What is mouth cancer?

Mouth cancer or oral cancer, is the development of cancerous tissue in anatomic structures such as tongue, mouth, lips, gums, salivary glands, tonsil or the pharynx (which is part of the throat). The different types of mouth cancer are categorised by the type of cells the cancer first develops in. Squamous cell carcinoma is the most common type of mouth cancer, squamous cells are found in the inside of the mouth and under the skin. Oral malignant melanoma, which starts in cells called melanocytes and adenocarcinoma, these are developed inside the salivary glands, they both are the less common type of cancer.

Risk factors which cause mouth cancer

Mouth cancer appears where the normal cell life cycle grows or reproduces uncontrollably. Some factors are directly related to the alteration of the normal cells life cycle, and stimulate the formation of tumors. Between these factors are included:

  • Smoking tobacco

The secondary causative factor in 75 percent of oral cancer cases have been directly associated to Tobacco use in any form by itself.

The irritation of the mucous membranes of the mouth is due to smoke, direct contact (chewed or snuffed tobacco), heat of cigarettes or pipes and combustion of carcinogens which are the main factor of damage.

  • Drinking alcohol

A heavy alcohol consumption in combination with tobacco seems to be a high risk factor for oral cancer.

  • Human papillomavirus

According to current trends and the spread of the virus HPV 16, human papillomavirus, which causes genital warts, is now considered the primary causative factor of mouth cancer in 63 percent of newly diagnosed patients. This is normally caught via sexual contact.

  • Hematopoietic stem cell transplantation

Mouth cancer in patients after hematopoietic stem cell transplantation can have worse prognosis and a higher risk for squamous cell carcinoma. This seems to be related to immune suppression.

Premalignant lesions

– Leukoplakia – white patches.

– Erythroplakia – red patches.

– Erythroleukoplakia or speckled leukoplakia – mixed red and white patches.

– Oral lichen planus, with lichenoid lesions on mucous membranes and/or skin.

– Oral submucous fibrosis, characterized by limited opening of mouth and burning sensation on eating food and later on even normal eating becomes difficult.

– Actinic cheilitis, where there is thickening whitish discoloration of the lip at the border of the lip and skin. It is usually painless.

Treating mouth cancer

The three main treatment options for mouth cancer are:

  1. Surgery – the cancerous cells are surgically removed.
  2. Chemotherapy – the cancerous cells are killed by medication.
  3. Radiotherapy – the cancerous cells are killed by high energy X-ray.

The treatments for cancer are often used in combination in order to prevent the cancer returning with courses of radiotherapy and chemotherapy after surgery. The side effects of these treatments can cause dysphagia that makes speaking and swallowing difficult.

Prognosis

– Disfigurement of the face, head and neck after surgery.

– Complications of the radiation therapy, including dry mouth and difficulty swallowing.

– Complete cure, which is often possible if mouth cancer is diagnosed early. It estimates that around the 80% of people with early-stage mouth cancer will live more than five years after their diagnosis.

– Spreading of the cancer or metastasis, where mouth cancer is diagnosed at a later stage. Statistics shows that around the 20% of people with mouth cancer, which have spread from the mouth into surrounding tissue, will live for at least five years after being diagnosed.

Common symptoms of mouth cancer

– One or more mouth ulcers that do not heal and persist more than three weeks.

– A red or red and white patches on the gum or on the lining of the mouth or tongue.

– Swelling in your mouth or in the jaw, which can cause a bad fitting of dentures, that lasts for more than three weeks.

– Awkwardness in chewing or moving the jaw or tongue of the mouth or tongue.

– A feeling that there is something caught in the throat.

– Difficulty swallowing.

– Hoarseness or sore throat that persists more than three weeks.

– Persistent nasal obstruction with difficulty breathing through nose.

– Unaccountable earache.

Visit your dentist or doctor at once if you notice any abnormal problems because they can often spot the early stages of mouth cancer.

Dr Margarita Sanz finished her bachelor’s degree in dentistry at Alfonso X el Sabio University of Madrid and started her professional experience in a Unit of Oral and Maxilofacial Surgery, where she developed a special interest in oral surgery and implantology. Dr Sanz joined the Brighton Implant Clinic team in 2013.

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