Oral and oropharyngeal cancers are
malignancies that include the lips, tongue, lining of the cheeks (buccal mucosa),
floor of the mouth, gum (gingiva), the area behind the lower wisdom teeth (retromolar
trigone), the roof of the mouth (hard and soft palates), the back of mouth and throat (oropharynx), and the sides of the throat (tonsil areas).
Oral and oropharyngeal cancers are most often diagnosed in older adults (average age at diagnosis is between 60 and 63), with
over 95% of the
oral cancer cases
occurring after the age of 45. Men are diagnosed with oral and oropharyngeal
cancer twice as often as women. Over the past several decades, the overall
number of oral and oropharyngeal cancers has not changed; however, the number of
men being diagnosed with the disease is decreasing and the number of women with
the disease is increasing.
All forms of tobacco and excessive use of alcohol have been identified as
major risks factors for oral and oropharyngeal cancers, and are suspected to
account for 75% of all oral and oropharyngeal cancers in the United States. Sun
exposure is a risk factor for lip cancer, while smokeless (snuff or spit) tobacco increases the risk for cancers inside the lips and cheek. Other
risk factors for oral and oropharyngeal cancer are vitamin A deficiency and
Plummer-Vinson Syndrome (a very rare iron deficiency).
The American Cancer Society estimates that 7,800 people will die because of
oral or oropharyngeal cancer in the year 2000. Overall, people surviving five
years after a diagnosis of oral and oropharyngeal cancer have shown little
improvement; half of the people diagnosed with this disease survive five years.
Deaths due to oral and oropharyngeal cancer vary greatly with the stage (spread)
of the cancer at diagnosis. Oral and oropharyngeal cancers that are detected and
treated early, and are localized, have greatly improved survival compared to
those that have spread.
Early localized
oral and pharyngeal cancers often are not bothersome and
therefore go undetected until the cancer has spread. About half of oral and oropharyngeal cancers have spread to the lymph nodes (spread to the neck) at the
time of diagnosis or treatment. Three sites within the mouth are high-risk for
the development of oral and oropharyngeal cancer: the floor of the mouth, the
sides of the tongue, and the soft palate complex (soft palate, inside the
retromolar trigone, and tonsil area).
Detection of an oral and oropharyngeal cancer also identifies an individual
who is at high risk for developing or having a cancer of the respiratory system
and upper digestive tract (larynx, lung, and esophagus).
Warning signs and symptoms of oral and oropharyngeal cancer:
- A mouth sore that does not heal
- A lump or thickened mass in mouth or
neck
- A red or white patch in mouth
- A sore throat or feeling that
something is caught
- Voice change
- Difficulty chewing or swallowing
- Difficulty moving the jaw or tongue
- Numbness
- Swelling
- Loosening of teeth
- Weight loss
Pain may not be present with early oral and oropharyngeal lesions. Traumatic
oral lesions will resolve or greatly improve after the cause of the trauma is removed (such as a sharp
tooth or denture). A biopsy, to rule out or confirm a
malignancy, is indicated if an
oral lesion persists after two weeks. A dentist
and/or physician should evaluate all suspicious lesions.
