Is oral cancer deadly?

Yes. Oral cancer is deadly. India has one-third of the world's mouth cancer cases, posing a challenge. In India, 77,000 new cases and 52,000 fatalities are recorded yearly. The survival rate is as follows: Early cancer diagnosis results in an 85% 5-year survival rate. This stage diagnoses 28% of oral and oropharyngeal malignancies. If cancer spreads to nearby organs or lymph nodes, the 5-year survival rate is 68%. This stage diagnoses over half of the cases. If cancer spreads, 5-year survival is 40%. This stage diagnoses 18% of oral and oropharyngeal malignancies.

What age is oral cancer common?

While the average age of most people diagnosed with oral cancers is 63 years, there are various cases of patients reporting oral cancers at even younger ages. Just over 20% (1 of 5) of cases occur in patients younger than 55 years of age.

Does oral cancer lead to death?

As evidenced by autopsy reports, various factors can cause the death of patients suffering from oral cancer. Around 11% of death was due to recurrent or uncontrollable disease above the clavicles. Nearly 17% of patients died of metastatic disease beyond the neck. About 24% of the death accounted for the frequent complications of treatment. Most complications were putrid lung abscess and rupture of the carotid artery. About 80% of the patients who died of unrelated causes had no metastases or tumours. The overall incidence of multiple primary cancers was 34% The death rate from a second primary cancer was 24%

Can oral cancer be fully cured?

Surgery alone may cure if the cancer hasn't gone beyond the mouth or oropharynx. If the metastasis (spread of cancer) is significant or has progressed to the neck, surgery, radiation, and chemotherapy may be necessary. The therapies could be given as a monotherapy or as a combined therapy.

Is oral thrush a sign of cancer?

No. Oral thrush is not a sign of oral cancer. Nevertheless, oral thrush can increase the risk of contracting oral cancer. Oral thrush is caused by Candida spp, which also produces carcinogens such as nitrosamine and acetaldehyde. These chemicals, combined with other risk factors such as tobacco use and alcoholism, can magnify the odds of oral cancer contraction.

Can poor oral hygiene cause cancer?

Yes. Poor oral hygiene can have increased chances of oral cancer. Research from 2011 demonstrated that oral cancers are strongly associated with poor oral hygiene. Poor oral hygiene increases the chances of microbial colonization. With other carcinogens like tobacco and alcohol, the carcinogenic potential increases significantly. Bad breath, bleeding gums, dry mouth, tooth decay, tooth erosion, and gum disease are a few symptoms of poor oral hygiene.

Can I get cancer from oral sex?

No. Oral sex does not cause oral cancer, as oral cancer is not a communicable disease. However, Oral sex causes the risk of an increase in HPV16 infection, which magnifies the risk of oral cancer. Oral sex, several partners, and HPV 16 infection raise cancer risk. On average, patients with viral infection reportedly had four-lifetime oral sex partners. Men have more oral sex partners than women, potentially increasing their risk for oropharyngeal cancer.

Is there a treatment for oral HPV infection?

At present, there is no treatment for oral HPV infection. However, it must be understood that in most patients, the virus is cleared on its own within a year or two without therapy or assistance. Most persons with oral HPV won't acquire cancer.

Can a blood test detect oral cancer?

No. Currently, no blood tests can detect oral cancer. However, blood tests are regularly done to understand the patient's health status. Before therapy, the oncologist may conduct standard blood tests to assess overall health. Poor nutrition and low blood cell count may be diagnosed. A complete blood count (CBC) measures blood cell count and can detect anaemia (low number of red blood cells). Blood chemistry testing may measure liver and kidney function.

Can cheek biting cause oral cancer?

Yes. Cheek biting can increase the chances of oral cancer. While research linked oral lesions, it's not exclusive to cheek biting. Long-standing wounds in cheek biters, which produce ulcers or lesions on the tongue, can cause oral cancer. Deep and recurrent cheek biting is the most harmful mechanical irritation creating buccal mucosal lesions that may lead to an increased risk of oral cancer owing to alterations in the cheek tissue and cells in the worst and most uncommon cases.

