Oral cavity cancer, also known as mouth cancer, is a type of cancer that affects the tissues of the oral cavity. It can occur in various parts of the mouth, including the:

• Lips
• Tongue
• Cheeks
• Gums
• Area under the tongue
• Roof of the mouth or hard palate

Like any other form of cancer, early detection is crucial for successful treatment. Therefore, awareness of the signs and symptoms of oral cavity cancer is essential.

Symptoms

Head and neck surgical oncologist Elizabeth Bradford Bell, MD, says she commonly sees individuals with pain from a mass or ulcer in the mouth that is not healing.

“It's not uncommon for us to see patients who have had persistent pain and a course of antibiotics, and their symptoms didn't improve,” she says. “They can still see or feel something in their mouth.”

Individuals with oral cavity cancer may experience ear pain on the same side of the mass or ulcer. They may also notice an enlarged bump in the neck on the same side, which is caused when the cancer has spread to nearby lymph nodes.

Tumors, which feel like firm bumps surrounded by soft tissue, may appear in several spots, including:

• The inside of the lips
• On the gums
• Inside of the cheeks
• On or under the tongue

“Everything in your mouth that you can touch with your tongue is a potential site that we as surgeons are thinking about when it comes to oral cavity cancer,” Dr. Bradford Bell says.

Oral cancer causes

Smoking and chewing tobacco products increases your risk of oral cancer. Those with alcohol use disorder are also at an increased risk.

However, Dr. Bradford Bell emphasizes that someone should not ignore mouth pain, lumps or sores because they don’t use tobacco or drink.

“There is a relatively new trend over the last five to 10 years in that we’re seeing more and more younger women, between 20 and 50, who have no prior history of tobacco use or alcohol use disorder, who are coming in with cancers growing on the tongue,” she says.

Dr. Bradford Bell says there is no clear answer for why younger women develop tongue cancers. It is not believed to be hereditary or caused by a known exposure.

People with have autoimmune diseases of the mouth, such as oral lichen planus, that cause chronic inflammation may also be at an increased risk of developing oral cancers.

When should I see a doctor?

You should seek medical attention whenever you have persistent symptoms, especially if they last for more than a few weeks. Dr. Bradford Bell says she commonly hears from patients who noticed symptoms and saw their primary care doctor, who prescribed a treatment that failed to alleviate symptoms. When this happens, patients need to stay vigilant, she says.

“I tell patients, ‘You are your own best advocate. If you are worried about something and it’s not getting better, don’t let it rest. Please bring it up to your doctor and make them do something about it.’”

When someone with potential oral cancer is evaluated by a head and neck cancer specialist, the first step is almost always a biopsy, which provides a definitive diagnosis. Imaging, such as CT scans, may also be performed to provide additional information.

How is oral cancer treated?

According to Dr. Bradford Bell, oral cancers are almost always treated surgically. If the cancer is contained in a very small tumor, removing it surgically may be curative.

For larger or more complex cancers, further steps may be necessary.

“If we are concerned there is a risk of spread to lymph nodes, we’ll remove lymph nodes from the neck at the same time, and then, if patients have larger tumors or higher stage cancers, sometimes they will need radiation therapy following surgery,” Dr. Bradford Bell says.

The good news is that oral cancers can be successfully treated. “The majority of patients we see have curable disease,” Dr. Bradford Bell says.