Oral cancer refers to cancer occurring between the vermilion border of the lips and the junction of the hard and soft palates or the posterior one third of the tongue. Early, curable lesions are rarely symptomatic; thus, preventing fatal disease requires early detection by screening. Treatment is with surgery, radiation, or both, although surgery plays a larger role in the treatment of most oral cavity cancer. See also Overview of Head and Neck Tumors. Oral squamous cell carcinoma affects about 34, people in the US each year. As with most head and neck sites, squamous cell carcinoma is the most common oral cancer. The combination of heavy smoking and alcohol abuse is estimated to raise the risk fold in women and fold in men.
The oral cavity (mouth) and oropharynx (throat)
Anatomy The anatomy of the oral cavity is particularly challenging because there are many different types of tissue located in this relatively small area. The oral cavity begins at the lips and extends backwards to the front part of the tonsils. Beginning at the front of the upper and lower lips is the very specialized tissue called the vermilion border, which lines the lips. Once inside the mouth, this entire region is coated with a lining that is specialized to provide lubrication of the oral cavity. The bone of the lower jaw called the mandible and of the upper jaw, called the hard palate, are also included in this region as well as the teeth. The lining of the mouth becomes thick overlying this bone. Directly behind the lower teeth is a smooth gutter, known as the floor of mouth. Here, the lower saliva gland empties saliva through specialized ducts just under the tip of the tongue. The front two-thirds of the tongue are also included within the oral cavity.
The oral cavity includes the following:. Most lip and oral cavity cancers start in squamous cells , the thin, flat cells lining the inside of the lips and oral cavity. These are called squamous cell carcinomas. Cancer cells may spread into deeper tissue as the cancer grows. Squamous cell carcinoma usually develops in areas of leukoplakia white patches of cells that do not rub off. Lip and oral cavity cancer is a type of head and neck cancer. Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your doctor if you think you may be at risk.
NCI Definition: A squamous cell carcinoma arising from the oral cavity. It affects predominantly adults in their fifth and sixth decades of life and is associated with alcohol and tobacco use. Human papillomavirus is present in approximately half of the cases. It is characterized by a tendency to metastasize early to the lymph nodes. When the tumor is small, patients are often asymptomatic. Physical examination may reveal erythematous or white lesions or plaques. The majority of patients present with signs and symptoms of locally advanced disease including mucosal ulceration, pain, difficulty with speaking, chewing, and swallowing, bleeding, weight loss, and neck swelling. Patients may also present with swollen neck lymph nodes without any symptoms from the oropharyngeal tumor. The most significant prognostic factors are the size of the tumor and the lymph nodes status.