We do know that people with certain risk factors may be more likely than others to develop oral cancer. A risk factor is something that may increase the chance of getting a disease.
Studies have found the following risk factors for oral cancer:
- Tobacco: Tobacco use causes most oral cancers. Smoking cigarettes, cigars, or pipes, or using smokeless tobacco (such as snuff and chewing tobacco) causes oral cancer. The use of other tobacco products (such as bidis and kreteks) may also increase the risk of oral cancer.
- Heavy alcohol use: People who are heavy drinkers are more likely to develop oral cancer than people who don’t drink alcohol. The risk increases with the amount of alcohol that a person drinks. The risk increases even more if the person both drinks alcohol and uses tobacco.
- HPV infection: Some members of the HPV family of viruses can infect the mouth and throat. These viruses are passed from person to person through sexual contact. Cancer at the base of the tongue, at the back of the throat, in the tonsils, or in the soft palate is linked with HPV infection. The NCI fact sheet Human Papillomaviruses and Cancer has more information.
- Sun: Cancer of the lip can be caused by exposure to the sun. Using a lotion or lip balm that has a sunscreen can reduce the risk. Wearing a hat with a brim can also block the sun’s harmful rays. The risk of cancer of the lip increases if the person also smokes.
- A personal history of oral cancer: People who have had oral cancer are at increased risk of developing another oral cancer. Smoking increases this risk.
- Diet: Some studies suggest that not eating enough fruits and vegetables may increase the chance of getting oral cancer.
- Betel nut use: Betel nut use is most common in Asia, where millions chew the product. It’s a type of palm seed wrapped with a betel leaf and sometimes mixed with spices, sweeteners, and tobacco. Chewing betel nut causes oral cancer. The risk increases even more if the person also drinks alcohol and uses tobacco.
Cancer research has led to real progress in oral cancer detection and treatment. Because of research, people with oral cancer can look forward to a better quality of life. Continuing research offers hope that, in the future, even more people with this disease will be treated successfully.
Doctors all over the world are conducting many types of clinical trials (research studies in which people volunteer to take part). Clinical trials are designed to find out whether new approaches are safe and effective.
Doctors are testing chemotherapy, targeted therapy, and combinations of drugs for oral cancer. They are studying radiation therapy combined with drugs and other treatments. Doctors are also testing drugs that prevent or reduce the side effects of radiation therapy.
Even if the people in a trial do not benefit directly, they may still make an important contribution by helping doctors learn more about oral cancer and how to control it. Although clinical trials may pose some risks, doctors do all they can to protect their patients.
Life after being diagnosed with cancer will be different for everyone. Some people will have minimal disease and it will be a short chapter of their lives, while others will have a diagnosis that will change the course of the rest of their lives. Cancer diagnoses can change relationships, your routines, your work and home life. One thing is certain, no one person’s experience will be exactly the same. There are however, plenty of resources to learn about what life was like for other people, and what they did to achieve balance, maintain their health and personal life, keep peace of mind, and enjoy their lives with or after cancer.
Your experience with cancer will depend on the type of cancer you have, your choices of treatment and the lifestyle you lead. Be sure to speak with your Doctor about the side effects of your disease and the treatments you choose. Your Doctor will be able to consult with you on realistic lifestyle expectations.
Every cancer diagnosis is different, just as every person who is diagnosed with cancer is different. Cancer knows no barriers to race, age, or social group. However there is one thing that each and every person who is diagnosed with cancer will have in common: help with fighting and beating the disease.
Life after being diagnosed with cancer will be different for everyone. Some people will have minimal disease and it will be a short chapter of their lives, while others will have a diagnosis that will change the course of the rest of their lives. Cancer diagnoses can change relationships, your routines, your work and home life. One thing is certain, no one person’s experience will be exactly the same. There are however, plenty of resources to learn about what life was like for other people, and what they did to achieve balance, maintain their health and personal life, keep peace of mind, and enjoy their lives with or after cancer.
Clinical Trials
The search for a cure for cancer is an ongoing, constant battle. Clinical trials are the basis upon which new treatments and medications are proven to help the fight against cancer, or if researchers should pursue another tactic. The advancement of medicine depends on willing and able cancer patients to volunteer for experimental treatments so that future generations will have proven and effective cures. Not every patient with cancer will be eligible for a clinical trial, as the scientific method needs specific patients with specific types of cancers. However, patients who are selected for trials may benefit from being at the cutting edge of new research, and gain time they otherwise might not have had.
The National Cancer Institute at the National Institutes of Health has a comprehensive database of over 10,000 ongoing clinical trials that both help advance medicine and help patients.
Financial Help
Unfortunately, cancer treatment can be costly, even if a patient has very comprehensive health insurance. For patients who do not have health insurance, the cost of treatment may seem insurmountable. Fortunately many pharmaceutical companies offer cost assistance to help make treatment more affordable. The National Comprehensive Cancer Network has compiled a Virtual Reimbursement Room where patients can find information for accessing financial help with their treatment costs.