Oral Cancer – Symptoms, Causes, Stages, Risk Factors, Complications & Prevention

PACE Hospitals

Oral cancer definition

When healthy cells multiply out of control, forming a tumour (a mass of cells) which could be cancerous or benign. If cancer begins in the buccal cavity or oral cavity, it is called oral cancer.

The oropharynx, oral cavity and other parts of the head and neck provide the ability to chew, swallow, breathe, and talk. The oral cavity includes the following:

Lips
Front 2/3rds of the tongue
Hard palate (Roof of the mouth)
Gingiva (Upper and lower gums)
The floor of the mouth under the tongue
Buccal mucosa (Lining of the lips & cheeks)
Retromolar trigone (region behind wisdom teeth

Types of oral cancer | Different types of oral cancer | Oral cancer types

Types of Oral Cancers

The site of cancer origin distinguishes the basis of the types of oral cancer. The most common sites of oral cancer are:

Tongue
Gums
Palate (roof of the mouth)
Mouth linings (labial/buccal and alveolar mucosa)

Histologically, oral cancers are classified based on the tissue from which they origin. They are:

Squamous cell carcinoma
Adenocarcinoma
Sarcoma
Oral malignant melanoma
Lymphoma

The most common type of mouth cancer is the squamous cell carcinoma, as squamous cell epithelium is predominantly found in many areas of the body, including the inside of the mouth and in the skin. Around 90% of the oral cancers are squamous cell carcinoma.

Adenocarcinoma is the cancer which develops in the glands that line the organs. In the buccal cavity, adenocarcinoma is the cancer of salivary glands.

Sarcomas are the cancer developing in bone or in the soft tissues of the body, such as adipose tissue (fat), fibrous tissue, cartilage, muscle, blood vessels, etc. Soft tissue sarcomas in the oral maxillofacial region are less frequent. Their management requires a multidisciplinary approach.

Melanoma cancers develop in the melanocytes (the cells that give colour to the skin) which usually develop in the skin. One of the most aggressive forms of malignant tumour, oral malignant melanoma is a rare malignant tumour that has a higher proclivity for metastasis (cancer spread).

Lymphomas are the cancers of the lymphatic system which includes the network of bone marrow, spleen, thymus gland and lymph nodes (also called lymph glands). Lymphomas in the oral cavity are rarely seen but their development is inclined in patients suffering from acquired immunodeficiency syndrome (AIDS).

Causes of Oral Cancer

Oral carcinogenesis, like other cancers, progresses from dysplasia to invasive phenotypes. Genetic and proteomic approaches have revealed molecular pathology. Contributions by congenital abnormalities in oncogenes, tumour suppressor genes, genomic instability, and epigenetic modifications could cause oral oncogenesis. Various risk factors could play a key role in enhancing the aforementioned genetic abnormalities.

Oral Cancer Symptoms

A few of the common oral carcinoma symptoms include fatigue, nausea, and pain. In other patients, the symptoms are not presented. Dentists often identify oral cancer during regular exams. The most common symptoms are:

Lump on the lips, mouth, throat or neck, or a feeling of cheek thickening
Red or white patches/spots on the gums, tongue, tonsil, or lining of the mouth
Persistent sore throat or feeling of something caught up in the throat
Difficulty in chewing, swallowing, or moving the jaws or tongue
Numbness of the mouth or tongue
Loosening of teeth or toothache
Hoarseness or change in voice
Pain or bleeding in the mouth
Dentures that no longer fit
Unexplained weight loss
Anorexia at later stages
Ear and/or jaw pain
Chronic bad breath
Changes in speech
Fatigue

Early Signs of Oral Cancer

Tongue cancer: The most common early symptom of tongue cancer is a painful sore on the tongue that increases gradually and doesn't heal, and bleeds easily.
Tonsil cancer: The earliest symptom of tonsil cancer is an enlarged tonsil, but if both tonsils are swollen or enlarged, it not is tonsil cancer.
Gums cancer and cancer at the floor of the mouth: Ulceration was the most frequent clinical appearance, followed by lesions, induration (thickening and hardening of soft tissues) and rupture.

