Oral and oropharyngeal cancers, which begin in the mouth or throat, have been on the rise throughout the last decade. These head and neck cancers develop in the thin cells that line the lips, gums, tongue, inside of the cheeks, tonsils, or pharynx (the back of the throat). Every year, there are more than 54,000 cases in the U.S.
At Summit Health, physicians rely on a team approach to tackle head and neck cancers. “Oral and oropharyngeal cancers require careful coordination of complex treatments,” explains Andrew Wong, MD, a radiation oncologist based out of the Berkeley Heights and Florham Park offices. “It is important for patients to receive care at experienced centers that have multidisciplinary teams in place to guide them through treatment and follow-up care.”
What are the symptoms of oral cancer?
Identifying oral cancer early can save your life. For oral cavity cancers, the first sign is typically a growth, sore, or patch on the tongue or mouth that does not heal after several weeks. In oropharyngeal cancers, the most common symptoms include sore throat, ear pain, weight loss, voice changes, difficulty swallowing, and an enlarged lymph node or mass in the neck.
If these symptoms go away after a few days, they are likely caused by a cold or harmless irritation. Persistent symptoms, however, are abnormal and may be cause for concern. Make an appointment with your dentist or physician if you have any of these symptoms for longer than a few weeks
“Head and neck cancer is treatable, especially if detected in the early stages,” says Serena Byrd-Gillman, MD, an ear, nose, and throat specialist at Summit Health. “Early detection also decreases complications like difficulty swallowing or speaking that can be associated with the treatment of head and neck cancer.”
Dr. Byrd-Gillman says it is important to know that some patients with oral cavity or oropharyngeal cancer have no symptoms. Others may notice a sore throat, ear pain, or a mass in their neck. She advises that any of these symptoms that last more than two weeks should be evaluated by a physician.
Are there any ways to screen for oral cancer?
There are no screening tests or scans for oral cavity or oropharyngeal cancers. But it is important to see your dentist regularly for an oral exam, particularly if you are at a higher risk. You should also get in the habit of self-examining your mouth, neck, and face each month to look for any changes.
“The best strategy is to have regular checkups with your primary care physician and dentist, so that early cancers and precancerous lesions can be picked up and treated,” says Sarada Gurubhagavatula, MD, MPH, a medical oncologist at Summit Health.
How is oral cancer diagnosed?
A diagnosis of oral cancer starts with a physical exam. If the area of concern is in a difficult-to-reach place like the throat, your physician may use an endoscope — a small, flexible camera to examine the area.
If your doctor or dentist finds a suspicious growth or area, they typically perform a biopsy. This involves removing a piece of the affected tissue and testing the cells in the laboratory. The biopsy will show what stage the cancer is in.
In more advanced cancers, imaging tests like X-ray, CT, or MRI may be used. These tools can help identify if the cancerous cells have spread to other areas of the body.
Who gets oral cancer?
Oral cavity and oropharyngeal cancers occur more often in men over the age of 50. “Strong risk factors include smoking, tobacco use, alcohol abuse, and betel nut chewing,” explains Dr. Wong. “Oral cancers can be prevented by avoiding these behaviors.”
Over the last several decades, however, there has been a significant increase in the disease among young, healthy patients without these risk factors. Human papillomavirus (HPV) is a sexually transmitted infection that is commonly being linked with oropharyngeal cancer.
HPV infects a type of cell that lines the surface of the body, including the skin and mucosa, that covers the mouth and throat. When these so-called epithelial cells get out of control, it can lead to cancer.
“Decreasing your number of sexual partners and following safe sexual practices can help reduce your risk,” advises Dr. Byrd. “Vaccinating children for HPV before they become sexually active also helps decrease their risk.”
How is oral cancer treated?
There are many successful treatments for oral cancer. Modern treatment of oral and oropharyngeal cancers includes care from multiple medical specialties, explains Dr. Wong. Depending on the stage and severity of disease, this may include surgery, radiation, and chemotherapy.
Surgery is used to remove the tumor and any surrounding cancerous cells. Early-stage cancers can often be treated with surgery or radiation alone. Sometimes the cancerous cells spread to the lymph nodes. In these cases, your physician may recommend removing these lymph nodes as well.
In more advanced cases, radiation treatment with or without chemotherapy is used in addition to surgery. If these cancers have spread to other parts of the body, then treatment would involve chemotherapy or immunotherapy.
“Immunotherapy is a newer form of cancer treatment in which a drug is given that stimulates the body’s immune system to attack the cancer cells. It has been shown to be effective against multiple types of cancers, including oral and oropharyngeal cancers,” explains Dr. Wong.
What is the outlook for oral cancer?
The prognosis for patients diagnosed with oral cancer has improved dramatically as a result of advancements in surgical and radiation techniques, drug development, and imaging technologies. HPV-associated oropharyngeal cancers have a better prognosis than HPV-negative cancers, as they seem to be more responsive to our current treatments.
Statistics show that survival rates have been increasing. Patients are living longer, and often with fewer side effects than in the past. “The treatments are highly effective,” says Dr. Gurubhagavatula. “We can often cure head and neck cancers if they are picked up early. The goal is to cure patients and preserve their quality of life as much as possible.”