Oral Cancer

Dr. Ayush PandeyMBBS,PG Diploma

June 28, 2017

June 04, 2022

Oral Cancer
Oral Cancer


Oral cancer or mouth cancer as it is popularly known is a malignant (cancerous) condition affecting people of any gender and all age groups. Research claims that its incidences are more prevalent in middle age group (29-50 years) resulting in untimely deaths. Global oral cancer statistics indicate that oral cancer is among the top three cancers impacting the Indian subcontinent majorly because of excessive tobacco consumption. However, with the advancement of medical science oral cancer can be effectively cured when detected in early stages. The treatment of oral cancer includes drug targeted therapy, radiation therapy, chemotherapy and oncosurgery of the oral cavity. Read on to find out everything about oral cancer.

Types of Oral Cancer

These are the common types of oral cancer:

  • Squamous cell carcinoma
    This is the most common type of oral cancer. Research hints that almost 90% of people suffering from oral cancer are having squamous cell carcinoma. An uncontrolled abnormal growth of cancer cells (squamous) in the oral cavity. 
  • Verrucous carcinoma
    This is an uncommon but an existing form of oral cancer which results in 5% of mouth cancer cases. Research hints this cancer is caused due to tobacco consumption.
  • Minor salivary gland carcinoma
    This is a type of cancer which originates from the glands producing saliva inside the mouth. They can cause cancer of the mouth and throat. They can also lead to cystic carcinoma, mucoid carcinoma, polymorphous carcinoma and low-grade carcinoma.
  • Oropharyngeal tumours
    They are tumours cancerous or benign (non-cancerous) in nature which is caused due to human papillomavirus or excessive smoking.
  • Leukoplakia associated with oral cancer
    This is a typical type of condition which is often associated with mouth cancer. This is caused due to the formation of “white patch” known as leukoplakia which can be benign (non-cancerous) also. But mostly leukoplakia has been one of the precursors of the early stage of cancer. Sometimes leukoplakia patches which are commonly found in men and women who are into smoking or tobacco consumption are tested and they are found to be one of the early indicators of cancer in the mouth.
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What is Oral Cancer

Oral cancer is a disease caused due to malignant or cancerous cells found in the cell lining present inside the oral cavity (mouth). If this condition is not treated at the right time it could be life-threatening. Research claims that the main culprit of oral cancer is tobacco and excessive intake of alcohol. However, there are many other reasons which may be responsible for causing oral cancer. Keep reading to learn more about oral cancer.

Symptoms of Oral Cancer

The symptoms of oral cancer are often detected at later stages specially during the spread of the disease. This is because early symptoms of oral cancer have minimal signs and symptoms and often mimic symptomatic mouth ulcers. You are recommended to check with your doctor preferably a dentist/ general practitioner if you are having the following

  • A white or reddish patch of lining in the oral cavity (mouth) for more than 3 weeks.
  • A sore throat persists for more than 1 month
  • Mouth ulcers that do not heal for more than 3-4 weeks
  • An unusual lump or a tumour in the walls or lining of the oral cavity (mouth)
  • Loosening or falling off teeth without any reason
  • A consistent pain in the throat which makes swallowing difficult.
  • Change in voice such as sudden hoarseness or loss of voice.
  • Pain in opening the mouth, lips, jaws, tongue, ears, neck, tonsil region for more than 2-3 weeks should not be neglected and investigations to be done immediately to rule out early stages of oral cancer.  

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Causes & Risk Factors of Oral Cancer

Oral cancer or mouth cancer can occur in both men and women. But it has been observed that men suffer twice more from oral cancer than women. Children and young adults suffer very rarely from oral cancer as per researchers. However, the main reason and risk factor for oral cancer can be blamed on tobacco consumption (orally). The infamous readily available forms of tobacco such as pan masalas, gutkha powders which contain tobacco as their main ingredient is responsible for the onset as well as widespread of this disease. However, there are certain other factors which risk you to get oral cancer. Read below to find out other factors

