Mouth Cancer

Mouth Cancer

Oral cancer is cancer that occurs in the lining of the mouth, lips, tongue, gums, or palate. Oral cancer can also attack the tissues in the throat (pharynx) and salivary glands.

Oral cancer is generally characterized by canker sores that do not go away, as well as the appearance of white or red patches, and pain in the mouth.

Oral cancer treatment methods can be in the form of radiotherapy, chemotherapy, surgery, and targeted therapy. The cure rate of patients with oral cancer depends on the stage of cancer suffered and their health condition.

Causes of Oral Cancer

Oral cancer occurs when tissue in the mouth grows abnormally. It is caused by genetic changes or mutations in the cells in these tissues. Even so, the cause of this genetic mutation itself is not known with certainty.

There are several factors that are thought to increase the risk of oral cancer, including heredity and age (over 50 years). Some behaviors and diseases that are also thought to make a person more at risk of developing oral cancer are:

  • Smoking
  • Consuming alcoholic beverages
  • Often chew betel nut
  • Rarely eat vegetables and fruit
  • Not maintaining oral hygiene and health, for example leaving  cavities
  • Frequent exposure to sunlight, for example field workers

While the diseases that are thought to be at risk of causing oral cancer are:

  • HPV  infection
  • Oral herpes infection 
  • Diseases that can lower the immune system, such as HIV/AIDS
  • Certain genetic diseases, such as Fanconi anemia or congenital dyskeratosis

Symptoms of Oral Cancer

In some people, changes that occur in oral tissue due to oral cancer may not be realized, because it is considered a harmless thing. However, there are signs of change to watch out for, including:

  • Canker sores that don't go away for weeks
  • Canker sores accompanied by bleeding
  • Red or white patches in the mouth
  • A lump or thickening on the inside of the mouth that doesn't go away
  • Teeth shaking for no apparent reason

In addition to changes in the tissues in the mouth, symptoms that can be felt by people with oral cancer are:

  • Pain in the mouth
  • Difficulty or pain when swallowing or chewing
  • Jaw feels stiff or sore
  • Sore throat
  • Changes in voice or speech (e.g. being slurred)
  • Difficulty speaking

In oral cancer that has entered an advanced stage, symptoms do not only occur in the mouth. At this stage, cancer cells have spread and cause lumps in the neck due to  swollen lymph nodes .

When to go to the doctor

To maintain healthy teeth and oral cavity, do regular checkups to the dentist once every 1-2 years. However, examinations can be done more often, depending on the doctor's judgment based on your oral health condition.

Early symptoms of oral cancer, such as canker sores, are often considered a harmless condition and ignored until the condition is severe. Be aware of the symptoms of oral cancer above and immediately consult  a dentist  if the complaint does not go away for more than 2 weeks.

Oral Cancer Diagnosis

The doctor will perform an examination to confirm oral cancer, as well as to determine the stage and spread of the cancer. Initially, the doctor will ask about the symptoms experienced by the patient, then examine the condition of the patient's mouth.

If oral cancer is suspected, the doctor will perform  a biopsy , which is taking a sample of oral tissue for examination in a laboratory. Oral tissue samples can be taken through a fine needle ( fine needle aspiration ) or through a small incision in the skin.

A biopsy can also be done with an  endoscope . In this procedure, the doctor will insert an instrument in the form of a camera tube through the mouth (endoscope).

In addition to taking samples of oral tissue, endoscopy can also be used to see the condition of the oral cavity and the area around it. With the help of an endoscope, parts that are difficult to see around the oral cavity, such as the throat or nasal cavity, can be seen clearly.

Meanwhile, to see the spread of cancer, the doctor will perform scans, such as X-rays, CT scans, MRI, or  PET scans .

Oral Cancer Stage

Based on the size and extent of spread, oral cancer is divided into 4  stages . Here is the description:

  • Stage 1
    At this stage, oral cancer is still very small, about 2 cm and has not spread to surrounding tissues.
  • Stage 2
    At this stage, oral cancer is 2–4 cm in size, but has not spread to surrounding tissues.
  • Stage 3
    At this stage, oral cancer is more than 4 cm in size, or has spread to the lymph nodes.
  • Stage 4
    At this stage, the lymph nodes have enlarged, and the cancer has spread to some tissues outside the mouth or to other distant organs, such as the liver.

Oral Cancer Treatment

Treatment of oral cancer depends on the stage, location, and type of oral cancer, as well as the patient's health condition. Treatment methods are surgery, chemotherapy, radiotherapy, and targeted therapy. These four treatment methods can be combined to get maximum results.


Early-stage oral cancer can be treated with surgery using laser light ( photodynamic therapy ). However, if the cancer has spread to some of the tissues around the mouth, it may be necessary to remove the tumor.

Doctors may also perform facial reconstruction surgery to reshape the removed part or tissue.


Cancer treatment through  radiotherapy  aims to kill cancer cells using special rays, such as X-rays or protons. Radiation therapy can be done from outside or from inside the body.

Radiotherapy is generally combined with chemotherapy or surgery. Radiotherapy before surgery aims to shrink the size of the cancer before it is surgically removed. While radiotherapy after surgery aims to eradicate the remaining cancer cells.

Radiotherapy for end-stage cancer cannot kill all cancer tissue in the patient's body. However, radiotherapy is performed on late-stage cancer can help relieve symptoms of cancer suffered.


In treating cancer that has spread widely or is at high risk of regrowth, doctors recommend that patients undergo  chemotherapy . The drugs used in this process destroy the DNA of cancer cells so they can't multiply. Some of the types of drugs used are:

  • Cisplatin
  • Carboplatin
  • Fluorouracil
  • Docetaxel
  • Methotraxate
  • Bleomycin

Although they can help cure cancer, radiotherapy and chemotherapy have the risk of causing side effects, such as nausea, vomiting, fatigue, canker sores, and pain in the mouth. These drugs can also lower the body's resistance so that the patient is susceptible to infection.

Target therapy

In addition to surgery, radiotherapy, and chemotherapy, oral cancer can also be treated with targeted drug therapy. This therapy serves to kill cancer cells and stimulate the immune system to kill these cells.

Targeted drug therapy can be given with chemotherapy drugs. One type of drug that doctors give for this therapy is cetuximab. Targeted drug therapy can cause side effects such as itching, rash, diarrhea, and infection.

Oral Cancer Prevention

Oral cancer cannot be completely prevented, because the cause is unknown. However, patients can take simple steps to lower their risk of developing oral cancer, namely:

  • Do not smoke
  • Avoid consumption  of alcoholic beverages
  • Increase consumption of vegetables and fruits
  • Maintain oral hygiene by  brushing your teeth regularly
  • Checking dental health regularly, at least once a year
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