Mouth Cancer Symptoms, Causes, Risk, and Treatment Options

All About Mouth Cancer Concerns 

The prevalence of mouth diseases drastically increases with changes in living conditions and urbanisation. Globally, mouth cancer ranks 13th among the most common cancers. The combination of mouth, lip cancer, and oral cavity is estimated to be around 188,438 death cases and 389,846 new cases in 2022.  This is a stark reminder of the importance of early detection and awareness.

Therefore, understanding the mouth cancer symptoms, causes, and risk factors of mouth cancer is crucial not only for personal health but also for protecting your loved ones. 

This article offers a clear overview of the stages of mouth cancer, key symptoms to watch for, and how it is diagnosed. It also covers available treatment options, all aimed at encouraging preventive care and timely medical attention.

What is Mouth Cancer? 

Mouth cancer is known as oral cancer, which affects several areas of the mouth, including the lips, the tongue, and the cheeks. This can also damage the tonsils, salivary glands, and pharynx, where the tumour develops and surrounds the mouth. 

There are different types of mouth cancer, which can occur rarely: 

• Mouth cancers are mostly squamous cell carcinomas (SCC) that grow in the skin.
• Salivary gland cancer that grows in the gland.
• Lymphoma occurs in lymph glands near the tonsils and tongue.     

What are the Symptoms of Mouth Cancer at Different Stages of Progression? 

Mouth cancer affects the mouth and oropharynx, including two-thirds of the tongue, roof, and floor of the mouth, as well as the gums and lips. In the early stage, mouth cancer symptoms can appear as anatomical issues like patches on gums and lesions inside cheeks. From the advanced stages of mouth cancer, a person can have functional symptoms. A brief demonstration is done below to recognise cancer symptoms at different stages.   

1.First Stage Mouth Cancer Symptoms 

In the early stage of mouth cancer, possible suspicious signs to look for are listed below.

• Leukoplakia, white patches in the gum area as pre-mouth cancer symptoms
• Initial symptoms of mouth cancer include erythroplakia, red patches 
• Erythroleukoplakia, a mixture of red and white patches in the mouth 
• Ulcer in mouth and lip sores that bleed and don't heal within 2 weeks of appearance.
• Inner cheek thinning as 

2. Second and Third Stage Mouth Cancer Symptoms 

After becoming deeper and larger, the tumour can initiate affecting nerve cells of the neck and head. As mouth cancer progresses, individuals may notice such symptoms: 

• The first symptom of mouth cancer in Stage II is loss or numbness of sensation around the tongue, lips, and jaw. 
• Invaded nerve cells often cause pain and hypersensitivity.
• Excessive pain in closing or opening the mouth and chewing foods. 
• Swollen lymph nodes. 
• Slurred speech. 
• Swollen salivary glands.
• Swelling of the jaw results in dentures becoming uncomfortable or fitting poorly.

3. Fourth Stage Mouth Cancer Symptoms 

Once the mouth cancer cell reaches an advanced stage, it spreads beyond the original location and affects major nerves. Stage IV mouth cancer symptoms can include: 

• Feeling numbness or significant pain in larger areas of the mouth.
• Bumps or swelling or lumps in the jaw and neck.
• Lockjaw or Trismus prevents movement, as well as an open or closed mouth.
• Swelling of tongue or jaw bones.
• Loose teeth.
• Persistent sore throat, experiencing that something is gripped in the throat.  
• Loss of voice.   

Other Signs and Symptoms of Mouth Cancer Appear from the Initial to Advanced Stages 

Pain, hoarseness, swallowing, and voice changes are common symptoms of mouth cancer. Some symptoms appear in late and early stages that need to be prioritised for initiating treatment from the early stages. 

• Weight loss occurs in early-stage mouth cancers since patients are not able to eat well.
• Bleeding in the mouth, a small amount of blood that can ooze out with saliva while brushing teeth is an early-stage mouth cancer symptom. 
• Later-stage mouth cancer causes a loss of appetite. 
• The most serious last-stage symptom of mouth cancer is Throat Cancer, called Oropharyngeal cancer.  
  Now that you know the symptoms of mouth cancer at different stages, let's see the causes that can result in this disease. 
   

What are the Causes of Mouth Cancer? 

Mouth cancer occurs in squamous cells in the oral cavity. Tumours in the oral area become cancerous when the DNA of squamous cells changes and begins multiplying or growing. Over time, these cells spread to the inside of the mouth, other neck and head areas.  

Most mouth cancer cases first develop among 50 to 74-year-old adults due to smoking, drinking habits, and viral infection. The risk factors of causing mouth cancer are listed below: 

• One of the major factors of mouth cancer is tobacco use; smoking cigarettes 
• Regularly drinking excessive alcohol.   
• Extreme sun exposure without protecting face and lips with sunblock. 
• Family history of having oral cancer.     
• Having an infection with sexually transmitted human papillomavirus.  
• Gum Disease and poor oral hygiene.
• A poor diet with low vegetables and fruits is linked with a higher risk of mouth cancer. 

