Mouth Cancer

Mouth cancer can occur on the lips, gums, tongue, inside lining of the cheeks and the roof and floor of the mouth. Risk factors include tobacco and alcohol use, as well as exposure to the human papillomavirus (HPV).

Symptoms include a non-healing wound, which may or may not be painful, on the tongue, in the floor of the mouth or along the inner cheek. The sore may grow larger and additional symptoms may include new or increased pain, painful swallowing, ear pain, change in speech or a lump in the neck. If you have a sore in your mouth that does not heal within three weeks, you should see a physician.

Diagnosis

A physician will review your medical history and complete a physical examination that covers the head and neck region, including the throat, nose and ears.

Physicians may recommend a specialized type of X-ray, such as a CT scan or an MRI. Physicians may also order an X-ray or CT scan of the chest to evaluate for spread of disease to the lungs, the most common site of spread outside of the neck.

A biopsy, a small piece of tissue taken from the suspected tumor, is often taken from the patient in the doctor’s office. The surgeon may also obtain a biopsy with the patient under anesthesia. Evaluation of the entire throat, voice box, esophagus and windpipe is also often recommended as a percentage of patients who have one cancer of the mouth, throat or voice box may also have another tumor present elsewhere in the head and neck.

Treatment

The main tools for treating cancers of the oral cavity are surgery, radiation therapy and chemotherapy, depending on the staging. For this reason, someone with a cancer of the oral cavity may also meet a specialist from radiation oncology as well as medical oncology.

Surgical removal is the first line of treatment for the majority of mouth cancers. For tumors that are at the early stage, the tumor is addressed through the mouth, sometimes using a laser. Because tumors from the mouth may spread to the neck lymph nodes, removal of those nodes may also be required.

For larger tumors, reconstructive surgery may be needed following the removal of the cancer to restore the form and function of the mouth.

Reconstruction

Surgeons at Palmdale Regional Medical Center use advanced surgical techniques to help patients who have had oral cancer surgery restore function and appearance. Reconstruction may be as simple as putting the tongue muscles back together in the best possible fashion after the removal of the tongue cancer, or placing a skin graft to replace the missing oral cavity lining.

With advanced cancers, more advanced reconstruction may be required. In such cases, not only is new lining of the oral cavity needed in greater amount, but bone may need to be replaced with tissues taken from elsewhere in the body. For example, skin and muscle can be moved from the chest to rebuild the tongue and mouth. Skin can also be moved from the area of the wrist and used to reline the mouth and rebuild the tongue. Bone can be moved, with or without skin, from the lower leg, hip or shoulder blade and used to rebuild the upper or lower jaw.

Rehabilitation

Following treatment of cancers in the oral cavity with surgery, radiation therapy, chemotherapy or combinations of the techniques, several important functions of the oral cavity may be severely affected. These include lubrication of the mouth and throat, swallowing without choking on foods or liquids, speech and movement in areas where surgery has been done. Rehabilitation of various mouth functions can be accomplished with the help of a speech therapist.