Close

Oral Cancers

Oral cancer is also known as mouth cancer. Mouth cancers typically start as a lump, bump or patch in the mouth (these are called “lesions”). Something suspicious that does not go away after a few weeks is usually discovered either by you, your dentist or another doctor. Most mouth cancers are squamous cell carcinomas (cancer cells come from the cells lining all parts of the inside of the mouth), but salivary gland cancers and other types of cancers can arise in the mouth as well.

http://vimeo.com/67598979

Non-cancerous Oral Lesions

Remember, not all lumps, bumps and patches are cancer. Some non-cancerous lesions in the mouth that might be mistaken for cancer include:

  • Infectious lesions
    • Viruses (such as herpes or warts), including papillomas
    • Fungus (like thrush)
    • Bacterial infections
    • Papillomas
  • Non-infectious oral lesions
    • Necrotizing sialometaplasia
    • Granular cell tumor
    • Hyperplasia of lymphoid tissue
    • Aphthous ulcers
    • Pemphigus
    • Pemphigoid
    • Pyogenic granuloma
  • Benign jaw tumors
    • Jay cysts
    • Ameloblastoma
    • Osseous dysplasia
    • Torus palatini and mandibularis
    • Fibromas
    • Myxomas
    • Cementomas

Pre-cancerous Oral Lesions

There are also a few common pre-malignant lesions of which you should be aware.

Leukoplakia: This is simply a white patch in the mouth that can’t be rubbed off. Whether it goes away, grows bigger or transforms into cancer is quite unpredictable, and there is no standard treatment for it. The chance that leukoplakia is cancer is somewhere around 5 percent according to one major study.1Waldron CA,Shafer WG. Cancer.Leukoplakia revisited. A clinicopathologic study 3256oralleukoplakias.1975 Oct;36(4):1386-92. You may be told that you have leukoplakia as a diagnosis after a biopsy shows that it is benign (not cancer) and there is no other apparent diagnosis. Just be sure to get a regular follow-up with a specialist.

Erythroplakia: This is simply a red patch somewhere in the mouth that has no apparent cause or other diagnosis. This type of lesion is more likely to be cancer than a leukoplakia but still may not be. All of these lesions should be biopsied to help find a diagnosis if possible or at least to make sure there are no cancer cells within them.

Dysplasia: This is a diagnosis of abnormal cells made by looking at cells under a microscope after a biopsy. The dysplasia can be mild, moderate or severe, depending on how deep into the surface layer of tissue the abnormal cells extend. If the abnormal cells do not invade beyond the surface layer, dysplasia is not considered cancer. However, if the abnormal cells extend through the entire depth of the surface layer, this is called severe dysplasia or carcinoma in situ, and it should be removed as if it is cancer. Mild dysplasia can sometimes go away. It is not totally clear what percentage of dysplasia progresses to cancer, so it should be followed by a specialist.

Lichen planus: This is a disease in which your own body attacks cells within the lining of your mouth. It causes lesions that can look like cancer. The diagnosis is made by a biopsy. There is no real cure. Suspicious lesions need to be followed closely by a specialist because there is a small chance cancer could develop at these or other sites in the mouth.3, Mignogna MD, Lo Russo L, Fedele S, Ruoppo E, Califano L, Lo Muzio L. Clinical behaviour of malignant transforming oral lichen planus. Eur J Surg Oncol. 2002 Dec;28(8):838-43.4de Vries N, Van der Waal I, Snow GB. Multiple primary tumours in oral cancer. International journal of oral and maxillofacial surgery. Feb 1986;15(1):85-87.

What prompted me to get checked out was some lesions in my mouth that looked like scrapes or scratches. They didn’t hurt, but I did notice them for awhile. They weren’t going away.Tony L. (oral cancer survivor)

Navigating oral cancers

To learn more about a particular type of oral cancer, choose an article below.

Basics of Oral Cancer

An overview of the basics of oral cancer.

Buccal Cancer

Buccal cancer begins inside the mouth in the mucosal lining of the cheek. Explore this page to learn more about buccal cancer.

Lip Cancer

Lip cancer begins on the lips, either upper or lower. Explore this page to learn more about lip cancer.

Oromandibular Cancer

Oromandibular cancer involves the lower jaw. This can be from any oral cavity subsite, but most commonly starts at the gums (alveolar ridge), floor of mouth or retromolar trigone (mucosa behind the bottom molars). Explore this page to learn more about oromandibular cancer.

Oral Salivary Gland Cancer

Oral salivary gland cancer begins in the minor salivary glands that are located inside the oral cavity underneath the mucosal layer all over the mouth and throat. Explore this page to learn more about oral salivary gland cancer.

Palatomaxillary Cancer

Palatomaxillary cancer begins in the roof of the mouth (the hard palate) or the upper alveolar ridge (which is part of the maxilla or upper jaw). However, cancers from other regions such as the retromolar trigone (mucosa behind the bottom molars) or buccal mucosa can involve the palatomaxillary region as well. Explore this page to learn more about palatomaxillary cancer.

Tongue Cancer

Tongue cancer begins in the oral tongue, which is the front two-thirds of the tongue. Explore this page to learn more about tongue cancer.

References

1 Waldron CA,Shafer WG. Cancer.Leukoplakia revisited. A clinicopathologic study 3256oralleukoplakias.1975 Oct;36(4):1386-92.

2 Bombeccari GP, Guzzi G, Tettamanti M, Giannì AB, Baj A, Pallotti F, Spadari F. Oral lichen planus and malignant transformation: a longitudinal cohort study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Sep;112(3):328-34.

