What is Oral Cancer?

Oral cancer (often known as oral squamous cell carcinoma) is the most common type of cancer in the mouth affecting any of the tissues of the tongue, floor of mouth, lip, gums and palate. Oral cancer is an aggressive type of cancer and must be treated early to improve patient survival and provide better long-term outcomes.

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Common Signs and Symptoms:

• Oral cancer does not have one typical clinical presentation, which makes its definitive diagnosis difficult.

• Lesions may present as a hard fixed lump, a necrotic lesion, a white plaque, an exophytic mass, or a chronic ulcer.

• Early lesions may only demonstrate a white or mixed red/white appearance (leukoplakia/erythroleukoplakia).

• On rare occasions a solitary red lesion (erythroplakia).

• More advanced lesions may have raised rolled margins, and central necrosis, and are typically larger in size.

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Causes:

• Traditional risk factors for oral cancer include older age, male gender, tobacco smoking, and excessive alcohol consumption.

• Oral hygiene status, local trauma, and chronic inflammation are thought to play very minor, if any, roles in the initiation of oral cancer.

• Human papillomavirus (HPV) is a cause in only a small number of cases.

• More recently, oral cancer has become more common in younger patients for reasons we still do not understand.

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Diagnosis:

The Clinicians at Perth Oral Medicine & Dental Sleep Centre have particular expertise and experience in diagnosing oral cancer. Our Clinicians are leaders in this area of oral disease. We encourage early detection and diagnosis, and are available to help you exclude other diseases and diagnose any suspicious lesion early.

• Oral cancer can be assessed on a clinical basis (visual and palpation) as part of a comprehensive head and neck cancer examination.

• This can be done with white light and with the assistance of other tools such as auto-fluorescence.

• CT scans are often required of the head and neck area to check for the spread of disease into the neck nodes.

• MRI and PET scans are also used in selected cases, along with CT of the chest, particularly in patients with a history of smoking.

• An incisional biopsy of an adequate size and depth is mandatory for a final diagnosis and before any treatment is undertaken.

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Treatment:

• Early and small tumours typically undergo wide local excision or resection with no requirement for reconstruction.

• More extensive tumours require wider/deeper resection, often with reconstruction depending on location.

• Neck dissection is often required in later disease.

• Depending on the stage of the tumour, post-operative radiotherapy is utilised to improve outcomes. Chemotherapy is typically not used for oral cancer, but can be used in selected cases.

 

Recovery:

• 5 year overall survival rate ranges from 25-85% depending on the disease stage, so early diagnosis is very important.

• Long-term review is required for all patients diagnosed with oral cancer to prevent new or recurrent lesions.

• Smoking cessation and improved diet and oral hygiene measures also help patient outcomes in the long term.