All You Need to Know About Mouth Cancer Symptoms, Causes, & Risk Factors

Cancer is characterized by uncontrolled cell growth invading and impairing adjacent tissues. In India, Mouth cancer is the most prevalent, accounting for 50–70% of total cancer mortality and having the highest incidence among Asian countries. Globally, it ranks as the sixth most common cancer, with India contributing nearly one-third of the total burden and ranking second for Mouth Cancer cases. Annually, India reports around 77,000 new cases and 52,000 deaths, representing approximately one-fourth of global incidences. 

Mouth cancer manifests as small, unfamiliar growths or sores in various mouth areas, including the lips, cheeks, sinuses, tongue, hard and soft palate, and the base of the mouth extending to the oropharynx. The late detection of mouth cancer in advanced stages poses a significant challenge, with cure chances as low as 20% in the five-year survival rates. 

Oral squamous cell carcinoma dominates cases globally, affecting various parts of the oral cavity. Incidence rates vary globally, with high rates observed in India, France, Brazil, central and eastern Europe, attributed to regional variations in social customs and lifestyle habits. The incidence of mouth cancer increases with age, peaking around 70–79 years. Men are more susceptible than women, with a two to six times higher likelihood due to higher alcohol and tobacco consumption. 

Major risk factors for mouth cancer include tobacco consumption, betel-quid chewing, excessive alcohol intake, poor oral hygiene, and viral infections like human papillomavirus. Preventive and control programs target these risk factors, recognizing the diverse global incidence influenced by knowledge gaps, environmental exposure, and behavioral factors, contributing to variations in death rates due to oral or mouth cancer. 

Oral cancer, also referred to as mouth cancer or cancer of the oral cavity, originates in the mouth region. The cause of mouth cancer is uncontrolled cell growth and multiplication in the oral cavity. Signs of oral cancer may resemble common mouth issues, such as persistent white patches or bleeding sores. The crucial distinction lies in these changes persisting without resolution for a long time. If left untreated, oral cancer has the potential to spread throughout the mouth, throat, and other areas of the head and neck. 

It is estimated that over 700 people are diagnosed with mouth cancer in 2023, with the average age at diagnosis being 67 years old. On average, about 11 individuals per 100,000 will develop oral cancer during their lifetime. Men face a higher likelihood than women, and individuals of White ethnicity are more prone to oral cancer than those of Black ethnicity. Approximately 63% of individuals diagnosed with oral cavity cancer survive five years post-diagnosis.

Your oral cavity plays a crucial role in both your digestive and respiratory systems, facilitating essential daily functions such as eating, speaking, and breathing. Positioned as an oval-shaped opening just below your nose, it commences at the lips and extends toward the tonsils. The anatomy of your mouth comprises various parts that collaborate seamlessly to aid in activities like chewing, speaking, and breathing.

The external aspect of your mouth forms a boundary that secures food and aids in articulating sounds and words, encompassing your cheeks and lips. Internally, your mouth houses teeth, gums, palate (roof of the mouth), oral mucosa (mucous membranes), salivary glands, tongue, and taste buds.

Mouth cancer exhibits various signs and symptoms that might be misunderstood as typical issues or changes in the mouth. Such doubts can lead to late diagnosis and delayed treatment, causing treatment failure or poor success rate. For instance, you may observe patches inside your mouth that resist scraping, potentially indicating precancerous conditions.

These conditions present as patches in the mouth and throat, each displaying distinct colors:

• Leukoplakia is flat white or gray patches in the mouth or throat
• Erythroplakia is slightly raised or flat red patches that may bleed when scraped
• Erythroleukoplakia is cluster of red and white patches

The early signs of mouth cancer are generally difficult to spot. Therefore, these symptoms are sometimes overlooked. Early stage mouth cancer symptoms are:

• Sores on the lip or inside the mouth that bleed easily and persist without healing within two weeks
• Rough spots or crusty areas on the lips, gums, or inside the mouth
• Areas in the mouth bleeding without apparent cause
• Numbness, pain, or tenderness on the face, neck, or in the mouth without an apparent cause
• Difficulty in chewing or swallowing, speaking, or moving the jaw or tongue
• Unintended weight loss
• Ear pain
• Persistent bad breath

Approximately 75% of individuals diagnosed with oral cancer engage in the following behaviors:

• Smoking cigarettes, cigars, or pipes
• Using smokeless tobacco products, such as chewing tobacco, dip, snuff, or water pipes (hookah or shisha)
• Consistently consuming excessive amounts of alcohol
• Prolonged exposure to the sun without protecting their lips with sunblock
• Being infected with human papillomavirus (HPV)
• Having a family history of oral cancer

It's crucial to emphasize that 25% of individuals who develop oral cancer neither smoke nor possess other identifiable risk factors.

