About Oral Cavity and Oropharyngeal Cancer
Oral cavity cancer begins in the mouth. Oropharyngeal cancer starts in the middle part of the throat just behind the oral cavity, which can be seen when the mouth is open.
When head and neck cancers such as oral cavity and oropharyngeal cancer go untreated, they can metastasize, spreading to other parts of the body.
According to the National Cancer Institute, risk factors for oral cavity and oropharyngeal cancer include:
- Smoking — Smokers are six times more likely to develop oral cancers.
- Use of smokeless tobacco products — Users of these products are 50 times more likely to develop cancers of the gums, lips, and cheeks.
- Drinking alcohol — Consumers of alcohol are six times more likely to develop oral cancers. Combined alcohol and tobacco use increases your risk.
- Occupational exposure — Wood and metal dust, asbestos and synthetic fibers have all been associated with oral cancers.
- Family history of cancer
- Sun exposure — Excessive exposure, especially at a young age, can increase the risk of lip cancers.
- Other radiation exposures
- Human Papillomavirus (HPV) — A specific type of this virus can cause otherwise healthy men under 50 to develop cancers in their mouths and throats. The more people you and your partners have sex with, the greater your risk.
- Age — Oral cancers can take years to grow, and most occur in people over 55.
- Gender — While 1 in 60 men develop oral cancers compared to 1 in 140 women, this may be because men consume alcohol and smoke more than women.
- Poor diet — Studies have found a link between oral cancer and low consumption of fruits and vegetables.
- Ancestry — Asian ancestry, particularly Chinese ancestry, is a risk factor for oral cancers.
- Epstein-Barr virus infection
- Underlying genetic disorders
Types of oral cavity (mouth) and oropharynx (throat) cancers
The different parts of the oral cavity and oropharynx are made up of various types of cells. Different cancers can start in each type of cell. These differences are important because they can determine a person’s treatment options and prognosis.
Almost all cancers in the oral cavity and oropharynx start in squamous cells, which are flat, thin cells that form the mouth and throat lining. These cancers are called squamous cell carcinomas.
Other types of the oral cavity and oropharyngeal cancer can occur in the minor salivary glands in the lining of the mouth and throat, and in the lymphoid tissue in the tonsils and the base of the tongue, where cancers called lymphomas can start.
Oral cavity and oropharyngeal cancers occur most often in the tongue, tonsils, oropharynx, gums, and floor of the mouth. They are less often found in the lips, the minor salivary glands, cheeks, sinuses, and hard and soft palate.
Signs and Symptoms of Oral Cavity and Oropharyngeal Cancer
Common symptoms of the oral cavity and oropharyngeal cancer include:
- Abnormal tissue in the mouth, including swelling, thickening, lumps, bumps, rough spots, or eroded areas on the lips, gums, cheeks, or other parts of the mouth
- White, red, or speckled patches in the mouth
- Unexplained bleeding in the mouth
- Numbness, pain, or tenderness in any area of the face, mouth, or neck
- Sores in the mouth or on the face or neck that bleed easily and don’t heal within two weeks
- Soreness or a feeling that something is caught in the back of the throat
- Difficulty chewing, swallowing, speaking, or moving the jaw or tongue
- Hoarseness, chronic sore throat, or change in voice
- Unexplained ear pain
- Pain or swelling in your jaw. Dentures might be difficult or uncomfortable to put in.
- A change in the way your teeth or dentures fit together
- Dramatic weight loss
Tests to find oral cavity or oropharyngeal cancer
During an oral cancer screening, your dentist will perform a visual and physical exam of your face, neck, lips, inside of the nose, and oral cavity, looking for abnormalities. Your dentists may also feel your head and cheeks, around your jaw, under your chin, and in your mouth to detect unusual masses or nodules. This exam may utilize a VELscope®, which visualizes natural tissue fluorescence, identifying lesions undetectable to the human eye.
If your dentist finds an area of concern during your screening, they will advise you on the best way to proceed, which may include a follow-up visit or a biopsy. Our dental team partners with local Oral Surgeons to assist with biopsies and further follow-up with an Otolaryngologist or Oncologist who can assist in further treatment planning if suspicious abnormalities are identified.