Three Early Warning Signs of Oral Cancer

Cancers of the mouth are among the most curable malignancies—but only when they're detected early. However, the signs and symptoms are subtle, so most people overlook them.

Each year, approximately 34,000 Americans are diagnosed with oral or pharyngeal (throat) cancers, and about 8,000 die from those cancers—primarily because of delayed diagnosis.

What you may not know: The number of oral and pharyngeal cancer cases is on the rise—increasing by about 9% between 2006 and 2007—and studies are under way to find out why in hopes of curbing this increase. How to protect yourself…

Early Warning Signs

The tongue, the lips and the floor of the mouth are the most common sites for oral cancers. Malignancies also can develop on the gums, the roof of the mouth and the inside of the cheeks.

Initially, most early oral cancers are painless or cause minor irritation. However, early signs often can be spotted by looking inside the mouth. Warning signs include…

White patches, known as leukoplakia, which can occur on any mouth surface, including the tongue or the inside of the cheeks, and are usually flat.
Red raised patches, known as erythroplakia, can occur in any area of the mouth, but most commonly on the tongue. Erythroplakia is sometimes tender and may bleed when you brush the area or eat hard foods.
Sores in the mouth that don't heal within three weeks. They typically appear as an ulcer, lump, red patch, white patch or a combination of red and white patches.

Symptoms associated with early-stage oral cancer can easily be mistaken for a minor ailment such as an injury, toothache or infection.

That's why it's so important to pay attention to subtle changes that you may feel inside your mouth. Primary symptoms of oral cancer include pain or numbness anywhere in the mouth...difficulty swallowing...a sore throat and recently developed bad breath.

Important: If any of these signs or symptoms persists for more than three weeks, see your dentist or physician for an evaluation. Any suspicious area in the mouth usually requires a biopsy to confirm (or rule out the presence of cancer.

Are You At Risk?

Like most cancers, oral malignancies occur most often (although not solely) in older adults. In addition to age, there may be a genetic risk factor for oral cancer, but this is not well understood at this time.

Other factors…

Tobacco use. Cigarettes and cigars are considered equally harmful as risk factors for oral cancer. Chewing tobacco and smokeless tobacco (snuff) are even worse-they increase the risk for cancers of the cheek, the inside of the lips and the gums, with the risk rising with the years of usage. Pipe smoking is the least dangerous but also increases risk for oral cancer.

What to do: If you use any form of tobacco, talk to your dentist or physician about ways to quit, including stop-smoking medications such as nicotine-replacement patches or varenicline (Chantix), a prescription drug that diminishes the desire to smoke-and smoking-cessation programs.

Excessive alcohol consumption. People who have three to five hard-alcoholic beverages daily are far more likely to develop oral cancer than those who drink less.

Warning: The risk is greater for those who smoke and drink.

What to do: Abstain from alcohol or limit consumption. Beer and wine present less of a risk than hard liquor. Alcohol-containing mouthwash is not known to increase oral cancer risk.

Sunlight exposure. Ultraviolet light increases the risk not only for skin cancers, in general, but for lip cancer, in particular.

What to do: If you spend a lot of time outdoors-regardless of the season-use a lip balm that protects against ultraviolet-A and ultraviolet-B rays. Especially in the summer, wear a broad-brimmed hat to keep the sun off your face.

Human papilloma virus (HPV). This sexually transmitted virus is strongly associated with cervical cancer and there's some evidence that the virus, which can be contracted through oral sex, might be linked to some oral cancers.

What to do: If you have HPV, be vigilant about getting oral cancer exams from your dentist.

Best Treatment Options

Without treatment, oral cancers will invade deeper layers of tissue and spread to the neck and, in some cases, to other parts of the body. Research has shown that the cancer can spread to the neck as soon as four to eight weeks after diagnosis.

Oral cancers that are detected early usually can be cured with surgery and/or radiation therapy. The lesions may be so small that they can be removed by a head and neck surgeon with very little hospital time, no complications and excellent recovery. Surgery may be combined with radiation to kill cancer cells that may have been left behind. Chemotherapy is required only for larger and/or more invasive tumors.

Foods That Reduce Risk

Scientific studies show that people who eat a produce-rich diet (about five servings daily of fruits and vegetables) are less likely to get oral cancers than those who eat less produce.

New finding: In a laboratory study, increasing concentrations of berry extracts (taken from blackberries, black raspberries, blueberries, cranberries, red raspberries and strawberries) were linked with inhibition of cancer cells—including cells involved in oral cancers. Berries contain potent phytochemicals, including some with antioxidant and anticancer properties.

30-Second Mouth Exam

Your dentist should examine your mouth for possible signs of oral cancer once or twice a year, but you can help by doing a self-exam to check for suspicious changes.

What to do: While standing in front of a mirror in a well-lit room, pull the sides of your cheeks away from your teeth so that you can see inside your mouth. Check all areas of your mouth, including under the tongue, as well as your lips. If you notice any bumps, tender areas or changes in color, see your dentist promptly.

Gum Disease Linked to Cancer

In a recent study, researchers compared dental X-rays of 51 men diagnosed with tongue cancer and 54 men without cancer.

Result: Each millimeter of bone loss associated with gum disease equaled a 5.2 times greater likelihood that the study subject had tongue cancer.

Theory: Gum disease is caused in part by chronic inflammation, which has been linked to cancer.