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Advanced center for neck & ENT surgery

The one stop information portal for thyroid, neck, and ENT diseases

Mouth cancer

Mouth cancer

This section contains information on the following:

1. Presentation 

2. Diagnosis

3. Risk factors

4. Treatment

5. Surgery  

6. Non-surgical treatment 

7. Outcome

8. Prevention


1. How does cancer of the mouth present?

Cancer of the mouth usually presents as a painful ulcer (sore) or lump inside the mouth. Any sore or lump that does not heal within 2 weeks therefore needs urgent medical attention. Rarely, cancer can also present as a painless lump.

2. How do I find out if I have cancer?

Biopsy of a suspicious ulcer or lump needs to be performed to find out if it is a cancerous growth. This can usually be done under local anesthesia and the result will be available in 2 days.

3. Why does it occur?

Tobacco exposure in the form of smoking, chewing etc and heavy alcohol intake are known risk factors. There is some evidence to suggest that nutritional deficiencies may also play a role. Rarely, repeated trauma to the tongue or cheek by a sharp, jagged tooth may also pose a risk. In some patients, there are no obvious risk factors. 

4. How is it treated? 

A thorough clinical examination and contrast CT scan need to be performed to accurately stage the disease. Mouth cancers are usually treated by surgery. For early stage tumors, surgical removal of the tumor alone is often curative. For advanced stage tumors, combined treatment is essential. This involves surgical removal of the tumor, along with lymph nodes in the neck, followed by radiotherapy (with or without additional chemotherapy).

5. Is surgery associated with any problem afterwards?

In general, early stage tumors can be removed without any impairment of appearance, speech, chewing or swallowing. For advanced stage tumors, large portions of the tongue, cheek, floor of mouth or jaw bone may have to be sacrificed. This loss of tissue is filled with skin with or without adjacent muscle/bone from other parts of the body (microvascular free tissue transfer). The majority of patients thus reconstructed return to normal speech and swallowing functions.            

6. Can mouth cancer be treated without surgery?

Non-surgical therapy such as radiotherapy is not recommended as the only or primary treatment for mouth cancer. This is because the high radiation dose causes fibrosis (thickening/scarring of tissues) which results in tethering of the tongue, affecting speech, chewing and swallowing. It can also cause shrinking and scarring in the cheek, giving a poor cosmetic result. It can cause oteoradionecrosis of the jaw bone which is a dreaded and difficult-to-treat condition that results in prolonged infection, pain and even loss of the jaw bone.

7. What are my chances of cure?

Stage of the tumor is currently accepted as the most important factor that determines cure. Early stage tumors in general have an excellent outcome. Advanced stage tumors that are fully treated with combined strategies also have good potential for cure. In addition, lots of other data that become available after the tumor is removed and studied in full detail also help predict the outcome. 

8. How can I prevent mouth cancer?

Quitting smoking and moderating alcohol intake are the two most important preventive steps. Any sharp tooth may require attention from a dentist who can polish it to prevent repeated trauma and irritation. Maintaining a healthy lifestyle with good intake of fruits and vegetables and regular exercise is recommended. Attending screening camps, especially if you use tobacco, would also help pick up very early/suspicious lesions.