Oral cancer

Oral cancer is a potentially fatal disease that can affect people of all ages. It is an aggressive disease with a survival rate of only 50% over 5 years. This is due to multiple factors.

• It can often go undetected until the cancer is advanced.
• It often does not cause the patient to experience any symptoms until advanced.
• It is caused by a variety of lifestyle risks, many of which are a part of the everyday lives of many Australians.

Depending on the stage of cancer at the time of diagnosis, treatment may require surgery, radiation therapy and/or chemotherapy.

Warning signs

Oral cancer includes a range of cancers that affect any part of the oral cavity. This can include the lips, tongue, cheeks, floor of the mouth, gums, back of the throat or salivary glands. It occurs most commonly on the sides of the tongue and the floor of the mouth. The appearance of oral cancer varies greatly and can appear similar to other conditions that effect the mouth. In early stages, oral cancers will have often have no symptoms. Pain is more common in advanced cases.

• A sore, irritation, lump or change in the thickness of soft tissues.
• An ulcer that is present for longer than 2 weeks or continues to return over and over again.
• Blood blister in the mouth that does not heal or repeatedly comes back.
• A white or red patch in the mouth. 
• A continued feeling that something is caught in the throat.
• Difficulty chewing or swallowing.
• Difficulty moving the jaw or tongue around.
• Glands/lymph nodes under the jaw that are swollen and do not go away. 
• A sore throat that does not go away.
• Difficulty speaking, or a change in voice.
• The tongue or other areas of the mouth feel numb. 
• Swelling of the jaw that causes dentures to stop fitting properly or become uncomfortable to wear.

If after reading these symptoms, you feel that one or more may apply to you, do not panic. There can be a number of reasons other than oral cancer for the occurrence of such symptoms, however, it is best to contact your dentist for an examination.
 

An ulcer located on the side of the tongue. Getty Images.

Detection and diagnosis

Dentists perform cancer screenings of the head and neck as well as inside the mouth as part of dental examinations. People without teeth and who wear dentures should still visit a dentist regularly for an examination of the gums and other soft tissues in the mouth.

Early detection of possible oral cancer lesions is important to try and improve long-term outcomes. It is also important to detect lesions in the mouth that may develop into cancer. These lesions are made of abnormal cells that are not cancerous but can turn into cancer and are known as precancerous lesions. 

Squamous cell carcinoma

Squamous cell carcinoma is the most common cancer that develops in the mouth. It can affect any part of the soft tissue lining in the mouth known as the oral mucosa. Most commonly, it occurs on the sides of the tongue, the floor of the mouth or the gums.

Risk factors

There are multiple lifestyle factors that increase your risk of developing oral cancer. Many of these factors are a part of the everyday lives of many Australians. Alcohol and tobacco use are major risk factors for oral cancer development as they introduce cancer-causing material (known as carcinogens) into the mouth. The use of alcohol and tobacco together greatly increase risk of oral cancer.

Risk factors for squamous cell carcinoma development in the mouth include:

• Older age
• Male gender
• Smoking or tobacco use
• Areca nut (betel quid) chewing
• Alcohol use
• Infection by viruses, for example the human papillomavirus (HPV)
• Family history
• History of cancer therapy
• Long term immunosuppression

Cigarette smoking and tobacco use

Any kind of smoking including vaping, cigarette smoking, cigars, marijuana and any other inhalation habit where you burn the throat increases your risk of oral cancer. The best prevention is quitting. Your dentist can provide advice on strategies to help you quit smoking.
 

Alcohol

Alcohol consumption at all levels carries with it some level of inherit risk. The Australian Guidelines for Alcohol Intake recommend no more than two standard drinks per day to reduce your risk of alcohol-related diseases. Cancer risk increases with long-term consumption of alcohol rather than the amount consumed each time you drink. Even light drinking (defined as one drink/day) has been associated with oral cancers. The regular use of alcohol-containing mouthwashes is safe and have not been shown to increase risk of oral cancer.
 

Oral sex

Exposure to, and transmission of, the Human Papilloma Virus (HPV) through oral sex increases the risk of developing oral cancer, particularly oropharyngeal (throat) cancer. HPV can affect both males and females. Participating in oral sex always carries the risk of sexually transmitted diseases including HPV. It is best to take precautions and practice safe sex.

Vaccinations against HPV are available for males and females (Gardasil and Cervarix). Contact your doctor, local immunisation provider or visit www.hpvvaccine.org.au for more information.
 

Sun exposure

The skin on your lips can be easily damaged by sun exposure. Protect your lips from harmful UV rays when out in the sun by applying a minimum of SPF15+ lip balm. As well wear a hat and sunscreen. If you work outdoors, apply a broad-spectrum sunscreen (protects against UVA and UVB) to your lips and face throughout the day to stay protected.

For more information on how to reduce your risk, visit the Cancer Council Australia website.
 

Diet

A poor diet increases the risk of oral cancer by depriving your body of antioxidants and essential vitamins and minerals. This doesn't just mean cutting out junk foods but ensuring you drink plenty of water and have a healthy diet filled with fresh fruit and vegetables. Consult your doctor, dentist or dietician for dietary advice.

Steps to reduce your oral cancer risk:

• Quit the use of cigarettes and tobacco.
• Limit he amount of alcohol consumed. 
• Have the HPV vaccination and practice safe sex.

While it's impossible to fully prevent oral cancer, taking these steps can help reduce your chances of diagnosis. Visiting your dentist on a regular basis will help ensure any signs of oral cancer are identified as early as possible. If you don't have a regular dentist, use the ADA's Find-A-Dentist service to find an ADA member dentist near you.