Recognising the signs of mouth cancer
4 November 2020
If you found a lump on your tongue or cheek, would it cross your mind that this could be cancer? Probably not is the answer most people would give.
While other cancers like lung or breast cancer feature heavily in media coverage, mouth cancer is rarely spoken about. Yet every day, 18 people in this country are diagnosed with and each year 1,800 die.
The disease affects twice as many men as women but, if diagnosed and treated quickly, the recovery rate is encouraging.
Each year, the charity Oral Health Foundation aims to raise awareness of oral cancer through the Mouth Cancer Action Month campaign. The foundation wants people to be able to recognise the signs of mouth cancer and encourage people to discuss any concerns they may have with their dentist.
Mouth cancer can affect any part of the mouth including the lips, tongue and throat as well as the cheeks and gums.
Causes include smoking and second-hand smoke, regular excessive drinking, a diet lacking in fresh fruit and vegetables, the human papilloma virus (HPV – a group of viruses that affect the skin and the moist membranes lining the body), eating too much pickled and salted food and prolonged sun exposure, which can lead to cancer of the lips.
Smokers are three time more likely than non-smokers to develop mouth cancer and seven times more likely to be diagnosed with throat cancer. And while those who drink heavily increase their risk, those who drink and smoke increase their risk by up to 30 times.
Flossing is always a good idea and it gives you a good chance to have a look around your mouth for some of the important early signs of cancer, which include:
- a lump
- a swollen neck gland
- unexplained weight loss
- difficulty moving your jaw
- persistent pain in the mouth
- pain or difficulty when swallowing
- bleeding or numbness in the mouth
- red or white patches in the mouth or throat
- changes in your voice, or speech problems
- a loose tooth or teeth for no obvious reason
- ulcers that don’t heal and are sometimes painless
As well as looking at your cheeks, tongue and gums, gently run a finger along to feel for lumps or uneven surfaces. Look in the mirror – are your face and neck symmetrical or have any lumps or bumps begun to emerge?
The same is true for your lips. Have they changed? Women – when you’re putting on lipstick take a moment to actually look as you do it, and for men take a couple of extra seconds when shaving to take a look and get to know your lips, especially if you work outside or play lots of sport. Also think about buying a lip balm sunscreen. Lots of professional athletes wear it so don’t be shy about slapping it on.
Twice-yearly dental checks are not only important to keep your teeth and gums healthy. A dentist will also examine your mouth, throat and neck for signs of mouth cancer and will be able to make a referral. The quicker a diagnosis is reached, the better the prognosis.
Experts at the Oral Health Foundation say people with mouth cancer are more likely to die than those having cervical cancer or melanoma skin cancer because so many are identified at stage four, when nothing can be done.
If you find something you’re uncertain of, make an appointment with your dentist or GP – don’t wait to see what happens to it in a few months. If they suspect cancer a number of tests can be carried out, including a biopsy to remove a small sample of affected tissue to check for the presence of cancerous cells.
This can be done by using a local anaesthetic and removing a small section of the growth, or in the neck a fine needle can be used to draw off fluid. If the suspected tissue is at the back of your throat or inside one of your nasal cavities, a long thin tube with a camera and a light is guided through the nose then used to remove a small section of tissue.
If the cancer is diagnosed and it is in its very early stages, it may be possible to remove any tumours using a type of laser surgery known as photodynamic therapy that lasers away the tumour.
However, if the tumour is more advanced, part of the mouth lining or tongue may have to be removed and replaced by a graft using skin from the forearm or chest tissue. If the cancer has spread to the jawbone it can be replaced by taking bone from another part of the body.
The good news is that a healthy lifestyle can reduce your risk of developing oral cancer. By having a good regular cleaning programme you increase the chance of spotting changes and reduce risk – mouth cancer appears more often in people who have lost more than six teeth and those who wear poorly fitting dentures.
Regular visits to the dentist are a must for everyone, but particularly those who drink alcohol regularly to levels above the government guidelines and for anyone who uses tobacco.
Fresh fruit and vegetables can also reduce the risk of mouth cancer risk. People with the highest intake of certain foods, versus those with the lowest intake, have been found to have a 48 per cent lower risk from eating fruit, a 34 per cent lower risk from eating vegetables, a 24 per cent lower risk from taking vitamin C and a 36 per lower risk from taking calcium supplements compared to non-users.
Maybe most surprisingly, the more caffeinated amongst us (four cups a day) are at a 39 per cent lower risk while green tea drinkers face a 20 per cent lower risk.
Many Practice Plus Group Hospitals offer people a wide range of oral surgery options. During treatment, the consultants performing surgery also look for signs of mouth cancer and will discuss any concerns with patients as part of their post-procedure care.