3 Mignogna MD, Lo Russo L, Fedele S, Ruoppo E, Califano L, Lo Muzio L. Clinical behaviour of malignant transforming oral lichen planus. Eur J Surg Oncol. 2002 Dec;28(8):838-43.

4 de Vries N, Van der Waal I, Snow GB. Multiple primary tumours in oral cancer. International journal of oral and maxillofacial surgery. Feb 1986;15(1):85-87.

5 Petersen PE, Oral cancer prevention and control – The approach of the World Health Organization, Oral Oncol. 2008.

6 Ko YC, Huang YL, Lee CH, Chen MJ, Lin LM, Tsai CC. Betel quid chewing, cigarette smoking and alcohol consumption related to oral cancer in Taiwan. Journal of oral pathology & medicine: official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology. Nov 1995;24(10):450-453.

7 Ko YC, Huang YL, Lee CH, Chen MJ, Lin LM, Tsai CC. Betel quid chewing, cigarette smoking and alcohol consumption related to oral cancer in Taiwan. Journal of oral pathology & medicine: official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology. Nov 1995;24(10):450-453.

8 SilvermanJr. S. Early diagnosis of oral cancer. Cancer. Oct 15 1988;62(8 Suppl):1796-1799.

9 Scully C, Porter S. ABC of oral health. Oral cancer. BMJ. Jul 8 2000;321(7253):97-100.

10 Neville BW, Day TA. Oral cancer and precancerous lesions. CA: A cancer journal for clinicians. Jul-Aug 2002;52(4):195-215.

11 Spiro RH, Thaler HT, Hicks WF, Kher UA, Huvos AH, Strong EW. The importance of clinical staging of minor salivary gland carcinoma. Am J Surg. 1991 Oct;162(4):330-6.

12 Morton DL, Wen DR, Foshag LJ, Essner R, Cochran A. Intraoperative lymphatic mapping and selective cervical lymphadenectomy for early-stage melanomas of the head and neck. J Clin Oncol. 1993;11:1751-6.

13 Civantos FJ, Zitsch RP, Schuller DE, Agrawal A, Smith RB, Nason R, Petruzelli G, Gourin CG, Wong RJ, Ferris RL, El Naggar A, Ridge JA, Paniello RC, Owzar K, McCall L, Chepeha DB, Yarbrough WG, Myers JN. Sentinel lymph node biopsy accurately stages the regional lymph nodes for T1-T2 oral squamous cell carcinomas: results of a prospective multi-institutional trial. J Clin Oncol. 2010 Mar 10;28(8):1395-400.

14 Koch WM, Choti MA, Civelek AC, Eisele DW, Saunders JR. Gamma probe-directed biopsy of the sentinel node in oral squamous cell carcinoma. Arch Otolaryngol Head Neck Surg. 1998. 124:455-9.

15 Shoaib T, Soutar DS, MacDonald DG, Camilleri IG, Dunaway DJ, GrayHW, McCurrach GM, Bessent RG, MacLeod TIF, Robertson AG. The accuracy of head and neck carcinoma sentinel lymph node biopsy in the clinically N0 neck. Cancer.2001;91:2077-2083.

16 Kademani D. Oral cancer. Mayo Clinic proceedings. Mayo Clinic.Jul 2007;82(7):878-887.

17 Funk GF, Karnell LH, Robinson RA, Zhen WK, Trask DK, Hoffman HT. Presentation, treatment, and outcome of oral cavity cancer: a National Cancer Data Base report. Head neck. 2002 Feb;24(2):165-80.

18 Kraus FT, Perezmesa C. Verrucous carcinoma. Clinical and pathologic study of 105 cases involving oral cavity, larynx and genitalia. Cancer. Jan 1966;19(1):26-38.

19 Listl S, Jansen L, Stenzinger A, Freier K, Emrich K, et al.Survival of patients with oral cavity cancer in Germany. PLoS ONE.2013;8(1):e53415.

20 Anneroth G, Batsakis J, Luna M. Review of the literature and a recommended system of malignancy grading in oral squamous cell carcinomas. Scand J Dent Res.1987;95;229-249.

21 Edge SB, et al. The AJCC Cancer Staging Manual – Seventh Edition. American Joint Committee on Cancer 2010.

22 Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed November 9, 2016. To view the most recent and complete version of the guideline, go online to www.NCCN.org. The NCCN Guidelines are a work in progress that may be refined as often as new significant data becomes available. The NCCN Guidelines are a statement of consensus of its authors regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult any NCCN Guidelines is expected to use independent medical judgment in the context of individual clinical circumstances to determine any patient’s care or treatment. The National Comprehensive Cancer Network makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.

23 Jan JC, Hsu WH, Liu SA, Wong YK, Poon CK, Jiang RS, Jan JS, Chen IF. Prognostic factors in patients with buccal squamous cell carcinoma: 10-year experience. J Oral Maxillofac Surg. 2011 Feb;69(2):396-404.

24 Pradhan SA, Rajpal RM. Marginal mandibulectomy in the management of squamous cancer of the oral cavity. Indian J Cancer.1987;24;167-171.

25 Pentenero M, Gandolfo S, Carrozzo M. Importance of tumor thickness and depth of invasion in nodal involvement and prognosis of oral squamous cell carcinoma: a review of the literature. Head Neck. 2005 Dec;27(12):1080-91.

26 Maddox WA, Urist MM. Histopathological prognostic factors of certain primary oral cavity cancers. 1990 Dec;4(12):39-42; discussion 42,45-6.

27 Urist MM, O'Brien CJ, Soong SJ, Visscher DW, Maddox WA. Squamous cell carcinoma of the buccal mucosa: analysis of prognostic factors. Am J Surg. 1987 Oct;154(4):411-4.