What you should know about mouth cancer

mouth cancer

What you should know about mouth cancer

This guide contains everything you need to know about mouth cancer: what it is, its symptoms, diagnosis, treatments and alternative therapies.

What is mouth cancer?

Mouth cancer
Mouth cancer is also known as oral or buccal cancer.

Mouth cancer is the growth of a malignant tumor that starts in the oral cavity, which can compromise one or several structures of the mouth, including:

  • Lips
  • Tongue
  • Inside the cheeks
  • Gums
  • Roof of the mouth (palate)
  • Base of the mouth

Mouth cancer is also known as oral or buccal cancer.

Symptoms of mouth cancer

Symptoms of mouth cancer include:

  • Pain and sensitivity
  • Bleeding
  • Voice changes
  • Difficulty tasting food
  • Sores on the lips, gums or inside of the mouth that bleed easily and do not scar
  • White or red spots on the gums, tongue or inside the mouth
  • Growth, lump or thickening of the skin or lining of the mouth
  • Loose teeth
  • Loss of sensitivity or numbness in a certain area of the mouth
  • Pain in the mouth or sore throat
  • Difficulty chewing or swallowing food
  • Difficulty moving the tongue or jaw
  • Change in bite

These symptoms can be related to other symptoms further away from the mouth, such as:

  • Double vision
  • Change in sensitivity of the face
  • A cough that lasts for more than 2 weeks

It is not always easy to identify the warning signs, since they can be confused with symptoms of other diseases. Therefore, it is important to have regular checkups with your doctor and dentist; a dentist will be able to identify the warning signs of mouth cancer.

Causes of mouth cancer

The exact causes of mouth cancer are still unclear. Studies have concluded that the appearance of this disease is closely linked to poor lifestyle habits and exposure to toxins or carcinogenic substances in the mouth. What we do know, is that these factors promote the appearance of preneoplastic lesions and subsequently, carcinoma.

Below are some risk factors that can increase the chances of suffering from this type of cancer:

Risk factors for developing mouth cancer

Some factors that increase the risk of suffering from mouth cancer are:

  • Lifestyle-related:
    • Tobacco consumption (including cigarettes, cigars, pipes, chewing tobacco, snuff etc.)
    • Excessive consumption of alcoholic drinks
    • Excessive sun exposure
    • Poor oral hygiene
    • Untreated infections in the mouth
    • Unprotected sex, including oral sex, which encourages the formation of the Human Papillomavirus (HPV)
    • Weakened immune system (often caused by taking immunosuppressants: drugs that weaken the immune system)
    • Chronic grinding or clenching of the teeth (due to rough teeth, dentures or fillings)
  • Environmental factors
    • Exposure to toxic chemicals

Preventing mouth cancer

Preventing mouth cancer is almost exclusively related to lifestyle changes:

  • Avoiding alcohol and tobacco consumption
  • Eating more fruits and vegetables
  • Avoiding excessive sun exposure
  • Seeing your dentist regularly
  • Seeing your doctor regularly to check your immune system

Testing for and diagnosing mouth cancer

mouth cancer
A physical exam is the most common way to diagnose mouth cancer.

If your doctor suspects that you have mouth cancer, they will carry out one or several of the following tests:

  • Analysis of patient’s medical and family history
  • Physical exam (main diagnostic method)
    • Direct observation test
    • Toluidine blue test, brush biopsy or fluorescence staining
  • Biopsy (extraction of tissue sample to be analyzed)
  • Imaging studies (to determine the extent of the cancer):
    • Endoscopy
    • X-rays
    • Computerized tomography (CT) scan
    • Magnetic resonance imaging (MRI)
    • Positron emission tomography (PET)
    • Exfoliative cytology test
    • Barium swallow
    • Bone scintigraphy (bone scan)

Treatment depends on the stage of the disease:

