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Oral cancer at a glance

The name ‘oral cancer’ refers to cancers that occur in the mouth (or ‘oral cavity’), part of the throat called the ‘oropharynx’, the lips or the tongue.

The reason these cancers are grouped together is that they share a common set of risk factors and causes.

There are over 4,700 cases of oral cancer each year in the UK, broken down as follows:

The disease is about twice as common in men as in women, although this varies with precise cancer site. Although it is relatively rare compared to other cancers, oral cancers are on the increase in younger adults, especially in men in their 40s and 50s.

Click on the links below to find out more about oral cancers.

• Risks and causes
• Signs and symptoms
• Screening
• Detection
• Treatment

If you are a patient looking for information on oral cancer, please visit our patient information website, Cancerhelp UK.

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Risks and causes

Age and sex

As with almost all cancers, oral cancer is more common in older people. Very few cases occur in people under 50, although incidence in younger adults (40-50) is on the increase.

The disease is much more common in men, although the number of women getting the disease is also on the increase. This is because women took up smoking in large numbers much later than men and we are only now seeing the effects.

Tobacco and alcohol consumption are the most important risk factors for oral cancer. More than nine out of ten people with oral cancer use tobacco in some form.

Similarly, over seven out of ten drink frequently. The risk is even higher if a person drinks AND smokes, rather than only doing one or the other.

Chewing tobacco or betel quid (paan) also causes oral cancer.

There is some evidence to suggest that a poor diet, low in vitamins and minerals, may increase the risk of developing oral cancer.

Excessive sun exposure increases the likelihood of developing cancer of the lip.

People with acquired immunodeficiency syndrome (AIDS), or who are taking immune system suppressing drugs after an organ transplant, have a slightly increased risk of developing oral cancer.

You can find out more about what 'cancer risk' means in the 'Understanding 'risk'' section of this website.

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Signs and symptoms

The two most common symptoms of mouth cancer are:

• An ulcer in the mouth that will not heal – 8 out of 10 people with mouth cancer have this symptom
• Discomfort or pain in the mouth that will not go away

Other symptoms can include:

• A white or red patch in the mouth or throat that will not go away
• A lump or thickening on the lip, or in the mouth or throat
• Difficulty or pain with chewing or swallowing
• A feeling that something is caught in the throat
• Unusual bleeding or numbness in the mouth
• Loose or numb teeth
• Difficulty moving the jaw
• Speech problems
• A lump in the neck
• Weight loss

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Screening

There are no specific tests available to screen for oral cancers, but many dentists do routinely check for oral cancers. So having regular dental checkups can help spot the disease early, when it is much easier to treat.

You need to report any changes you or your dentist find to your GP. This is especially important if you smoke and drink a lot.

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Detection

If you or your dentist thinks you may have oral cancer, you must go and see your GP, who will examine you and refer you to a specialist if appropriate.

The specialist may look for hard-to-see problems with a nasoendoscope. But the only accurate way to diagnose oral cancer is by taking a sample from the affected area (a ‘biopsy’) and sending it away for tests in a laboratory.

If the problem is somewhere difficult to get at (for example, right at the back of the throat), this may be done using:

• Fine needle aspiration
• Punch biopsy
• Panendoscopy

Research is underway to find a way to detect oral cancer without taking tissue samples, by looking at the composition of saliva. Some early reports suggest that people with mouth cancer have different levels and types of bacteria in their mouths.

But there is still a long way to go before these early results can be turned into a reliable test.

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Treatment

Surgery

Surgery is frequently used to treat oral cancers. The amount of surgery required will depend on the stage of the cancer. If the doctor thinks the cancer may have spread, he may want to remove some of the lymph nodes (link to glossary) in your neck as well. Surgery may also be required to repair the wound (reconstructive surgery).

Radiotherapy is often used to treat oral cancers that have not spread. It is also sometimes used after surgery to kill any remaining cancer cells. Sometimes radiotherapy is used to relieve symptoms of advances oral cancer.

This can be alongside radiotherapy, or to treat oral cancers that have spread to other parts of the body. It is also used to treat oral cancers that have some back after previous treatment.

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