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</div><div><span>Oral cancer</span></div></div>
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<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
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</a><h1 class="with-also" itemprop="name">Oral cancer</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>Oral cancer is cancer that starts in the mouth.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>Oral cancer most commonly involves the lips or the tongue. It may also occur on the:</p><ul><li>Cheek lining</li><li>Floor of the mouth</li><li>Gums (gingiva)</li><li>Roof of the mouth (palate)</li></ul><p>Most oral cancers are a type called squamous cell carcinoma. These cancers tend to spread quickly.</p><p><a test="test" href="./002032.htm">Smoking and other tobacco use</a> are linked to most cases of oral cancer. Heavy <a test="test" href="./000944.htm">alcohol use</a> also increases the risk for oral cancer.</p><p>Human papillomavirus (HPV) infection (the same virus that causes <a test="test" href="./000886.htm">genital warts</a>) account for a larger number of oral cancers than in the past. One type of HPV, type 16 or HPV-16, is much more commonly associated with almost all oral cancers.</p><p>Other factors that may increase the risk for oral cancer include:</p><ul><li>Long-term (chronic) rubbing, such as from rough teeth, dentures, or fillings</li><li>Taking medicines (immunosuppressants) that weaken the immune system</li><li><a test="test" href="./001957.htm">Poor dental and oral hygiene</a></li></ul><p>Some oral cancers begin as a white plaque (<a test="test" href="./001046.htm">leukoplakia</a>) or as a <a test="test" href="./001448.htm">mouth ulcer</a>.</p><p>Men develop oral cancer twice as often as women do. It is more common in men older than 40.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>Oral cancer can appear as a lump or ulcer in the mouth that may be:</p><ul><li>A deep, hard-edged crack in the tissue</li><li>Pale, dark red, or discolored</li><li>On the tongue, lip, or other area of the mouth</li><li>Painless at first, then a burning sensation or pain when the tumor is more advanced</li></ul><p>Other symptoms may include::</p><ul><li>Chewing problems</li><li><a test="test" href="./003059.htm">Mouth sores</a> that may bleed</li><li>Pain with swallowing</li><li>Speech difficulties</li><li>Swallowing difficulty</li><li><a test="test" href="./003097.htm">Swollen lymph nodes</a> in the neck</li><li><a test="test" href="./003047.htm">Tongue problems</a></li><li>Weight loss</li><li>Difficulty opening the mouth</li><li>Numbness and loosening of teeth</li><li>Bad breath</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>Your health care provider or dentist will examine your mouth area. The exam may show:</p><ul><li>A sore on the lip, tongue, gum, cheeks, or other area of the mouth</li><li>An ulcer or bleeding</li></ul><p>A <a test="test" href="./003849.htm">biopsy of the sore or ulcer</a> will be done. This tissue will also be tested for HPV.</p><p><a test="test" href="./003330.htm">CT</a>, <a test="test" href="./003791.htm">MRI</a>, and <a test="test" href="./003827.htm">PET</a> scans may be done to determine if the cancer has spread.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>Surgery to remove the tumor is recommended if the tumor is small enough.</p><p>If the tumor has spread to more tissue or nearby lymph nodes, a <a test="test" href="./007573.htm">larger surgery is done</a>. The amount of tissue and the number of lymph nodes that are removed depend on how far the cancer has spread.</p><p>Surgery may be used together with <a test="test" href="../patientinstructions/000058.htm">radiation therapy</a> and <a test="test" href="./002324.htm">chemotherapy</a> for larger tumors.</p><p>Other treatments may include:</p><ul><li><a test="test" href="../patientinstructions/000902.htm">Targeted therapy</a>, which uses drugs to stop cancer from growing and spreading .</li><li><a test="test" href="../patientinstructions/000903.htm">Immunotherapy</a>, which uses substances made by the body or in a lab to help the immune system work harder or in a more targeted way to fight cancer .</li></ul><p>Depending on what type of treatment you require, supportive treatments that may be needed include:</p><ul><li>Speech therapy.</li><li>Therapy to help with <a test="test" href="../patientinstructions/000065.htm">chewing and swallowing</a>.</li><li>Learning to eat <a test="test" href="../patientinstructions/000035.htm">enough protein and calories to keep your weight up</a>. Ask your provider about liquid food supplements that can help.