on how early the cancer is detected, how soon treatment begins, and which parts of the head and neck are involved.


Prevention
To prevent oral cancer, don't smoke or chew tobacco. Drink alcohol only moderately, if at all. Practice good oral hygiene, and use sunscreen to protect your lips. If you wear dentures, make sure they fit properly. It's also helpful to eat a balanced diet that includes plenty of fruits, vegetables and other high-fiber foods. Finally, schedule regular checkups with your doctor and dentist.