How does Mouth Cancer Affect My Body?

Oral cancer can impact both your mouth and oropharynx (joining region of mouth and pharynx). The oropharynx includes sections of your tongue, the roof of your mouth, and the visible middle part of your throat when your mouth is wide open. When cancer occurs in the oropharynx, it is termed oropharyngeal cancer. 
This cancer can leave you disabled for even basic activities like chewing, swallowing, eating, drinking, as well as speaking. There will be severe burning sensation in the mouth. In later stages, this cancer may spread to other parts of the body also which can cause severe manifestations. 

The location and stage of your mouth cancer, along with your general health and personal preferences, will all influence your treatment options for mouth cancer. You might receive only one kind of cancer treatment, or you might receive several different kinds of treatments. Chemotherapy, radiation, and surgery are available treatment options for mouth cancer.

This cancer is associated with symptoms like persistent mouth pain/discomfort and difficulty in opening mouth, thereby disabling mouth’s functions like speaking, eating, swallowing, and even person’s normal working. The primary objectives of the treatment include reducing symptoms, enhancing the patient's quality of life, and restoring the normal function and appearance of the patient’s mouth.
In order to stop its progression to a more serious stage and spreading to other organs, early treatment is essential. It also improves long-term survival and raises the treatment's success rate. 

How is Mouth Cancer Treated?

Treatment for oral/mouth cancer is determined by several factors, including the cancer's location and stage, your overall health, and your personal preferences. Various treatment modalities include:

Surgery: Surgical procedures for oral/mouth cantcer can include:

• Tumor removal: This entails cutting away the tumor along with a margin of healthy surrounding tissue to ensure all cancer cells are removed. Minor surgery may suffice for smaller cancers, while larger tumours may require more extensive procedures, potentially involving the removal of jawbone or parts of the tongue.
• Neck dissection: If cancer has spread to neck lymph nodes or there's a high risk of it, your surgeon may recommend removing lymph nodes and related tissue in the neck. This procedure helps eliminate any cancer cells that may have spread and determines if additional treatment is necessary.
• Reconstructive surgery: After tumor removal, reconstructive surgery may be advised to restore mouth function for speaking and eating. This can involve grafting skin, muscle, or bone from other areas of your body, and dental implants might be used for tooth replacement.

Radiation Therapy: Radiation therapy employs high-energy beams, such as X-rays and protons, to destroy cancer cells. It can be administered externally from a machine or internally via radioactive seeds or wires placed near the cancer. Radiation therapy is often used after surgery or, in early-stage cases, as a standalone treatment. It may also be combined with chemotherapy, enhancing its effectiveness but potentially increasing side effects.

Chemotherapy: Chemotherapy employs chemicals to kill cancer cells and can be administered alone or in combination with other drugs or treatments. It may enhance the efficacy of radiation therapy.

Targeted Drug Therapy: Targeted drugs specifically target aspects of cancer cells that drive their growth. They can be used alone or alongside chemotherapy or radiation therapy. Cetuximab (Erbitux) is an example of a targeted therapy for certain oral/mouth cancer cases. It interferes with a protein found in cancer cells, inhibiting their growth. Side effects may include skin rash, itching, headache, diarrhea, and infections.

Immunotherapy: Immunotherapy harnesses your immune system to combat cancer by disrupting the mechanisms that shield cancer cells from immune system attacks. Typically reserved for advanced and treatment-resistant oral/mouth cancer, immunotherapy aims to overcome the immune evasion tactics of cancer cells.

Is cancer of the mouth curable?

Oral cancer is treatable if diagnosed early. And, as with other cancers, considerable effort has been devoted to determining causes and enhancing treatments.

What kills cancer cells in the mouth?

The majority of patients with stage I or II oral cavity cancers respond well to surgery and/or radiation therapy. Another option is chemoradiation, which combines chemotherapy and radiation.

What are 5 signs of oral cancer?

Sores on the lip or inside the mouth that bleed easily and persist without healing within two weeks, rough spots or crusty areas (on the lips, gums, or inside the mouth), areas in the mouth bleeding without apparent cause, numbness/pain/tenderness on the face/neck, or in the mouth without an apparent cause, difficulty in chewing or swallowing/speaking/moving the jaw or tongue are 5 signs of oral cancer.

What does Stage 1 oral cancer look like?

Oral cancer in stage 1 can manifest as rough/white/red patches of tissue, a hard painless lump near the back teeth or in the cheek, or a bumpy area near the front teeth.