  • Stage 0 (carcinoma in situ): only found in only one place, it can become cancerous and spread to the surrounding normal tissue.
  • Stage I: cancer has formed and the tumor measures no more than 2cm. The cancer has not spread to the lymph nodes.
  • Stage II: the tumor measures more than 2 cm, but no more than 4 cm, and the cancer has not spread to the lymph nodes.
  • Stage III: the tumor: can be of any size and has spread to a lymph node measuring no more than 3cm and is on the same side of the neck as the tumor; or the tumor measures more than 4 cm.
  • Stage IV: is divided into stages IV-A (cancer has spread to the surrounding tissue and to the nearby lymph nodes); IV-B (can be of any size and has spread to one or more lymph nodes that measure more than 6 cm, muscles or bones of carotid artery are compromised); IV-C (the tumor has spread to other parts of the body, like the lungs, regardless of the size of the initial tumor).

Treatments for mouth cancer

Mouth cancer
Surgery can be accompanied by other treatments like radiotherapy and chemotherapy.

Treatment for mouth cancer depends on many factors, but here are the most common treatments:

Surgery

The most common treatment for mouth cancer consists of surgically removing the tumor. This surgery is ideal if the cancer is small enough. If the tumor has spread to the surrounding lymph nodes, a larger surgery is required, which should be accompanied with other treatments like radiotherapy and chemotherapy.

Some procedures may require subsequent reconstructive surgery to improve functioning.

Radiotherapy

Radiotherapy can be used as a treatment prior to surgery or in combination with chemotherapy. It consists of using high-energy X-rays to destroy cancer cells.

It can be external (using a machine similar to that which is used for MRIs) or internal (by administering a radioactive substance through a needle, tube, wire or catheter to be applied directly to the tumor or the surrounding area).

The largest lesions are usually treated using external radiotherapy to include the primary site of the tumor and the regional lymph nodes, although they are not clinically compromised.

Tumors in stages I and II can be controlled through surgery and radiotherapy alone. Most patients with tumors in stages III or IV are best suited to a combination of surgery and radiotherapy.

Chemotherapy

A chemical substance (drug) is administered to destroy the malignant cells intravenously, attacking any remaining cells following surgery or radiotherapy. Chemotherapy can also be used before surgery to reduce the size of the tumor.

Depending on their chosen treatment method, it is possible that patients may also subsequently need:

  • Speech therapy
  • Therapy to help them chew and swallow
  • Help with relieving dry mouth
  • A nutritionist guide to learn how to get enough protein and calories
  • Psychological therapy in advanced cases of smoking or alcohol addiction

Complementary treatments for mouth cancer

These are the therapies that go hand-in-hand with conventional treatments.

Healthy habits

Maintaining healthy habits is essential for controlling any disease:

Diet

Adopt a balanced diet, eat at least  2 ½ cups of fruit and vegetables a day, as well as several portions of plant-based whole grains such as, bread, cereals, grains, rice, pasta or pulses. Limit your consumption of red and processed meat.

Exercise

Regular exercise is recommended for your general health, but especially when you have cancer. Exercise improves blood flow and helps your metabolism work more efficiently.

Mind-body medicine

Meditate, reflect, remember that you are the person who knows you and your body best. Get to know yourself and your body; sometimes, a bit of self-awareness can help you to better understand your disease and how best to combat it.

Cannabis

mouth_cancer
Medicinal cannabis can be used to relieve side effects from chemotherapy and radiotherapy treatments.

Cannabinoids reduce general discomfort, since they contribute to the improvement of nausea and vomiting, to the stimulation of appetite and to the pain relief that some chemotherapy and radiotherapy treatments produce. It can promote the death of tumor cells, reducing their ability to spread and metastasize.

Coping and support strategies

We know that a cancer diagnosis can be a huge emotional challenge, so it is important that you keep your friends and family close by and that you share your thoughts and feelings with them. Letting your loved ones know how you are coping and being open to their support will help you feel stronger.

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