Mouth Cancer

Diagnosis

Mouth cancer, also called oral cancer, is usually diagnosed through a combination of physical exams, biopsies, and imaging tests.

During a physical exam, a healthcare professional will look at and feel your lips, mouth, and throat. They check for:
• Lumps or areas of irritation
• White patches called leukoplakia
• Sores that do not heal

If something concerning is found, a biopsy may be performed. This involves removing a sample of tissue for lab testing to confirm the presence of cancer cells and examine their DNA for changes that guide treatment planning.

Staging tests determine whether the cancer has spread beyond the mouth. These may include:
• Endoscopy to view the throat using a small camera
• Imaging tests such as X-ray, CT, MRI, or PET scans

Mouth cancer stages range from 0 to 4. Lower stages indicate small, localized cancers, while stage 4 means the cancer has grown large, deeply invaded tissue, or spread to lymph nodes or other body parts.

Treatment

Treatment for mouth cancer depends on the cancer’s location, size, spread, and patient preferences. Options may include surgery, radiation therapy, chemotherapy, targeted therapy, or immunotherapy.

Surgery options:
• Remove the cancer and surrounding healthy tissue (margin)
• Reconstructive surgery using tissue or bone from other parts of the body to restore function and appearance
• Neck dissection to remove lymph nodes if cancer has spread or as a precaution
• Sentinel lymph node biopsy to check the first few lymph nodes where cancer may have spread

Radiation therapy:
• External beam radiation targets cancer with high-energy beams
• Brachytherapy involves placing radioactive material inside the body
• Often used after surgery or combined with chemotherapy to kill remaining cancer cells
• Side effects may include dry mouth, tooth decay, and jawbone damage

Chemotherapy:
• Uses strong medicines to kill cancer cells
• Often combined with radiation therapy after surgery or used to control spread
• Side effects include nausea, vomiting, and hair loss

Targeted therapy:
• Medicines attack specific chemicals in cancer cells to kill them
• May be used alone or with chemotherapy or radiation therapy

Immunotherapy:
• Helps the immune system detect and destroy cancer cells
• Often used when cancer recurs or spreads to other body parts

Treatment plans are individualized, considering the cancer’s behavior, overall health, and patient preferences. Supportive care, including physical therapy, dental care, and nutritional support, helps manage side effects and maintain quality of life.