Oral Cancer: Symptoms, Causes, and Treatments

Symptoms

Symptoms of oral cancer can vary depending on the stage and the affected area. Typically, these symptoms appear as mouth sores that do not heal. The main symptoms include:

mouth sores: wounds that do not heal within two weeks, which may or may not be painful

white or red patches: discolored areas on the inner walls of the mouth, which may indicate changes with potential to develop into cancer

difficulty or pain when chewing or swallowing: a sensation of something stuck in the throat, which can cause discomfort when eating or drinking

pain or numbness: a painful or numb sensation in a part of the mouth that persists without an apparent cause

earache sensation: involvement of nerves in the brain region can cause pain perceived in the ear

swollen lymph nodes in the neck: the presence of a small lump in the neck may be a sign of cancer, especially if it lasts more than two weeks, feels firm and fixed, and is usually painless

Other symptoms may include unexplained weight loss, persistent bad breath, and difficulty moving the jaw or tongue.

Causes

Oral cancer can have several causes, involving genetic, environmental, and lifestyle factors. The main causes are:

smoking: using any type of tobacco (cigarettes, cigars, pipes, and chewing tobacco) is one of the main causes of oral cancer due to the carcinogenic substances in tobacco
genetics: a minority of patients may have a genetic predisposition to oral cancer, increasing the risk of developing the disease
excessive radiation exposure: prolonged sun exposure without protection can damage mouth cells, increasing cancer risk

In addition, a diet low in fruits and vegetables may also contribute to the development of oral cancer. Infection with Human Papillomavirus (HPV) is more associated with oropharyngeal tumors, a region near the mouth but different from the oral cavity.

Diagnosis

Diagnosing oral cancer involves a series of evaluations and tests performed by healthcare professionals to confirm the disease and determine its extent. Common steps in the diagnostic process include:

clinical examination: visual inspection of the mouth, throat, and neck, looking for lesions, swelling, or abnormalities
biopsy: collection of a tissue sample for microscopic analysis, allowing identification of cancerous cells
imaging tests: X-rays, CT scans (which use X-rays to create detailed body images), or MRIs (which use magnetic fields to generate body images) to assess the extent of the cancer and detect whether it has spread
blood tests: to check general health and organ function

A biopsy is essential to confirm the diagnosis of oral cancer, as it allows for detailed analysis of the affected cells.

Treatment

Treatment for oral cancer varies depending on the stage of the disease, tumor location, and the person’s overall health. The main treatment options include:

surgery: removal of the tumor and possibly nearby tissues. In some cases, part of the jaw or tongue may need to be removed
radiotherapy: use of high-energy radiation to destroy cancer cells. It may be used alone or in combination with other treatments, but is usually considered a complement after surgery in specific cases
chemotherapy: drugs that kill or inhibit the growth of cancer cells. Administered intravenously, usually in combination with radiotherapy in specific cases
immunotherapy: stimulates the immune system to fight cancer using drugs that help the body recognize and attack cancer cells, typically reserved for more advanced stages of the disease

Treatment is personalized and may involve a combination of these approaches, depending on the patient’s individual needs.

Einstein's Oncology and Hematology unit offers comprehensive care from diagnosis to treatment. Learn more.

Prevention

Most cases of oral cancer cannot be directly prevented, as many risk factors are difficult to control. However, some measures can help reduce the risk:

avoid smoking using tobacco: refrain from all types of tobacco products, including cigarettes, cigars, and chewing tobacco
consume alcohol in moderation: limit alcohol intake, as excessive consumption is associated with a higher risk of oral cancer
protect lips from the sun: use lip balm with sunscreen and wide-brimmed hats to reduce UV exposure
maintain a healthy diet: include fruits and vegetables in your diet, as they are rich in antioxidants and nutrients that help protect against cancer
regular check-ups: visits to healthcare professionals for oral exams can help detect suspicious changes early

Adopting a healthy lifestyle and avoiding risky behaviors are key steps in preventing oral cancer.