How to Diagnose Mouth Cancer? 

Dentists may refer to regular checkups and tests to spot potential tumour or cancer locations, stages, and treatments. 

1. Physical Test: 

This test includes physical checking of the insides of the mouth, face, head, and neck to measure potential signs of mouth cancer. 

2. Incisional Biopsy: 

Incisional biopsy examines a small portion of suspicious tissues of tumour or cancer cells. This test helps to identify cancerous lesions, type of cancer, and seriousness of cancer cells. 

3. Brush Biopsy: 

One of the important tests helps to determine early-stage or precancerous lesions even when cancer or tumour is not suspected clinically.  

4. Indirect pharyngoscopy and laryngoscopy: 

Indirect pharyngoscopy and laryngoscopy allow dentists to examine the base of the tongue, throat, and larynx parts and detect cancerous areas.   

5. Endoscopy: 

In this endoscopy test, the endoscope is a flexible tube placed to examine the sinuses, nose, throat (pharynx) and voice box (larynx). This test can facilitate doctors with visual inspection of the oral cavity, abnormal tissues or tumours, and the spread of cancer to lymph nodes. 

6. Scans: 

MRI, PET, and CT scans help to identify growth, such as the progress stage, location, and spread of the mouth cancer cells. 

What are the Available Treatment Options for Mouth Cancer? 

Mainly three types of treatment options are available for mouth cancer: Surgery, Chemotherapy, and Radiation Therapy. 

1.Surgery

Doctors may recommend surgeries to eliminate tumour cells from the mouth at an early stage. Furthermore, surgeries refer to the removal of lymph nodes or tissues that can reduce the chances of recurring cancer cells. 
Potential surgery options for mouth cancer are:

• Primary Tumour Surgery: Remove tumour cells from the neck or mouth.  
• Mandibulectomy: Jawbone surgery to remove tissues and restore jaw functions. 
• Glossectomy: Removal of total or partial tongue. 
• Maxillectomy: This surgery removes all or cancerous parts of the upper jaw. It carries a high risk of speech changes and swallowing. 
• Neck Dissection: Prevent cancer growth by removing lymph nodes and tissues in the neck. 
• Reconstructive Surgery: This surgery removes tumours and large tissue from lips, palate, tongue, and jaw that need repairing. Reconstructive surgery helps to restore the natural appearance of the face and mouth and bodily functions like breathing, eating, and talking.      

2. Therapy and other Management

Depending on the cancer stage and symptoms, doctors prefer different therapeutic and care treatments, including: 

• Radiation Therapy: Uses high-energy radiation X-rays or particles to kill cancer cells and slow cell growth. This therapy damages the DNA of cancer cells and destroys shrinking tumours, prevents recurrence, and eliminates advanced cancer cell symptoms.   
• Chemotherapy: It moves through the bloodstream to reach and shrink tumours and destroy the potential dividing and growing power of cancer. This therapy helps to relieve cancer symptoms and risk of recurrence after initial treatment.    
• Targeted Therapy: This therapy includes drugs like angiogenesis and EGFR inhibitors to precisely determine and kill cancer cells without harming healthy cells.  
• Immunotherapy: Also known as biological therapy, it aims to improve the body's immune system to fight against tumour cells. 
• Palliative Care: Doctors prefer palliative care to reduce mouth cancer symptoms and side effects of therapeutic or drug treatments. Palliative care helps to manage cancer symptoms, including stress, pain, fatigue, nausea, and eating difficulties.     
   

What are the Possible Complications of Treating Mouth Cancer? 

Mouth cancer and radiation chemotherapy treatments may cause complications; these are: 

• Smell and appetite loss with taste changes.
• Changes in speech and voice. 
• Swallowing issues, lip and mouth sores.
• Malnutrition and Weight Loss.
• Poor immunity.
• Fatigue, pain and numbness. 
• Hair loss and skin rashes. 
• Headache, fever, nausea and vomiting. 

What to do to Prevent Mouth Cancer? 

The following tips can prevent or reduce the risk of having mouth cancer. 

• Need to quit smoking. 
• Reduce drinking alcohol to a moderate level.
• Use UV-AB blocking sunscreen on sunblock and face. 
• Maintain good oral hygiene regularly. 
• A well-balanced diet and monthly dental checkups.  

Final Words

Mouth cancer aggressively affects the tongue, lips, and the inside areas of the mouth. Excessive tobacco smoking, regular alcohol consumption, and poor oral hygiene are the main risk factors. Mouth cancer symptoms include mouth ulcers, painless lumps, difficulties in opening or closing the mouth, and voice loss. Dentists prefer radiotherapy, chemotherapy, surgeries, immunotherapy, and palliative care to treat mouth cancer.