Risk factors of Oral Cancer

Various risk factors can increase the potentiality of oral cancer, such as:

Chemical Factors
Biological Factors
Dental Hygiene and Related Factors
Nutritional Factors
Demographic factors

Chemical Factors

Tobacco - There are ample amounts of evidence demonstrating that the consumption of tobacco in various forms, including (smoking, chewing, and in betel quid) could have a carcinogenic impact in the oral cavity, with smoking being the most standard form of tobacco use (cigarettes, cigars, pipe and bidi, hookah, or chillum). In some parts of India (Mizoram and other northeast regions.), tobacco smoke is dissolved in water (“smoke on the water”) which is another peculiar form of tobacco use.
Alcohol - Multiple studies have linked alcoholism to oral cancer and is exceptionally high in people indulging in alcoholism and tobacco use. Individuals consuming more than 170 g of whiskey/day demonstrate ten times increased risk of oral cancer.
Marijuana - studies showed the increased average risk for patients using marijuana.

Biological Factors

Viruses - Viruses are capable of hijacking host cellular apparatus, modifying DNA and inducing proliferative changes in the cells. Human papillomavirus (HPV) Epstein Barr Virus (EBV), human herpesvirus-8 (HHV-8) and cytomegalovirus and Herpes simplex virus (HSV) have been established in recent years as causative agents of oral cancers. HSV-1, or "oral herpes", is commonly associated with sores around the mouth and lip and has been suggested to be a causative agent of oral cancers. Approximately 23.5% of oral cancers are caused by HPV - an infection of the middle throat and mouth that can contract unhealthy sexual practices and indulgence with multiple sexual partners.
Candida - Candida plays a role in initiating oral cancer by causing nodular leucoplakia (thick, white patches inside mouth surfaces), increasing the tendency for dysplasia and malignant transformation.

Dental Hygiene and Related Factors

Oral hygiene and the incidence of oral cancer are inversely proportional. Sharp teeth can cause poor oral hygiene and prolonged irritation, paving the way for the development of oral cancer. The carcinogenic action of tobacco is greatly enhanced by poor oral hygiene and dental sepsis.

Nutritional Factors

Dietary deficits may potentially cause oral cancer. A reduced risk can be seen with a diet rich in fruits and vegetables.

Demographic factors

Gender – Male individuals are more likely to develop oral cancers when compared with women.
Fair skin - Fair skin is linked to a higher risk of lip cancer.
Age - despite the development of oral cancer at any age, patients older than 45 years are more prone to it.
Prolonged sun exposure – without sun protection measures can increase lip cancer.

Book an appointment

Call Us at 04048486868

Whatsapp Us

Complications of Oral Cancer

There could be several oral cancer complications, including medical phenomena such as dysphagia (difficulty swallowing) and aphasia (speech problems). Since oral cancer occurs in the orofacial part, patients may also suffer from self-esteem, social anxiety disorder, and reclusive ness (withdrawal from social life), considering an unaesthetic facial consequence.

A Taiwanese study from 2021 demonstrated an increased inclination towards the development of depression is seen in oral cancer patients. It is especially pronounced in patients suffering from tongue cancer, as they experience worse functional dysphagia when compared with patients suffering from oral cancer in other locations.

While oral surgery can significantly affect the treatment of cancer, it often causes significant function loss. Any side effects of chemoradiotherapy, such as mucositis, pharyngitis-related dysphagia, nausea, vomiting, and masticatory disorders, could further plunge the patient into their mental dungeon through social isolation. The result is even more pronounced when combined with painkillers, especially narcotic analgesics, as they are reported to possess a higher risk of depression.

As emotional instability is seen in all kinds of oral patients, the comprehensive treatment plan must subsume psychological counselling for both the patients and their family members, as the latter also experience emotional distress. The steady job of caregiving can negatively impact the connotations of psychosocial aspects.

Till date, the psychosocial interventions combined with the regular treatment of oral cancer demonstrated an overall positive effect on the patients. Although being a caregiver is challenging enough, additional unique psychological training can greatly amplify the patient's care and reduce the caregivers' mental burden.

