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19 October 2021

What causes oral cancer?

What do we mean by ‘mouth cancer’? Mouth cancer is a colloquial term for oral cancer.

Oral cancer is cancer that starts in cells that make up the inside of the mouth or the lips. Although oral cancer does not get much media attention, it is actually fairly common. In Australia, the Australian Institute of Health and Welfare says oral cancers are the seventh most commonly diagnosed cancer. They estimate about 5000+ cases will be diagnosed this year.

The most common type of oral cancer is squamous cell carcinoma (approximately 90%).

The presentation can take many forms. Early lesions are usually asymptomatic—commonly seen as a white/red patches or ulcer on the lateral borders of the tongue and lip that does not go away within a couple of weeks and pain is seldom present. Early diagnosis is the most important factor influencing prognosis. A healthcare provider or dentist often finds oral cancer in its early stages because the mouth and lips are easy to examine.

Oral cancer can be very aggressive and have debilitating consequences. I very vividly remember a 45-year-old man consult with me for an ulcer on his tongue. Suspecting that it was an oral cancer, I sent that across to an oral medicine specialist and the next time I saw that client, he had half his tongue and half his mandible (lower jaw) removed. So depending on the stage of the cancer, it can be quite aggressive.

An important thing to know is that oral cancer isn’t just something smokers get. The key thing to know is just because you don’t have symptoms doesn’t mean it isn’t there.

Who is at risk for oral cancer?

The risk of oral cancer increases at 40 years of age onwards. There are other risk factors as well, however, as the exact cause of someone’s cancer may not be known. Some risk factors may not be in your control. But others may be things you can change.

Risk factors include:

  • Past or current use of any form of tobacco
  • Alcohol use
  • A lot of sun exposure
  • Fair skin
  • Human papillomavirus (HPV) infection
  • Lack of fruits and vegetables in your diet
  • Chronic mouth irritation, such as from dentures that aren’t fitted correctly
  • Using betel quid or gutka chewing tobacco products
  • Weakened immune system

What I understand is that you can see symptoms in the mouth fairly early on in the case of when you have cancer. But it’s easier for a dentist to spot than it is for you. Some people don’t find the cancer until it is relatively advanced because there might not be any pain or symptoms.

What are the symptoms of oral cancer?

Oral cancer is often found because a person notices changes in their mouth. The symptoms of oral cancer include:

  • A sore on your lip or in your mouth that won’t heal
  • A lump on your lip, in your mouth, or in your throat
  • A white or red patch on the gums, tongue, or lining of your mouth
  • Abnormal bleeding, pain, or numbness in your mouth
  • A feeling of something caught in your throat
  • Numbness in your mouth or tongue
  • Trouble chewing or swallowing
  • Pain when you chew or swallow
  • Swelling around your jaw
  • Loose or painful teeth
  • A lump, swelling, or mass in your neck that doesn’t go away
  • Unexpected weight loss
  • A change in your voice
  • Pain in your ear or jaw

Oral cancer is often found during routine dental check-up as usually early presentation is painless and people are unaware. If your dentist thinks you may have oral cancer, they’ll refer you to an oral medicine specialist for further investigation.

Early diagnosis is key.

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