OVERVIEW

What is oral cancer?

Broadly speaking, oral cancer includes lip cancer, intraoral cancer (such as tongue cancer, gum cancer, etc.), and oropharyngeal cancer (such as base-of-tongue cancer, tonsil cancer, etc.). In recent years, tongue cancer has become the most common type of oral cancer.

In China, oral cancer is relatively rare and primarily occurs in middle-aged and elderly individuals, with a higher incidence in men than women. Risk factors may include smoking and betel nut chewing. Symptoms can manifest as oral mucosal ulcers and lumps that gradually enlarge, potentially affecting functions like swallowing and speech. Treatment mainly involves surgery and radiotherapy. Patients with early-stage tumors generally have better survival outcomes.

Is oral cancer common?

It is not common.

SYMPTOMS

What are the symptoms of oral cancer?

In the early stages, oral cancer may present as ulcers or lumps on the oral mucosa. As the ulcer enlarges, the center may necrotize and form a depression with raised, everted edges resembling cauliflower, possibly accompanied by bleeding or infection.

As the tumor grows, it may cause destruction of surrounding soft tissues or bones, leading to symptoms such as pain, bad breath, loose teeth, and difficulty opening the mouth, which can affect eating, swallowing, and speech. If the cancer affects nearby nerves, it may cause facial numbness or restricted tongue movement.

Does oral cancer metastasize easily?

Metastasis to cervical lymph nodes is the most common route of spread for oral cancer. Over half of patients already have cervical lymph node metastasis at the time of initial diagnosis. Even in patients without metastasis, prophylactic neck dissection may be considered based on risk assessment.

Does oral cancer affect eating or speaking?

The tumor itself may impair muscles and bones involved in movement and speech. After surgical resection, functional deficits such as appearance, swallowing, chewing, or speech may persist, requiring reconstructive surgery and rehabilitation exercises to aid recovery.

CAUSES

What are the causes of oral cancer?

The exact cause is unknown, but it is generally believed that unhealthy habits such as smoking, excessive alcohol consumption, and long-term chronic irritation are the main causes. It may be related to the following factors:

• Betel nut: The risk of oral cancer is significantly higher in betel nut chewers than in the general population, and multiple carcinogens have been found in betel nuts;

• Sun exposure: Prolonged exposure to sunlight is closely related to lip cancer;

• Viral infection: Human papillomavirus (HPV) is strongly associated with tonsil cancer;

• Nutrition: Deficiencies in nutrients such as vitamin A and vitamin C are linked to oral cancer;

• Residual roots or crowns in the mouth: These can irritate the oral mucosa over time, potentially leading to cancer;

• Unhealthy lifestyle: Such as smoking and drinking.

Is oral cancer hereditary?

There is no evidence linking it to genetics.

Can oral cancer occur in young people?

In recent years, there has been a trend toward younger onset, with increasing cases among young people.

Which groups are more prone to oral cancer?

Most cases occur in individuals over 45, with men affected more often than women. Those with unhealthy habits like smoking, drinking, or chewing betel nuts, as well as people with residual roots or crowns in the mouth that chronically irritate the mucosa and cause ulcers, have a higher risk of developing oral cancer.

DIAGNOSIS

What tests do oral cancer patients need?

Mainly rely on pathological examination, where a small piece of the lesion tissue is taken to make a specimen for testing and observation to determine the nature of the lesion.

Which diseases can oral cancer be easily confused with?

It needs to be distinguished from oral ulcers and benign oral tumors.

TREATMENT

Which department should I visit for oral cancer?

Oncology, Dentistry, Otolaryngology.

How is oral cancer treated?

Surgery and radiotherapy are the primary treatments.

Early-stage oral cancer is usually treated with either surgery or radiotherapy alone, while advanced cases require a combination of both.

Chemotherapy is generally used as an adjuvant therapy. The status of neck lymph nodes must also be evaluated to determine whether surgical removal and the extent of removal are necessary.

The specific treatment plan should also consider post-treatment factors such as appearance, speech, swallowing, and chewing function.

Do oral cancer patients need follow-up examinations? How often should they be checked?

Long-term follow-up is required to monitor for recurrence.

Most recurrences occur within the first 2 years after surgery. Generally, it is recommended to have follow-up examinations every 1–3 months in the first year after treatment, every 2–4 months in the second year, every 4–6 months from the 3rd to 5th year, and every 6–12 months after 5 years. Each examination should include a physical check of the lesion and neck, as well as an ultrasound. If suspicious findings arise, CT, MRI, or even a biopsy may be needed for confirmation.

What is the effectiveness of oral cancer treatment?

In recent years, the 5-year survival rate for oral cancer patients has reached 60% of that of their peers, showing improvement compared to the past.

Early-stage patients have significantly better outcomes than late-stage patients. The 5-year survival rate is about 80% for patients without metastasis, around 50% for those with neck metastasis, and approximately 30% for those with distant metastasis.

Is oral cancer prone to recurrence?

After treatment, about 12% of oral cancer patients experience recurrence. Additionally, secondary cancers (non-metastatic) are relatively common.

Genetic predisposition and radiotherapy both increase the likelihood of recurrence. If oral cancer patients continue smoking and drinking after diagnosis, their risk of developing another oral cancer is more than twice that of the general population.

DIET & LIFESTYLE

What should oral cancer patients pay attention to in daily life and diet?

• After treatment, oral cancer patients should quit smoking and limit alcohol consumption;

• If there are residual roots or damaged crowns in the mouth, seek prompt treatment and adhere to regular follow-up examinations;

• Maintain a balanced diet with a mix of whole and refined foods for proper nutrition;

• Avoid drinking or eating overly hot water and food to prevent irritation of oral tissues.

• Develop good oral hygiene habits.

PREVENTION

How to Prevent Oral Cancer?

1. General Population

• Avoid known carcinogenic factors such as smoking, alcohol consumption, and betel nut chewing;
• Minimize prolonged sun exposure to prevent lip cancer;
• Maintain good oral hygiene;
• Promptly address residual roots or damaged teeth in the oral cavity.

2. Denture Wearers:

Seek medical attention immediately if pain or inflammation occurs under the dentures. Early detection, diagnosis, and treatment are crucial, along with regular check-ups.

3. High-Risk Groups Require Regular Screening, including:

• Heavy smokers;
• Heavy drinkers;
• Individuals with viral infections;
• Those with low intake of vegetables and fruits;
• Betel nut consumers;
• People over 45 years old;
• Males.