</li><li>Help with <a test="test" href="../patientinstructions/000032.htm">dry mouth</a>.</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Support Groups</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>You can ease the stress of illness by joining a <a test="test" href="./002166.htm">cancer support group</a>. Sharing with others who have common experiences and problems can help you not feel alone.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>About one half of people with oral cancer will live more than 5 years after they are diagnosed and treated. If the cancer is found early, before it has spread to other tissues, the cure rate ranges from 59% to 94% depending on where the cancer is located. More than half of oral cancers have spread when the cancer is detected. Most have spread to the throat or neck.</p><p>Cancers that test positive for HPV appear to respond better to treatment and may have a better outlook. Also, those who smoked for less than 10 years may do better.</p><p>People who require larger doses of radiation along with chemotherapy are more likely to have more severe problems with swallowing.</p><p>Oral cancers can recur if tobacco or alcohol use is not stopped.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Possible Complications</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p>Complications of oral cancer may include:</p><ul><li>Complications of radiation therapy, including dry mouth and difficulty swallowing</li><li>Disfigurement of the face, head, and neck after surgery</li><li>Other spread (<a test="test" href="./002260.htm">metastasis)</a> of the cancer</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-8" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-8"><p>Oral cancer may be discovered when the dentist does a routine cleaning and examination.</p><p>Contact your provider if you have a sore in your mouth or lip or a lump in the neck that does not go away within one month. Early diagnosis and treatment of oral cancer greatly increases the chance of survival.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Prevention</h2></div><div class="section-button"><button type="submit" aria-controls="section-9" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-9"><p>Oral cancer may be prevented by:</p><ul><li>Avoiding smoking or other tobacco use</li><li>Having dental problems corrected</li><li>Limiting or avoiding alcohol use</li><li>Visiting the dentist regularly and practicing good oral hygiene</li></ul><p>The <a test="test" href="./007648.htm">HPV vaccine</a> recommended for children and young adults targets HPV sub-types most likely to cause oral cancers. They have been shown to prevent most oral HPV infections and 90% of cancers caused by HPV.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Cancer - mouth; Mouth cancer; Head and neck cancer - oral; Squamous cell cancer - mouth; Malignant neoplasm - oral; Oropharyngeal cancer - HPV; Carcinoma - mouth</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Patient Instructions</h2></div><div class="section-button"><button type="submit" aria-controls="section-carepnt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Kerr AR, Miller CS, Rhodus NL, Stoopler ET, Treister NS. Cancer and oral care of patients with cancer. In: Kerr AR, Miller CS, Rhodus NL, Stoopler ET, Treister NS, eds. <em>Little and Falace's Dental Management of the Medically Compromised Patient</em>. 10th ed. Philadelphia, PA: Elsevier; 2024:chap 26.</p><p>National Cancer Institute website. Oropharyngeal cancer treatment (adult) (PDQ) - health professional version. <a href="https://www.cancer.gov/types/head-and-neck/hp/adult/oropharyngeal-treatment-pdq#link/_528" target="_blank">www.cancer.gov/types/head-and-neck/hp/adult/oropharyngeal-treatment-pdq#link/_528</a>. Updated September 5, 2023. Accessed January 16, 2024.</p><p>Rettig E, Fakhry C, Gourin CG. Human papillomavirus and the epidemiology of head and neck cancer. In: Flint PW, Haughey BH, Francis HW, et al, eds. <em>Cummings Otolaryngology: Head and Neck Surgery</em>. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 74.</p><p>Wein RO, Weber RS. Malignant neoplasms of the oral cavity. In: Flint PW, Haughey BH, Francis HW, et al, eds. <em>Cummings Otolaryngology: Head and Neck Surgery</em>. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 91.</p></div></div></section>
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<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 12/31/2023</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<div id="section-version" class="section-body"><p>Updated by: Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.</p>
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