If you have symptoms that suggest oral cancer, your doctor or dentist will check your mouth and throat for red or white patches, lumps, swelling, or other problems. A physical exam includes looking carefully at the roof of your mouth, back of your throat, and insides of your cheeks and lips. Your doctor or dentist also will gently pull out your tongue so it can be checked on the sides and underneath. The floor of your mouth and lymph nodes in your neck will also be checked.
If your doctor or dentist does not find the cause of your symptoms, you may be referred to a specialist. An ear, nose, and throat specialist can see the back of your nose, tongue, and throat by using a small, long-handled mirror or a lighted tube. Sometimes pictures need to be made with a CT scan or MRI to find a hidden tumor. (The Staging section describes imaging tests.)
The removal of a small piece of tissue to look for cancer cells is called a biopsy. Usually, a biopsy is done with local anesthesia. Sometimes, it’s done under general anesthesia. A pathologist then looks at the tissue under a microscope to check for cancer cells. A biopsy is the only sure way to know if the abnormal area is cancer.
Symptoms of oral cancer may include:
- Patches inside your mouth or on your lips:
- White patches (leukoplakia) are the most common. White patches sometimes become malignant. Mixed red and white patches (erythroleukoplakia) are more likely than white patches to become malignant.
- Red patches (erythroplakia) are brightly colored, smooth areas that often become malignant.
- A sore on your lip or in your mouth that doesn’t heal
- Bleeding in your mouth
- Loose teeth
- Difficulty or pain when swallowing
- Difficulty wearing dentures
- Numbness of lower lip and chin
Most often, these symptoms are not from oral cancer. Another health problem can cause them. Anyone with these symptoms should tell their doctor or dentist so that problems can be diagnosed and treated as early as possible.
Almost all oral cancers begin in the flat cells (squamous cells) that cover the surfaces of the mouth, tongue, and lips. These cancers are called squamous cell carcinomas.
Oral cancer cells can spread by breaking away from the original tumor. They enter blood vessels or lymph vessels, which branch into all the tissues of the body. The cancer cells often appear first in nearby lymph nodes in the neck. The cancer cells may attach to other tissues and grow to form new tumors that may damage those tissues.
Tumors in the mouth or throat can be benign (not cancer) or malignant (cancer). Benign tumors are not as harmful as malignant tumors:
Benign tumors:
- are rarely a threat to life
- can be removed and usually don’t grow back
- don’t invade the tissues around them
- don’t spread to other parts of the body
Malignant tumors:
- may be a threat to life
- can grow back after they are removed
- can invade and damage nearby tissues and organs
People with early oral cancer may be treated with surgery or radiation therapy. People with advanced oral cancer may have a combination of treatments. For example, radiation therapy and chemotherapy are often given at the same time. Another treatment option is targeted therapy.
Surgery
Surgery to remove the tumor in the mouth or throat is a common treatment for oral cancer. Sometimes the surgeon also removes lymph nodes in the neck. Other tissues in the mouth and neck may be removed as well. You may have surgery alone or in combination with radiation therapy.
Radiation Therapy
Radiation therapy uses high-energy rays to kill cancer cells. It’s an option for small tumors or for people who can’t have surgery. Or, it may be used before surgery to shrink the tumor. It also may be used after surgery to destroy cancer cells that may remain in the area.
Doctors use two types of radiation therapy to treat oral cancer. Some people with oral cancer have both types:
- External radiation therapy: The radiation comes from a machine. Some treatment centers offer IMRT, which uses a computer to more closely target the oral tumor to lessen the damage to healthy tissue. You may go to the hospital or clinic once or twice a day, generally 5 days a week for several weeks. Each treatment takes only a few minutes.
- Internal radiation therapy (implant radiation therapy or brachytherapy): Internal radiation therapy isn’t commonly used for oral cancer. The radiation comes from radioactive material in seeds, wires, or tubes put directly in the mouth or throat tissue. You may need to stay in the hospital for several days. Usually the radioactive material is removed before you go home.
Chemotherapy
Chemotherapy uses drugs to kill cancer cells. The drugs that treat oral cancer are usually given through a vein (intravenous). The drugs enter the bloodstream and travel throughout your body.
Chemotherapy and radiation therapy are often given at the same time. You may receive chemotherapy in an outpatient part of the hospital, at the doctor’s office, or at home. Some people need to stay in the hospital during treatment.
Targeted Therapy
Some people with oral cancer receive a type of drug known as targeted therapy. It may be given along with radiation therapy or chemotherapy.
Cetuximab (Erbitux) was the first targeted therapy approved for oral cancer. Cetuximab binds to oral cancer cells and interferes with cancer cell growth and the spread of cancer. You may receive cetuximab through a vein once a week for several weeks at the doctor’s office, hospital, or clinic.