Detecting Cancer of the Mouth

Cancer of the mouth can be devastating. Unfortunately, there is little awareness about this condition.

Most people mistakenly think they have food allergies, common cold or dental problems.

This leads to delayed diagnosis and poor outcome of treatment.

What does mouth cancer look like?

Initially, cancer of the lip may look like a cold sore, ulcer or a pimple. It does not respond to medication used to treat cold sores. With time, it slowly enlarges and can be painful and crusted.

Tongue cancer may appear as a red or white patch on the tongue. This patch can be painful and is not related to dentures or inadvertently biting one’s tongue. Usually, these patches (sores) do not heal on their own and do not resolve with use of antiseptic mouthwashes or ointments. There may be an unusual sensation on the affected side of the tongue.

Gums, inner cheeks and palate

Cancer in these areas may present as either white or red patches, abnormal bleeding or persistent pain. You may have unexplained loose teeth and places in which teeth have been extracted may not heal. If you have dentures, you may notice that they no longer fit appropriately.

Cancer can affect the bones that form the jaw. This presents as a jaw swelling (can either be painless or may be associated with discomfort depending on the location). This swelling can cause difficulty in opening the mouth and chewing.

The mouth has multiple salivary glands. Usually, if they are affected by cancer, there may be swelling in the floor of the mouth. The largest salivary gland (parotid) is located at the angle of the jaw and cancer of this gland can cause swelling in the cheek an even weakness on one side of the face.

Other symptoms of oral (mouth) cancer include:

—A persistent sore throat

—Sensation that there is something ‘stuck’ at the back of the throat.

—Difficulty chewing or swallowing.
—Difficulty speaking, you may develop a new lisp.
—Hoarseness or change in voice.
—Ear pain.
—Lumps in the neck. This can be due to swollen lymph nodes with cancer cells.
—Dramatic weight loss.

Risk factors for development of oral cancer

• Use of tobacco products: Smoking cigarettes, pipes or cigars, chewing tobacco, and use of snuff significantly increases your risk of getting mouth cancer.
• Smoking increases that risk by six times (as compared to the general population) whilst use of snuff and chewing tobacco increases your risk of getting oral cancer by 50 times.
• Excessive consumption of alcohol: Mouth cancers are five times more common in heavy drinkers than in non-drinkers.
• Infection: Human papilloma virus (HPV) infection has been associated with increased risk of mouth cancers. HPV has also been associated with warts, cervical and anal cancer.
• Family history of cancer: If you have an immediate relative with oral cancer, you have an increased chance of getting it as well.
• Excessive sun exposure on the lips
• However, not everyone who gets oral cancer smokes or drinks. Over 20 per cent of all newly diagnosed cases neither smoke nor drink.

What to do if you have a suspicious mouth sore

Go for a check-up. You can see a dentist or an ear, nose and throat specialist. They will perform a full examination of the mouth and possibly take a biopsy (specimen) from any abnormal looking areas.

This specimen will then be assessed under a microscope to determine if it is cancer.
Depending on the findings, you may be asked to perform various scans.

The type of cancer determines the treatment. Most cancers require surgery to remove the tumour. This can be followed by reconstruction of the affected area (if needed). Some cancers require radiotherapy or chemotherapy.

(Radiotherapy uses radiation to kill cancer cells whilst chemotherapy uses medication/drugs to kill cancer cells). If detected early, mouth cancer can be treated with very good outcomes.

—Conduct a self exam at least once a month.

—Stand or sit in front of a mirror with very bright light.

—Look at your lips and feel them for any unusual thickness or sores. —Evert the lips and look on the inside. Check for any unusual redness or any whitish sores.

—Bare your teeth and look at your gums for areas of bleeding or mouth ulcers/sores. Remove dentures and examine the gum.

—Pull your cheeks out to view the inside of your mouth. Use your finger to feel for any abnormalities.
—Tilt your head and look at the roof of your mouth. Shine a torch to look at the back of the mouth/throat.

—Finally, feel your chin, jaw line and neck for unusual swellings.
—Notify your dentist or ENT doctor if you notice any abnormalities.

Steps to reduce your chances of getting mouth cancer

—Stop using tobacco products

—Keep alcohol intake to the desired minimum (The maximum intake of alcohol is two drinks/day for both men and women. Previously, it was thought that men could take three units/day – this has been found not to be safe in the long run).

—Visit a dentist twice a year for a check-up. He or she will be able to detect any abnormalities early and institute appropriate measures. The dentist is also able to detect precancerous lesions (areas which will eventually develop cancer) and can treat them appropriately.