What is mouth cancer?

There are over 700 cases of mouth, head and neck cancer in Ireland each year. It is most common among those aged 50 or older but can be diagnosed in younger people too and instances of this are increasing. These cancers are more common among men but this too is changing.

What is mouth cancer?

Cancer is a genetic disease. This means it is caused by a change in genes, specifically the genes that control the way cells function. These genetic changes can run in families and be passed down from your parents, or be caused by external factors, like smoking. Usually cells divide to form new cells as the body needs them, and die when they are old or damaged. These genetic changes cause cells in a particular area begin to divide without stopping and don’t die when they normally would.

There are several different types of cancers that can grow in parts of the head, neck or mouth including:

• oral cancers (lips, tongue, gums, cheeks, hard palate (roof of the mouth) and floor of the mouth)
• oropharyngeal cancers (soft part of the roof of the mouth, the back and side wall of the throat and the base of the tongue)
• cancer of the nose (nasopharynx, where the throat joins the nose, nostril and the lining of the nose)
• cancer of the ear
• cancer of the tonsils

The different types of cancer are named after the cell where the cancer starts to grow. The most common mouth, head and neck cancers are squamous cell carcinoma. These are cancers that start in the skin lining of the tongue, mouth, nose, throat or ear. Other types of mouth, head and neck cancer are:

• Lymphomas which start in the lymphatic system (a network of tissues and organs that help clear toxins, waste and unwanted materials from the body) and travel to areas of the mouth, head and neck
• Sarcomas, which start in the cells of the muscles and cartilage around the mouth, head and neck
• Melanomas, which are cancer cells that grow in melanocytes: the cells that give colour to the skin and eyes

What are the symptoms of mouth cancer?

There are many different symptoms of mouth cancer and they can vary from person to person. If you are experiencing any of these signs for more than three weeks you should organise a visit to you GP or dentist so you can have them checked.

Symptoms of mouth, head and neck cancer include:

• A sore or ulcer in the mouth that doesn’t heal
• An ongoing sore throat, hoarse voice or difficulty speaking
• Problems chewing or swallowing
• White or red patches in the mouth
• A swelling or a lump anywhere in the mouth or neck
• Nose bleeds or a persistent blocked nose
• Problems with hearing or ringing in the ears
• Pain in the face or jaw
• Numbness
• A thickening of the cheek or tongue
• Unexplained loose teeth

How to check yourself

You can check yourself for any of these symptoms by using a torch to check inside your mouth, tongue, lips and throat. You can also check your neck and jaw by doing an extra-oral exam on yourself.

Look for lumps by:

• Placing your hands on the back of your jaw under your ears and opening and closing your mouth
• Feeling your neck for and turning your head from right to left
• Swallowing while holding your oesophagus (the front of your neck)
• Feeling the underside of your jaw with your chin down

How it’s diagnosed

The dentist or doctor will examine the area, and if they are still concerned they will refer you to a specialist, such as an ear, nose and throat specialist known as an ENT specialist. They will also examine you and run some tests. They may do one or more of the following tests:

• X-ray, which may include a special x-ray of the jaw and teeth called an orthopantomogram (OPG)
• A nasoendoscopy, which involves a small tube with a light being inserted in your nose while a mirror is held at the back of the throat to better view the throat
• A biopsy, where some cells abnormal cells are collected from the area for testing
• Fine needle aspiration, a type of biopsy where cells are taken from a lump to test for cancer

What increases your chances of getting mouth cancer?

A number of risk factors may increase your chances of getting the disease. These include:

• Smoking
• Excessive alcohol consumption
• Age- mouth, head and neck cancers are most common in people over 50 but everyone should be vigilant if symptoms arise as younger people can also be diagnosed
• Gender – mouth, head and neck cancers are more common in men
• UV exposure from the sun or sunbeds – particularly to the lips
• Diet- not eating enough fruit and vegetables may leave you more susceptible to cancer
• Human papilloma virus (HPV) – it is passed on through sexual contact and may increase your chances of getting cancer of the mouth, head and neck

How to reduce your risk of mouth cancer

• Avoid smoking
• Limit your alcohol consumption
• Always use a lip balm with sun protection
• Eat a diet high in fruit and vegetables
• Check your mouth for symptoms when brushing your teeth
• Get regular dentist check ups

What are the treatments for mouth cancer

The treatment for mouth cancer will vary depending on the location and type of cancer and your general health. Your doctors will develop a treatment plan to suit your case which may include one or more of the following treatments:

• Surgery – to remove the cancer
• Radiotherapy – to kill cancer cells using x-rays
• Chemotherapy – to kill the cancer cells with drugs

Where to be checked

If you have any of the symptoms above for more than three weeks see your dentist or GP. They will examine the area and recommend the next steps if necessary. More information on mouth, head and neck cancers can be found on:

• Cancer.ie
• Dentalhealth.ie
• Mouthcancerawareness.ie
• Dentist.ie