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What is oral cancer?

Oral cancer is cancer found in the oral cavity. Oropharyngeal cancer is cancer found in the oropharynx (the throat area at the back of the mouth). The oral cavity includes:

  • The lips, teeth and gums
  • The front two-thirds of the tongue
  • The lining inside the lips and cheeks (buccal mucosa)
  • The floor of the mouth (under the tongue)
  • The top of the mouth (hard palate)
  • The small area behind the wisdom teeth

The oropharynx includes:

  • The back one-third of the tongue
  • The soft palate
  • The tonsils
  • The back of the throat

Our approach

Northwell Health Cancer Institute takes a comprehensive approach to treating oral cancer. Our multidisciplinary team of specialists has unparalleled experience diagnosing and treating oral cancer at one of the largest cancer centers in the New York metro area. We offer specialized therapies available at only a few cancer centers in the nation, including:

  • Advanced microvascular reconstruction of mandibular and extensive tongue defects
  • Innovative transoral robotic surgery (TORS) and other minimally invasive procedures that remove tumors of the mouth and throat while speeding recovery and preserving speech, swallowing and other key functions
  • Leading edge radiation therapies and chemotherapies

If you have been diagnosed with oral cancer, your oncologist will explain all your treatment options and create a treatment plan tailored to your specific needs and goals. Throughout your treatment, you will work closely with a dedicated team of specialists in medical oncology, surgical oncology and radiation oncology who collaborate to ensure seamless coordination of your care. Because every oral cancer diagnosis is unique, the physicians providing your treatment will meet once a week to share ideas and will review every step of your care. Convenience is also a primary focus throughout your treatment, so every effort is made to provide services in one location.

Research at Northwell

As part of your oral cancer treatment plan, you may have opportunities to participate in clinical trials, including promising new vaccine trials for oral cancer. These trials study new chemotherapy drugs, radiation technologies and surgical approaches. While not every patient is a candidate for clinical trials, your care team will work with you to determine eligibility. Learn more about clinical trials at Northwell Health.

Symptoms

The following are the most common symptoms of oral cancer. However, you may experience symptoms differently. Symptoms include:

  • A lip or mouth sore that does not heal
  • A white or red patch on the gums, tongue or lining of mouth
  • A lump on the lip or in the mouth or throat
  • Unusual bleeding, pain, or numbness in the mouth area
  • Swelling of the jaw or neck
  • Pain in the ear
  • Change in voice
  • A chronic sore throat
  • Feeling as if something is caught in the throat
  • Pain or difficulty in swallowing or chewing
  • Cough

The symptoms of oral and oropharyngeal cancers may resemble other disorders or medical problems. Always consult your healthcare provider for a diagnosis.

Causes

The main causes of this condition are:

  • Tobacco use
  • Alcohol use

Other causes may include:

  • A diet low in fruits and vegetables
  • Human papillomavirus (HPV) infection
  • Excessive sun exposure, which can cause cancer on the lip

Diagnosis

In addition to a complete medical history and physical examination, diagnostic procedures for cancers of the oral cavity and oropharynx may include one or more of the following:

  • Biopsy—A procedure in which tissue samples are removed (with a needle or during surgery) from the body for examination under a microscope to determine if cancer or other abnormal cells are present
  • Computed tomography (CT or CAT scan)—A noninvasive procedure that takes horizontal, or axial, images of the brain or other internal organs to detect any abnormalities that may not show up on an ordinary X-ray
  • Ultrasonography—A diagnostic imaging technique that uses high-frequency sound waves to create an image of the internal organs
  • Magnetic resonance imaging (MRI)—A noninvasive procedure that produces 2-dimensional view of an internal organ or structure, especially the brain and spinal cord. If additional imaging is needed, a doctor may order a PET scan, which can determine where the cancer started.
  • Barium swallow—Because cancer of the esophagus may occur with oral cancer, a doctor may order this test, often called an upper GI series, to look for cancer of the esophagus. The patient will drink a chalky solution while X-rays are taken.
  • Endoscopy—A small fiberoptic scope can be used to examine the oropharynx and oral cavity. The scope can also be used to obtain biopsies.

Once a diagnosis is made, the cancer will be staged (to determine the extent of the disease) before a treatment plan is established.

Treatment types

Standard treatment includes:

  • Surgery—Surgery is commonly used to remove the cancer while sparing healthy tissue. At Northwell Health Cancer Institute, the most advanced surgical treatments are offered for oral cancer, including transoral robotic surgery and transoral laser microsurgery. These treatments use robotic instruments to remove tumors without the need for large incisions.
  • Radiation therapy—External-beam radiation therapy is most often used to treat oral and oropharyngeal cancer. Advanced treatments, such as proton therapy and intensity modulated radiation therapy (IMRT), enables more effective doses of radiation to be used to destroy cancer cells while minimizing damage to healthy tissue. Radiation therapy frequently is used following surgery to remove any remaining cancer cells.
  • Chemotherapy—Chemotherapy is often used in combination with radiation therapy to control tumor growth.
  • Immunotherapy—Also called biologic or biotherapy, immunotherapy enables the body’s natural defenses to fight oral cancer. Several immunotherapy drugs have been approved by the U.S. Food and Drug Administration (FDA) for the treatment of certain types of oral cancer.

Prognosis

Today, due in to advancements in treatment, prognosis is excellent for most patients.

Living with

  • Take your medicines exactly as prescribed. Call your doctor if you have any problems with your medicine. You may get medicine for nausea and vomiting if you have these side effects.
  • Eat healthy food. If you do not feel like eating, try to eat food that has protein and extra calories to keep up your strength and prevent weight loss. Drink liquid meal replacements for extra calories and protein. Try to eat your main meal early. Some people do better with small, frequent meals rather than one or two large ones.
  • Your doctor may suggest a feeding tube if your mouth and throat are too sore to chew and swallow. This will help you get the right nutrition, a key part of your recovery.
  • Get some physical activity every day, but do not get too tired. Keep doing the hobbies you enjoy as your energy allows.
  • Take steps to control your stress and workload. Learn relaxation techniques.
    • Share your feelings. Stress and tension affect our emotions. By expressing your feelings to others, you may be able to understand and cope with them.
    • Consider joining a support group. Talking about a problem with your spouse, a good friend, or other people with similar problems is a good way to reduce tension and stress.
    • Express yourself through art. Try writing, dance, art, or crafts to relieve tension. Some groups may be available just for people who have cancer.
    • Be kind to your body and mind. Getting enough sleep, eating a healthy diet, and taking time to do things you enjoy can contribute to an overall feeling of balance in your life and can help reduce stress.
    • Get help if you need it. Discuss your concerns with your doctor, counselor, or other health professional.
  • If you are vomiting or have diarrhea:
    • Drink plenty of fluids (enough so that your urine is light yellow or clear like water) to prevent dehydration. Choose water and other caffeine-free clear liquids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
    • When you are able to eat, try clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Other good choices include dry toast, crackers, cooked cereal, and gelatin dessert, such as Jell-O.
  • If you have not already done so, prepare a list of advance directives. Advance directives are instructions to your doctor and family members about what kind of care you want if you become unable to speak or express yourself.
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