  • Tobacco
    Tobacco is a known and a researched culprit not only for mouth cancer but also throat cancer. Tobacco consumption in any form (cigarettes, powder) causes aggressive types of life-threatening cancers.
  • Alcohol
    Alcohol itself is not a cancer-causing agent. But it may come as a surprise to many that the way alcohol metabolises in the body can make people prone to several kinds of cancers including mouth cancer. Alcohol consumption along with tobacco increases your risk doubly, to get oral cancer.
  • Betel leaf
    betel leaf or better known as paan has a unique property to blend in the mouth and penetrate its enzymes into the mouth lining. Betel leaf itself does not cause mouth cancer but researchers hint that people living in south-east Asian countries such as India, Bangladesh, Pakistan consume it along with tobacco excessively. Hence making you prone to oral and throat cancer.
  • Genetics
    There has been reported medical cases where people have got oral cancer inspite of not consuming either tobacco or alcohol. This is because there is a possibility of passing cancer genes from parents to their progenies. However it is rare, but existing. Hence people whose either parents or close relatives are suffering from oral cancer should get themselves screened on regular basis to prevent from oral cancer.
  • Weak immune system
    Oral cancer is also caused when a person has a weak immune system. Research hints that Weak immune system invites a lot of health conditions, bacterial and pathogenic invasions including cancer.
  • Human papillomavirus
    Medical investigators and researchers claim that the Human papillomavirus (HPV) is one of the most prevalent reasons for oral and throat cancers. HPV is believed to spread via sexual contact from one person to other. As Human papillomaviruses are present in the infected woman's vulva as well as in the penis of the men. Doctors claim that Oral sex is one of the most common ways of the spread of HPV which causes oral cancer. Sexually active males and females are highly recommended to screen for Human papillomavirus to prevent from all types of cancers.  
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Prevention of Oral Cancer

There is no sure-shot way to prevent oral cancer. However, maintaining good oral health and hygiene is your best bet. Here are some lifestyle practices you should adopt to minimize the chances of getting oral cancer:

  • Keep oral and personal hygiene
    It has been observed that when you successfully maintain personal and oral hygiene effectively you prevent a number of communicable and non-communicable diseases. In the case of oral cancer brushing your teeth along with keeping your tongue and gums clean is very important. White patches known as leukoplakia are to be instantly checked for cancer by a qualified dentist or a cancer specialist.
  • Eat a healthy nutritious diet
    Eating right is the key to a healthy body. Strong immunity is not built in a day it is developed by always nourishing your body with the required vital nutrients such as vitamins, minerals, carbohydrates, and proteins. Prevention of all types of cancers including oral cancer can be achieved by keeping your body's immune system internally strong. Research suggests that low or weak immune system can also be one of the reasons for cancer.
  • Limit alcohol intake and stop smoking
    One of the biggest scientifically proven reasons for oral cancer is believed to be the excessive intake of tobacco and alcohol. Hence it goes without saying that limiting alcohol and tobacco intake can definitely prevent men and women from oral cancer to many folds. 
  • Practice safe sex
    As you may already know that oral cancer spreads through unprotected sexual practices. Hence people should take extra care. Multiple partners and sex with infected partners increase the risk of oral cancer to manifolds.
  • Don't hesitate to see a doctor
    Sometimes a stitch in time saves nine If you are suspecting or you have indulged in any activity with an infected person you are urged not to hesitate and talk to a healthcare practitioner freely. Your doctor may prescribe you screening tests to detect oral or any form of infection or cancer.  
  • Maintain a healthy weight
    Studies show that people with cancer show a pattern of weight loss during the onset of this disease. Same applies to people suffering from oral cancer hence any sign of weight loss because of unknown reasons are to be reported. Especially if you are having difficulty in swallowing or chewing food one must show a doctor to rule out even remote possibilities of oral cancer.
  • Get a routine Dental checkup every 6 months
    This is especially for people who consume tobacco in all forms. Dentists recommend that a six monthly routine checkup can not only help detect oral cancer in the early stages but also help remarkably in preventing oral cancer.  You are recommended to get the inspection done of suspicious mouth lesions and ulcers which do not heal for more than a week.

Diagnosis of Oral Cancer

The first step to the diagnosis of this disease is a complete thorough physical check-up.

Preliminary Inspection

  • Physical Inspection
    Your Dentist/ general practitioner will first examine your lips, gums, mouth wall lining, tonsil region, upper palate, tongue to locate the site of the lesion.
  • Patch/tissue testing
    After detection and inspection of the suspected site or lesion a portion of the patch (cell sample) or the sore ulcer (sample cells) are taken for testing and tested in the laboratory for malignancy (cancer). This test not only determines whether the cells are cancerous or not but also predicts the stage and type of cancer. By performing this test doctors can predict the future course of actions such as medicines, therapies and surgeries for the patient.

Advanced diagnosis

A camera is inserted via the buccal cavity (mouth) to view extensively areas and patches to determine the spread and the stage of the disease. This procedure is known as endoscopy and is usually painless with minimal chances of scarring.

