Overview of Lip and Oral Cavity Cancer

Lip and oral cavity cancer is a disease in which malignant (cancer) cells form in the lips or mouth.

The oral cavity includes the following:

• The front two thirds of the tongue.
• The gingiva (gums).
• The buccal mucosa (the lining of the inside of the cheeks).
• The floor (bottom) of the mouth under the tongue.
• The hard palate (the roof of the mouth).
• The retromolar trigone (the small area behind the wisdom teeth).

Most oropharyngeal cancers are squamous cell carcinomas. Squamous cells are the thin, flat cells lining the inside of the oropharynx.

Common risk factors for developing lip and oral cavity cancer:

• History of smoking cigarettes and other tobacco use.
• Heavy alcohol use.
• Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) over long periods of time.
• Being male

Signs and symptoms of oropharyngeal cancer

• A sore on the lip or in the mouth that does not heal.
• A lump or thickening on the lips or gums or in the mouth.
• A white or red patch on the gums, tongue, or lining of the mouth.
• Bleeding, pain, or numbness in the lip or mouth.
• Change in voice.
• Loose teeth or dentures that no longer fit well.
• Trouble chewing or swallowing or moving the tongue or jaw.
• Swelling of jaw.
• Sore throat or feeling that something is caught in the throat.
• Lip and oral cavity cancer may not have any symptoms and is sometimes found during a regular dental exam.

Diagnosis of Oropharyngeal Cancer

Physical exam and health history: An exam of the body to check general signs of health, swollen lymph nodes in the neck or anything else that seems unusual. Includes a complete exam of the mouth and neck and looks under the tongue and down the throat with a small, long-handled mirror to check for abnormal areas.

CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the head, neck, chest, and lymph nodes, taken from different angles. The pictures are made by a computer linked to an x-ray machine.

PET scan (positron emission tomography scan): A procedure that makes a series of detailed pictures of areas inside the body after injecting a small amount of radioactive glucose (sugar) into a vein. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.

MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body.

Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. A fine-needle biopsy is usually done to remove a sample of tissue using a thin needle.

Endoscopy: A procedure to look at organs and tissues inside the body to check for abnormal areas. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. The nose, throat, back of the tongue, esophagus, stomach, larynx, windpipe, and large airways is checked.

HPV test (human papillomavirus test): A laboratory test used to check the sample of tissue for certain types of HPV infection, such as HPV type 16. This test is done because oropharyngeal cancer can be caused by HPV infection. This is important because HPV-positive oropharyngeal cancer has a better prognosis.

Stage of Lip and Oral Cavity Cancer

The process used to find out if cancer has spread within the oropharynx or to other parts of the body is called staging.

Cancer can spread to nearby tissue, through the lymph system, and through blood.

The following stages are used for lip and oral cavity cancer:

• Stage 0 (Carcinoma in Situ)
• Stage I
• Stage II
• Stage III
• Stage IV

In stage 0, abnormal cells are found in the lining of the oral cavity(mouth). These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.