All cancers that affect the oral cavity and back of the throat, known as the oropharyngeal, are grouped as Oral Cancer. Some areas where oral cancers can develop include the lips, tongue, gums, tonsils, and back of the throat. The American Cancer Society expects about 54,000 new cases of Oral cancer and over 11,000 associated deaths in 2022. While most oral cancers are diagnosed in individuals over age 60, about 20% of cases develop in younger patients (under age 55). Oral cancers are more common in men than women, and rates are elevated in Black and Hispanic men compared to White men. Over the past 20 years, there has been an increase in the prevalence of oral cancer due largely to the rise in human papilloma virus (HPV) driven oropharyngeal cancer.
Like many cancers, treatment is influenced by the stage and type of oral cancer diagnosed. Precancerous (Stage 0) oral cancer is often successfully excised with Mohs surgery. Stage I and II oral cancers can also be treated with surgery, but patients with early-stage oral cancer may opt for chemoradiation, a combination of radiation therapy and chemotherapy. Stage III and IVAB oral cancers are more prominent and may have spread to nearby tissues or lymph nodes. In these advanced cases, surgery is often done first to remove some of the cancer, but chemoradiation is administered post-surgery. Stage IVC oral cancers which have spread to distant parts of the body may require more aggressive therapy. Patients with these late-stage, metastatic cases are treated with surgery, radiation, or chemotherapy. In addition, stage IVC oral cancer patients may receive Cetuximab, a monoclonal antibody therapy that targets the epidermal growth factor receptor (EGFR) protein on cancer cells. Patients who have become resistant to chemotherapy may benefit from immune checkpoint inhibitors targeting the PD-1 protein on immune cells.
Symptoms associated with oral cancers include sores, discoloration of the gums, excessive bleeding, hard lumps or growths. In conjunction with the recognition of April as Oral Cancer Awareness, the Oral Cancer Foundation has initiated the Check Your Mouth™ campaign encouraging everyone to regularly inspect their mouth for signs and symptoms of oral abnormalities. The foundation recommends that anyone experiencing symptoms for more than two weeks contact a doctor or dentist for further evaluation.
Sources: NIDCR, J Dent Res