Further to all the above procedures mandatory CT and MRI scans are done when the doctor suspects oral cancer. By doing so the doctor confirms the stage, type and spread of the disease. The stage of the disease is often scaled under Roman numeral (I-IV). Stage I refers to the early onset of the malignancy constricted to a specific place. Stage II & III indicate disease progression and stage IV indicates the spread and high intensity of the disease.  

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Treatment of Oral Cancer

With the advancement of medical science, there are successful treatments available for oral cancer patients depending upon the stage and type detected. Global studies on oral cancer indicate that 90 percent oral cancer survival patients were detected early at stage 1. Usually the treatment of oral cancer is a combination of radiation therapy, chemotherapy along with removal of the affected cancerous regions.

  • Radiation therapy
    Radiation therapy uses high beam X-ray waves to disrupt and kill fast abnormally growing cancer cells. Radiation therapy is frequently used in all forms of cancers to shrink the tumour size. Clinical studies are suggestive that stage 1 oral cancer requires minimal surgery and by taking radiation along with anticancer medicines one can effectively battle oral cancer and win over it.
  • Chemotherapy 
    Chemotherapy therapy is a procedure in which different combinations of anti cancer medicines are injected into your bloodstream directly to target fast spreading cancer cells. In case of oral cancer with special reference to oropharyngeal cancer, treatment with chemotherapy has been found to be very effective. The common chemo drugs used in oral cancer treatment are cisplatin, carboplatin, hydroxyurea. However, chemotherapy comes with its own benefits as well as side effects. You may experience nausea, vomiting, loss of sensation, and loss of appetite while on chemo treatment. However, after successful chemo cycles, most of the side effects begin to subside slowly and one can lead a normal life after the chemotherapy course is completed.
  • Surgery 
    Surgery is the most common procedure conducted in cases of oral cancer. But it is highly recommended to get the surgery done from an expert oncosurgeon, rather than a general surgeon. This is because an oncosurgeon is a specially trained surgeon who conducts surgeries to remove and prevent cancer spread. They use highly latest precision technology and surgical procedures to ensure complete eradication of oral cancer.

    Clinical studies have confirmed that surgeries of the buccal cavity (mouth) is an extensive surgery and may sometimes even lead to face and mouth deformities. There could be a possibility that after surgery you may require to additionally fit and take help of tubes to eat food and consume medicines. There also may be a possibility that you may lose vocal abilities (voice) temporarily or permanently. However, having said that one should not fear the side effects and go ahead and get the surgery done because spreading of cancer in the oral cavity can turn to be life threatening if not treated on time.
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Complications Of Oral Cancer

Oral cancer if not treated on time, as you may already know can be life-threatening. Apart from this, there are certain complications and risks which come attached with oral cancer.

  • Malnutrition
    Upon the onset of this disease many people find it very difficult to consume a full nutritious meal. This is because entire buccal cavity (tongue, palate, jaws etc) get affected and it is very difficult to even completely open their mouth and chew food. There can be a condition called dysphagia which is characterised by difficulty in swallowing food hence after oral cancer surgery patients are highly recommended medical insertion of tubes via which food is passed in.
  • A voice break down
    This is a common coexisting condition of oral cancer because of cancerous cells spreading to the throat and the voice box patients often undergo a change in voice pitch often affecting their speech. People with oral cancer may require speech therapy to regain their ability to talk and communicate once again. Nowadays with the advancement of medical science, there are instruments available which help patients of oral cancer communicate with complete voice breakdowns.
  • Depression
    As we all know, that oral cancer is a chronic condition followed by prolonged oral and chemo medications and major surgery. Patients with oral cancer develop a negative impact mentally due to social, psychological and monotonous disease management factors. Researchers claim that cancer patients even after successful surgeries and treatments slip into depression because of the strong medicines and the fear of relapse of the disease. Doctors often prescribe antidepressants to cancer patients to overcome depression.
  • Emotional balance
    It is quite easily said than done, but striking a balance is very essential as emotional health is equally as important as physical health. Research claims that sometimes it is not easy for a patient to accept that his/her life will never be normal again after oral cancer surgery or treatment. Distortion of the face, disruption in speech, dysphagia (difficulty in swallowing food) followed by malnutrition actually causes a deep impact not only on the patient but also to his/her family. Hence keeping an emotional balance is very important for caregivers, family members and patients.


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  3. Oral Cancer. [Internet]. Volume 3 ; 2019 Springer International Publishing Online ISSN 2509-8837. Oral Cancer.
  4. National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Lip and Oral Cavity Cancer Treatment
  5. National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Oral Cavity, Pharyngeal, and Laryngeal Cancer Prevention

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