Cancerous tumour of the lips, tongue, or lining of the mouth
- Most common over the age of 60; rare under the age of 40
- Twice as common in males
- Smoking, chewing tobacco, alcohol abuse, and excessive exposure to sunlight are risk factors
- Genetics is not a significant factor
About half of all cancerous tumours of the mouth occur on either the tongue or the lower lip. The gums, inside of the cheeks, floor of the mouth, and palate are less commonly affected.
In developed countries, mouth cancer accounts for around 2 per cent of all new cases of cancer. In developing countries such as India, where people chew tobacco, betel leaves, and nuts, mouth cancer is much more common. Worldwide, the disease is twice as common in men as it is in women, although the incidence is increasing in women. Mouth cancer occurs most commonly in people over the age of 60 and is rare in those under the age of 40. The outlook for lip cancer is good. The outcome is generally poorer for other forms of mouth cancer but is improved with early diagnosis.
What are the causes?
Some people develop mouth cancer for no apparent reason. However, various risk factors increase the chance of developing mouth cancer. The main risk factors are tobacco use, either smoking or chewing tobacco; drinking large amounts of alcohol, particularly if combined with tobacco use; chewing betel leaves or nuts; infection with the human papillomavirus (HPV); and the presence of oral leukoplakia. Repeated, unprotected exposure to sunlight increases the risk of developing lip cancer. In addition, other factors that may increase the risk of mouth cancer include a poor diet and a suppressed immune system.
What are the symptoms?
If you have mouth cancer, you may experience the following symptoms:
An ulcer or sore that fails to heal, occurring on the lining of the mouth or on the tongue.
A white or red patch in your mouth or throat that does not clear up.
Persistent pain or discomfort in the mouth.
A swelling that develops anywhere inside the mouth or on the lips.
Pain when swallowing.
Left untreated, mouth cancer usually spreads from the mouth to nearby tissues, the lymph nodes in the neck, and from there to other parts of the body.
How is it diagnosed?
Cancerous tumours in the mouth are often detected early by a dentist during a checkup. If your doctor suspects that a lump or nonhealing ulcer is a tumour, a small sample of tissue may be taken for examination. If cancer is found, further tests will establish how far it has spread (see Staging cancer).
What is the treatment?
A small cancerous tumour that is discovered early may be removed surgically or by laser treatment. In about 8 in 10 people, surgery is successful and the cancer does not recur following removal of the tumour. If the tumour is large, it will be removed surgically, and plastic surgery may be necessary to restore a more normal facial appearance. Following surgery, radiotherapy may be carried out to ensure that all cancerous cells have been destroyed and the cancer does not recur. If the tumour has spread, chemotherapy may be used in conjunction with radiotherapy.
What is the prognosis?
Tumours that are found early and are in an easily accessible part of the mouth can usually be treated successfully. The outlook is best for lip cancer, which is the most accessible site. For cancers within the mouth, less than half of the affected people survive for 5 years.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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