Oral Cancer: Signs and Symptoms

What is Oral Cancer?
Oral cancer is cancer that occurs on the lips (usually the lower lip) inside the mouth, on the back of the throat, the tonsils or salivary glands. In Australia, 4000 new cases are diagnosed each year1. Smoking in combination with heavy alcohol use is a key risk factor.

If not detected early, oral cancer can require surgery, radiation therapy or chemotherapy. It can also be fatal. Part of the reason for this poor prognosis is a failure to recognise the early symptoms, so detecting oral cancer early is the key to successful treatment.

What are the symptoms of oral cancer?
You will not always be able to spot the earliest warning signs of oral cancer, which is why regular check-ups with both your dentist and doctor are so important. Your dentist is trained to detect early warning signs of oral cancer. However, in addition to check-ups, you should see your dentist if you do notice any of the following:

  • A sore on the lips, gums, or inside of your mouth that bleeds easily and does not heal
  • A lump or thickening in the cheek that you can feel with your tongue
  • Loss of feeling or numbness in any part of your mouth
  • White or red patches on the gums, tongue or inside of mouth
  • Difficulty chewing or swallowing food
  • Pain and tenderness
  • Changes in your speech such as lack of clarity or slurring.

How can I prevent oral cancer?
If you do not smoke tobacco, do not start. More than 80 per cent of cancers of the mouth, nose and throat occur in people who smoke.2

Smoking – The link between smoking, lung cancer and heart disease is well established2. Smoking also affects your general health, making it harder for you to fight infections and recover from injuries or surgery. Among young adults, smoking can lead to stunted growth and other developmental difficulties. Many smokers find they cannot smell or taste as well as before, and risk developing bad breath and stained teeth.

Your oral health is also at risk every time you light up. Smoking cigarettes, a pipe or a cigar greatly increases your chances of developing cancer of the larynx, mouth, throat and oesophagus. Because so many people are not aware of or ignore early symptoms, oral cancer often spreads before it is detected.

It is best to avoid smoking cigarettes, cigars or pipes, chewing tobacco or dipping snuff. People who stop using tobacco, even after many years of use, greatly reduce their risk for oral cancer. Either chronic or heavy use of alcohol also increases your risk of cancer. Alcohol combined with tobacco creates an especially high risk.

How is oral cancer treated?
After a diagnosis has been made, a team of specialists (including an oral surgeon and dentist) develops a treatment plan to fit each patient's needs. Surgery is usually required, followed by radiation and chemotherapy. It is important to see a dentist who is familiar with the changes these therapies may cause in the mouth.

Each time you consume foods and drinks that contain sugars or starches, the bacteria in plaque produce acids that attack your teeth for 20 minutes or more. To reduce damage to your tooth enamel, limit the number of snacks and drinks between meals. When you do snack, choose nutritious foods such as cheese, raw vegetables, plain yoghurt or fruit.

What oral side effects occur with radiation therapy?
When radiation therapy is used for the head and neck area, many people feel irritation in the mouth. Dry mouth, difficulty in swallowing and changes in taste can be experienced. Radiation also increases the chances of getting cavities. Therefore, during radiation treatment it is especially important to take good care of your teeth, gums, mouth and throat.

Be sure to talk regularly with your cancer specialist and dentist about any mouth problems you might have during and after radiation treatment. Furthermore, prior to starting head and neck cancer therapy, discuss with your dentist what you can do to help prevent the possible oral side effects before, during and after.

How can I maintain oral health during my therapy?
Be sure to brush with a soft toothbrush after meals and floss daily. Avoid spices and coarse foods like raw vegetables, dry crackers and nuts. Also avoid tobacco and alcohol. Eat or chew sugar-free gum or sweets to keep your mouth moist.

Before starting radiation therapy, notify your dentist and make an appointment for a complete check-up. Ask your dental professional to consult your radiation oncologist before your radiation treatment begins.

1Smoking Causes Mouth and Throat Cancer. In Australian Government’s Quitnow.(August 2008). Retrieved 25th October, 2011 from http://www.health.gov.au/internet/quitnow/publishing.nsf/Content/warnings-mouth#sources
2 Cancers of the Mouth, Nose and Throat. In Cancer Council Victoria. (April 2003). Retrieved 25th October, 2011 from http://www.cancervic.org.au/about-cancer/cancer_types/mouth_nose_and_throat_cancers
3 When Smoke Gets in Your Eyes…Nose, Throat, Lungs and Bloodstream. In Cancer Council NSW. Retrieved 18th October, 2011 from http://www.cancercouncil.com.au/editorial.asp?pageid=1385