Oral Cancer Diagnosis

While there are various oral cancer tests for the diagnosis, it must be understood that not all of them will be used for every suspected patient. The oncologist takes into consideration the following before selecting the appropriate tests for diagnosis:

Biopsy
Fine needle aspiration biopsy
Oral brush biopsy
HPV testing
X-ray
Barium swallow/modified barium swallow
Computed tomography (CT or CAT) scan
Magnetic resonance imaging (MRI)
Positron emission tomography (PET) or PET-CT scan

Oral Cancer Treatment

The primary treatment options for oral or are surgery, radiation therapy, medication-based, and comprehensive dental treatment.

Surgery

Primary tumour surgery (surgery of tumour and healthy tissue surrounding it)
Glossectomy (partial or total removal of the tongue)
Mandibulectomy (partial or total removal of the jawbone)
Maxillectomy hard palate (roof of the mouth) removal.
Neck dissection (done to prevent the spread of cancer to neck lymph nodes)
Micrographic surgery (visible tumour and surrounding tissue are removed)
Tracheostomy (an opening in the neck if cancer blocks the airway)
Gastrostomy tube (for cancer patients with swallowing difficulty)
Reconstructive surgery (needed if large portions of tissue are removed)

Radiation therapy

External-beam radiation therapy (targets with a machine's radiation beam)
Internal radiation therapy (brachytherapy; radiation given using implants)

Therapies using medication

Chemotherapy
Immunotherapy (biologic therapy)
Targeted therapy
Comprehensive dental treatment

Why Choose PACE Hospitals?

Expert Super Specialist Doctors

Advanced Diagnostics & Treatment

Affordable & Transparent Care

24x7 Emergency & ICU Support

For Online Doctor Consultation

Call Us

Whatsapp Us

Prevention of Oral Cancer

Although not all oral cancers can be prevented, the risk can be significantly reduced with specific preventative tips given below:

Avoid tobacco and alcohol: Cessation of alcoholism, smoking and oral tobacco product usage is the best way to limit the risk of getting these cancers. Quitting tobacco use and alcoholism also greatly helps, even with many years of indulgence.
Vaccination to avoid HPV infection: HPV infection can be contracted with unhealthy sexual practices and indulgence with multiple sexual partners. Vaccines can reduce the risk of infection not only for oral cancer but also for cancers of the penis, anus, vulva, and vagina.
Limit exposure to ultraviolet (UV) light: Ultraviolet radiation is an avoidable risk factor for cancer of the lips. Limiting outdoor time during the middle of the day and wearing a wide-brimmed hat and sunscreen while going out can reduce the risk.
Maintain a healthy weight and eating pattern: Weak immunity due to poor nutrition must be corrected by a healthy eating pattern (more plant-based foods, non-starchy vegetables and whole fruit) to reduce oral cancer risk.
Get regular dental check-ups: Leucoplakia (white patches in the mouth) or erythroplakia (red patches in the mouth) could be pre-cancer growths. Regular dental check-ups can detect cancer early.

Frequently Asked Questions (FAQs) on Oral Cancer

Is oral cancer deadly?
Yes. Oral cancer is deadly. India has one-third of the world's mouth cancer cases, posing a challenge. In India, 77,000 new cases and 52,000 fatalities are recorded yearly. The survival rate is as follows:
- Early cancer diagnosis results in an 85% 5-year survival rate.
- This stage diagnoses 28% of oral and oropharyngeal malignancies.
- If cancer spreads to nearby organs or lymph nodes, the 5-year survival rate is 68%.
- This stage diagnoses over half of the cases. If cancer spreads, 5-year survival is 40%.
- This stage diagnoses 18% of oral and oropharyngeal malignancies.
What age is oral cancer common?

