ORAL CANCER

General Information

DEFINITION--Growth of malignant cells in the mouth or tongue. These are rare but dangerous. Any sore, ulcer or lump in the mouth that doesn't heal in 2 weeks should be examined by a doctor.

BODY PARTS INVOLVED--Lips; gums; palate; tongue; membranes inside the lip or cheek; floor of the mouth; tonsillar area.

SEX OR AGE MOST AFFECTED--Adults over 40; increasing in young people who chew smokeless tobacco.

SIGNS & SYMPTOMS--A pale lump--usually painless--

with a hard rim that appears in any part of the mouth or tongue. It has the following characteristics:

• It enlarges, ulcerates and bleeds easily.
• It may prevent dentures from fitting properly.
• It may make the tongue stiff and difficult to control, causing speaking and swallowing difficulty.

CAUSES--Unknown.

RISK INCREASES WITH

• Use of tobacco in any form (including smokeless).
• Family history of oral cancer.
• Past history of oral cancer.
• Excess alcohol consumption.
• Sun exposure (cancer on the lower lip).

HOW TO PREVENT--Don't use tobacco; and drink alcohol in moderate amounts, if any.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood studies.
• Biopsy (See Glossary) of the lump.
• X-rays of the head. Also CT scan or MRI (See Glossary for both) to help rule out spread of the malignancy. The larger the lesion at the time of diagnosis, the greater the chance that it has metastasized (spread) to other areas.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• Treatment will vary depending on location of the cancer (lips, tongue, palate, etc.).
• Surgery to remove the cancerous area.
• Radiation therapy and/or anticancer drugs.
• Speech therapy, if surgery impairs speech.

POSSIBLE COMPLICATIONS

• Slow healing after surgery.
• Spread to lymph nodes in the neck, requiring radical head and neck surgery.
• Permanent disfigurement.
• Permanent speech impairment.
• Persistent difficulty in swallowing.

PROBABLE OUTCOME--May be curable with early detection and treatment. Normal facial appearance can often be restored by plastic surgery.

How To Treat

GENERAL MEASURES--

• Discontinue use of tobacco in any form.
• Don't use any mouth rinses that contain alcohol.
• After surgery, cleanse the mouth 3 to 4 times a day with a soothing salt-water solution (1 teaspoon salt to 8 oz. warm water).
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• Anticancer drugs.
• Pain relievers after surgery.
• Antibiotics, if infection coexists.

ACTIVITY--Resume your normal activities gradually after surgery.

DIET--

• Don't drink alcohol.
• No special diet after recovery. A liquid diet (see Liquid Diet in Appendix) may be necessary for several days after surgery.

Call Your Doctor If

• You have signs of a mouth or tongue tumor.
• The following occurs after surgery: Increasing pain. Fever. New lumps. Excessive bleeding.