Overview Oral Cavity Cancer Lip and oral cavity cancer is a disease in which malignant (cancer) cells form in the lips or mouth.
The oral cavity includes the following:
• The front two thirds of the tongue. • The gingiva (gums). • The buccal mucosa (the lining of the inside of the cheeks). • The floor (bottom) of the mouth under the tongue. • The hard palate (the roof of the mouth). • The retromolar trigone (the small area behind the wisdom teeth).
Most lip and oral cavity cancers start in squamous cells, the thin, flat cells that line the lips and oral cavity. These are called squamous cell carcinomas. Cancer cells may spread into deeper tissue as the cancer grows. Squamous cell carcinoma usually develops in areas of leukoplakia (white patches of cells that do not rub off).
Oropharyngeal Cancer Oropharyngeal cancer is a disease in which malignant (cancer) cells form in the tissues of the oropharynx.
The oropharynx is the middle part of the pharynx (throat) behind the mouth, and includes the back one-third of the tongue, the soft palate, the side and back walls of the throat, and the tonsils. The pharynx is a hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes from the throat to the stomach). Air and food pass through the pharynx on the way to the trachea or the esophagus.
Most oropharyngeal cancers are squamous cell carcinomas. Squamous cells are the thin, flat cells that line the inside of the oropharynx.
Oral Cavity Cancer These and other symptoms may be caused by lip and oral cavity cancer. Other conditions may cause the same symptoms. Consult a doctor if any of the following problems occur:
• A sore on the lip or in the mouth that does not heal. • A lump or thickening on the lips or gums or in the mouth. • A white or red patch on the gums, tongue, tonsils, or lining of the mouth. • Bleeding, pain, or numbness in the lip or mouth. • Change in voice. • Loose teeth or dentures that no longer fit well. • Trouble chewing or swallowing or moving the tongue or jaw. • Swelling of jaw. • Sore throat or feeling that something is caught in the throat.
Lip and oral cavity cancer may not have any symptoms and is sometimes found during a regular dental exam.
Oropharyngeal Cancer These and other symptoms may be caused by oropharyngeal cancer. Other conditions may cause the same symptoms. Consult a doctor if any of the following problems occur:
• A sore throat that does not go away. • A dull pain behind the breastbone. • Cough. • Trouble swallowing. • Weight loss for no known reason. • Ear pain. • A lump in the back of the mouth, throat, or neck. • A change in voice.
Oral Cavity Cancer Different types of treatment are available for patients with lip and oral cavity cancer. Some treatments are standard (the currently used treatment, often referred to as “standard of care”), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Two types of standard treatment are used:
Surgery Surgery (removing the cancer in an operation) is a common treatment for all stages of lip and oral cavity cancer. Surgery may include the following:
• Wide local excision: Removal of the cancer and some of the healthy tissue around it. If cancer has spread into bone, surgery may include removal of the involved bone tissue. • Neck dissection: Removal of lymph nodes and other tissues in the neck. This is done when cancer may have spread from the lip and oral cavity. • Plastic surgery: An operation that restores or improves the appearance of parts of the body. Dental implants, a skin graft, or other plastic surgery may be needed to repair parts of the mouth, throat, or neck after removal of large tumors.
Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
Radiation therapy Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
For patients who smoke, radiation therapy works better when smoking is stopped before beginning treatment. It is also important for patients to have a dental exam before radiation therapy begins, so that existing problems can be treated.
Oropharyngeal Cancer Different types of treatment are available for patients with oropharyngeal cancer. Some treatments are standard (the currently used treatment, often referred to as “standard of care”), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Two types of standard treatment are used:
Surgery Surgery (removing the cancer in an operation) is a common treatment of all stages of oropharyngeal cancer. A doctor may remove the cancer and some of the healthy tissue around the cancer. Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
Radiation therapy Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated. Fractionated radiation therapy divides the total dose of radiation therapy into several smaller, equal doses given over several days.
Radiation therapy may be more effective in patients who have stopped smoking before beginning treatment.
Radiation therapy to the thyroid or pituitary gland increases the risk of hypothyroidism (too little thyroid hormone). Thyroid function tests should be done before and after treatment.