While the average age of most people diagnosed with oral cancers is 63 years, there are various cases of patients reporting oral cancers at even younger ages. Just over 20% (1 of 5) of cases occur in patients younger than 55 years of age.
Does oral cancer lead to death?
As evidenced by autopsy reports, various factors can cause the death of patients suffering from oral cancer.
- Around 11% of death was due to recurrent or uncontrollable disease above the clavicles.
- Nearly 17% of patients died of metastatic disease beyond the neck.
- About 24% of the death accounted for the frequent complications of treatment. Most complications were putrid lung abscess and rupture of the carotid artery.
- About 80% of the patients who died of unrelated causes had no metastases or tumours.
- The overall incidence of multiple primary cancers was 34%
- The death rate from a second primary cancer was 24%
Can oral cancer be fully cured?

Surgery alone may cure if the cancer hasn't gone beyond the mouth or oropharynx. If the metastasis (spread of cancer) is significant or has progressed to the neck, surgery, radiation, and chemotherapy may be necessary. The therapies could be given as a monotherapy or as a combined therapy.
Is oral thrush a sign of cancer?

No. Oral thrush is not a sign of oral cancer. Nevertheless, oral thrush can increase the risk of contracting oral cancer. Oral thrush is caused by Candida spp, which also produces carcinogens such as nitrosamine and acetaldehyde. These chemicals, combined with other risk factors such as tobacco use and alcoholism, can magnify the odds of oral cancer contraction.
Can poor oral hygiene cause cancer?

Yes. Poor oral hygiene can have increased chances of oral cancer.

Research from 2011 demonstrated that oral cancers are strongly associated with poor oral hygiene. Poor oral hygiene increases the chances of microbial colonization. With other carcinogens like tobacco and alcohol, the carcinogenic potential increases significantly.

Bad breath, bleeding gums, dry mouth, tooth decay, tooth erosion, and gum disease are a few symptoms of poor oral hygiene.
Can I get cancer from oral sex?
No. Oral sex does not cause oral cancer, as oral cancer is not a communicable disease.
- However, Oral sex causes the risk of an increase in HPV16 infection, which magnifies the risk of oral cancer.
- Oral sex, several partners, and HPV 16 infection raise cancer risk.
- On average, patients with viral infection reportedly had four-lifetime oral sex partners.
- Men have more oral sex partners than women, potentially increasing their risk for oropharyngeal cancer.
Is there a treatment for oral HPV infection?

At present, there is no treatment for oral HPV infection. However, it must be understood that in most patients, the virus is cleared on its own within a year or two without therapy or assistance. Most persons with oral HPV won't acquire cancer.
Can a blood test detect oral cancer?

No. Currently, no blood tests can detect oral cancer. However, blood tests are regularly done to understand the patient's health status. Before therapy, the oncologist may conduct standard blood tests to assess overall health. Poor nutrition and low blood cell count may be diagnosed. A complete blood count (CBC) measures blood cell count and can detect anaemia (low number of red blood cells). Blood chemistry testing may measure liver and kidney function.
Can cheek biting cause oral cancer?

Yes. Cheek biting can increase the chances of oral cancer. While research linked oral lesions, it's not exclusive to cheek biting. Long-standing wounds in cheek biters, which produce ulcers or lesions on the tongue, can cause oral cancer.

Deep and recurrent cheek biting is the most harmful mechanical irritation creating buccal mucosal lesions that may lead to an increased risk of oral cancer owing to alterations in the cheek tissue and cells in the worst and most uncommon cases.

When to consult a doctor for oral cancer?

Consult a doctor for oral cancer if mouth sores, lumps, or unusual patches inside the mouth do not heal within two weeks or if they start making it difficult to eat, speak, or swallow. Identifying the disease at an early stage offers the best opportunity for effective treatment.

Warning signs to watch for include:

Mouth ulcers or sores that don’t heal
White or red patches in the mouth
Lumps or thickened areas on the tongue, cheek, or gums
Trouble chewing, swallowing, or moving the jaw
Unexplained numbness, pain, or bleeding
Persistent sore throat or voice changes

An oral cancer specialist, such as an ENT doctor, oral and maxillofacial surgeon, or oncologist, can diagnose the condition and recommend suitable oral cancer treatment like surgery or radiation. Urgent care is needed if there is severe pain, heavy bleeding, or fast-growing mouth lesions.