Oral cancer is a form of cancer that affects the soft tissue in your throat and mouth, and is also referred to as mouth cancer. In this form of cancer, cancerous cells most commonly develop in the gums, lips, tongue and the inside of the cheeks. It is also possible for tumours to grow on the salivary glands, tonsils and pharynx.

There are a number of different types of mouth cancer, but around 90 percent of cases are classed as squamous cell carcinomas. Other, less common types of mouth cancer include oral malignant melanomas and adenocarcinomas.

Diagnosis of oral cancer

Signs of oral cancer can be detected by a GP or dentist. If they suspect a patient might have oral cancer, they will give them a referral for further tests in a hospital or with a specialist.

Initially, oral cancer is suspected when symptoms such as slow healing mouth ulcers, abnormal swelling and red or white patches are present in the mouth.

To diagnose cancer, a tissue sample from the affected area is often removed. This is known as a biopsy and there are three main types associated with oral cancer.

• Punch biopsy – this involves cutting away a very small tissue sample and is used when the suspected cells are in an accessible area such as the tongue
• Fine needle aspiration – this procedure is usually recommended when symptoms are associated with the neck. It involves using a fine needle to remove a sample of tissue from the swollen area.
• Panendoscopy – this procedure is often carried out if the suspected tumour is located at the very back of the throat or inside the nostrils. It involves passing a thin tube through the nostrils. This process also helps to determine if cancerous cells have spread.

All biopsies are carried out under general anaesthetic to make the patient feel more comfortable. If you require a biopsy and are feeling worried about the procedure, talk to your doctor or nurse. They can help to ease your mind and answer any questions you have.

Further tests

If a biopsy reveals that a patient has oral cancer, further tests will be required to see how advanced the tumour is and whether it has spread to other parts of the body. Tests include a PET (positron emission tomography) scan, CT scan and x-rays.

Test results will be used to stage and grade the cancer case. The stage related to the progression of the cancer and the grade relates to how aggressive it is. Typically, aggressive forms of cancer spread quickly.

Planning treatment

The results of diagnostic testing are used to plan treatment. Low grade cases can usually be treated effectively, whilst high grade cancer is more difficult to treat, especially if it is highly aggressive or has already spread through the lymphatic system.

Coping with a diagnosis

Being diagnosed with cancer can be difficult and distressing and if you are diagnosed, it’s understandable to feel as though you’re battling with mixed emotions. The medical team will give you as much information as possible about the treatment options before you’re required to make a decision. You will also have the opportunity to speak to people who can provide help and support. Charities such as Cancer Research UK, the Mouth Cancer Foundation and Macmillan provide information, advice and support services.