Oral cancer refers to tumors of the mouth that are malignant. There are many types of oral cancers, including squamous cell cancer, lymphoma, minor salivary gland cancers (mucoepidermoid cancer, adenoid cystic cancer), sarcomas, melanomas and other types. Oral cancers are tumors that arise from the abnormal growth of cells in the mouth, lips and gums area.

What is the oral cavity?

Oral cancer is found in the oral cavity (the mouth area), which includes: 

• The lips, teeth and gums
• The front two-thirds of the tongue
• The inner lining of the lips and cheeks (buccal mucosa)
• The area underneath the tongue (floor of the mouth)
• The roof of the mouth (hard palate)
• The small area behind the wisdom teeth (retromolar trigone)

What are the symptoms of oral (mouth) cancer? 

Common symptoms of oral cancer include:

• A sore that does not heal
• A white or red patch
• A lump or swelling that does not go down
• Unusual bleeding, pain or numbness in the mouth area that is persistent
• Swelling of the jaw or neck
• Pain in the ear
• Pain or difficulty swallowing, talking or chewing
• Persistent numbness in the face or neck
• Persistent bad breath

Each person with oral cancer may experience different symptoms, and some symptoms may resemble those of other disorders or medical problems. Always consult your health care provider for a diagnosis.

What are the causes of oral cancer?

Oral cancer occurs when a genetic disruption of normal cell machinery occurs and cells grow abnormally into a tumor (a collection of cells with abnormalities).

The main known causes are:

• Tobacco use (including cigarettes, cigars, pipes and smokeless forms)
• Alcohol use
• Fanconi anemia
• Family history of oral cancer
• HPV infection
• Excessive sun exposure to the lips

Many cancers do not have an etiology we can point to (the frequency of oral cancers in people without recognized risk factors is growing).

How is oral cancer evaluated and diagnosed?

An evaluation for oral cancer begins with a complete medical history and physical examination. An appointment may also include:

• Biopsy. A procedure in which a tissue sample is collected from the mouth. This is an in-office procedure in which patients receive numbing medication. The sample is sent to the laboratory, where a head and neck pathologist examines it under a microscope to determine if cancer or other abnormal cells are present. Samples are sometimes collected from the lymph nodes in the neck using a needle.
• Endoscopy. A small fiber-optic scope can be used to examine the throat for signs of cancer beyond the mouth area.
• Computed tomography (CT) scan or magnetic resonance imaging (MRI). These are noninvasive procedures that take images of your body to detect abnormalities that may not show up on an X-ray. 
• Ultrasonography. A noninvasive procedure that uses high-frequency sound waves to create an image of the internal organs. For oral cancer, ultrasonography may be used to examine or collect biopsies from the lymph nodes in the neck or to assess the tongue tumor. 
• Positron emission tomography (PET)/CT scan. A noninvasive procedure that uses special radioactive dyes that may help detect cancer in the body. 

Once a diagnosis is made, your doctor will determine the stage, or extent, of the cancer before a treatment plan is established. Your health care provider determines which tests are needed for your specific situation.

What is the treatment for oral cancer? 

Treatment options for oral cancer include surgery, radiation therapy and chemotherapy. You may need only one type of treatment, or you may need a combination of treatments. Recommendations are usually made after consultation among a multidisciplinary team of oncologists (head and neck surgeons, radiation oncologists and medical oncologists) and a speech-language pathologist.

• Surgery. Surgery for oral cancer includes different techniques that depend on the location, size and extent of the cancer. You may need surgery to remove the cancer from your mouth as well as to repair (reconstruct) your mouth after the cancer is removed. You may also need surgery to remove the lymph nodes from your neck if there is concern that the cancer may have spread there.
• Radiation therapy. Radiation therapy uses high-energy rays that damage cancer cells and halt the spread of the disease. Radiation therapy is localized and aimed at only the area where the cancer is present. This therapy is usually given externally with a machine, but it can be delivered internally with radioactive materials.
• Chemotherapy. Chemotherapy uses medications that go throughout the body to kill cancer cells. Chemotherapy may be given alone, or it can be used in combination with surgery or radiation therapy.
• Immunotherapy. Immunotherapy uses medications that help your body’s immune system fight cancer. It can be given as part of a clinical trial before surgery. It may be given to people with advanced oral cancers that are not responding to standard therapies.
• Targeted therapies. For some patients, drugs that target specific cancer cells may be an option. An example is cetuximab, which targets epidermal growth factor receptors.

Oral Cancer Prevention

You can help mitigate your risk for oral cancer by:

• Limiting alcohol intake
• Quitting or refraining from using tobacco products
• Not smoking or vaping
• Using sunscreen
• Receiving HPV vaccination
• Eating a healthy, well-balanced diet
• Having routine oral exams and checkups

Oral Cancer Survival Rates

Keep in mind that survival rates are based on averages and don’t necessarily reflect an individual patient’s outcome — they compare people with cancer to those in the general population. Every patient is different, and what works for one person might not work for another. It’s important to keep up with routine oral examinations and follow prevention guidelines. The National Cancer Institute also has an Oral Cancer Survival Calculator.