What is cancer of the mouth and throat?

Causes and Symptoms

Often, dentists detect cancers of the mouth and throat during routine dental examinations. People who visit their dentists regularly, preferably twice a year, will likely have such cancers detected and diagnosed in their earliest stages when treatment is effective and the cure rate high.

Valid generalizations can be made about the causes of mouth and throat cancers. The most significant cause is the regular use of tobacco products. Cigarette smoking over long periods often results in these cancers or in lung cancer. Males, especially those over forty, have a higher rate of mouth and throat cancer than do females. Pipe and cigar smokers are at greater risk of cancer than are cigarette smokers, and a correlation also exists between the use of chewing tobacco and snuff and the development of mouth cancer. About 90 percent of people suffering from mouth and/or throat cancer have been consistent users of tobacco.

A second causal factor is the regular consumption of substantial quantities of alcoholic beverages, usually over four drinks a day. Some 80 percent of people suffering from mouth and/or throat cancer have used alcohol regularly and in substantial quantities. They are particularly subject to cancers on the floor of the mouth, the tonsils, the lower pharynx, and the tongue.

People who smoke two packs of cigarettes a day and consume over four drinks a day increase the likelihood that they will develop mouth and/or throat cancers by forty times. Other factors in such cancers are poor dental hygiene, ill-fitting dentures, or irregular teeth that cause irritations in the mouth. Those whose work brings them into direct contact with certain toxic chemicals are also at risk.

The most common symptom of lip cancer is the formation of a small, whitish patch (leukoplakia), usually painless, on the lip. It frequently consists of squamous cells. As it develops, it may become ulcerous, causing bleeding and compromising surrounding tissue. If the tongue becomes involved, then it may stiffen. As the malignancy advances, the tongue often becomes painful. Speech, chewing, and swallowing become progressively difficult.

Cancer of the oropharynx, the mid-section of the pharynx, is often accompanied by difficulty in swallowing and hoarseness. Such cancers may also cause patients to expectorate blood-stained sputum. A sore throat frequently accompanies this form of cancer, and earache may also occur, although both of these symptoms frequently result from other causes. People with severe and consistent stomach acid reflux are vulnerable to throat cancer.

Treatment and Therapy

The usual treatment of mouth and throat cancer is surgery to remove the affected tissue. Such surgery is almost always followed by a course of radiation, which may also precede such surgery to shrink any tumors that might be present. Sometimes, removal of the tongue is indicated, although this is a very drastic treatment because of the problems that it causes for the patient, whose ability to speak and to chew and swallow food will be drastically compromised. Cancer of the tongue is the most aggressive form of mouth cancer, which is justification for using drastic measures to deal with it. Facial disfiguration may also be involved in treating cancers of this sort, so extensive plastic surgery may be necessary following it.

Throat cancers usually require the surgical removal of cancerous tissue followed by radiation, but treatment with anticancer medications may also be involved in the management of such cancers. Often, a biopsy is performed in the operating room prior to surgery, usually in conjunction with invasive procedures that permit surgeons and oncologists to view the pharynx, the lungs, and the esophagus using laryngoscopes, bronchoscopes, or esophagoscopes.

Perspective and Prospects

Cancer of the mouth and throat constitute about 8 percent of all the cancers diagnosed in the United States annually. The American Cancer Society estimates that, in 2013, approximately 36,000 people in the United States will develop oral cavity or oropharyngeal cancer and that about 6,850 people will die of these cancers. When an early diagnosis is made and is followed by prompt treatment, a cure results in 75 percent of cases. More than half the people diagnosed with mouth cancer, even those for whom late diagnoses are made, survive for at least five years following treatment. As in all cancers, early detection is the key to effective management and desirable outcomes.

Perhaps the most important factor in reducing the incidence of mouth and throat cancer is to convince young people not to develop the habit of using tobacco products and not to abuse alcohol. People who are already smokers and drinkers are well advised to stop smoking and to limit their alcohol intake to two drinks a day or less.

No conclusive correlation has been made between mouth and throat cancer and secondhand smoke. As an increasing number of public venues and workplaces have become smoke-free, however, people who patronize or work in such places have been smoking less.

Most inveterate smokers want to overcome the habit, but nicotine
addiction is so powerful that giving it up is difficult. Various methods have proved helpful in enabling people to control their habits, among them hypnosis, acupuncture, laser treatment, psychotherapy, and nicotine replacement through patches or nicotine chewing gum.

In 2013, researchers from Penn State reported the results of their study of about two thousand smokers who took part in the US National Health and Nutrition Examination Survey. They found that people who smoked a cigarette within five minutes of waking up in the morning were more likely to develop lung and oral cancer than other smokers. The research team published their findings in the March 29, 2013, issue of Cancer Epidemiology, Biomarkers and Prevention.

Bibliography

American Cancer Society. "Oral Cavity and Oropharyngeal Cancer." American Cancer Society, February 26, 2013.

DeConno, Franco, et al. “Mouth Care.” In Oxford Textbook of Palliative Medicine, edited by Derek Doyle et al. 3d ed. New York: Oxford University Press, 2006.

Dougherty, Lisa, and Sara E. Lister, eds. The Royal Marsden Hospital Manual of Clinical Nursing Procedures. 8th ed. Oxford: Wiley-Blackwell, 2011.

Hahn, Michael J., and Anne Jones. Head and Neck Nursing. Edinburgh, N.Y.: Churchill Livingstone, 2000.

Hellwig, Jennifer. "Throat Cancer." Health Library, May 1, 2013.

Lydiatt, William M., and Perry J. Johnson. Cancers of the Mouth and Throat: A Patient’s Guide to Treatment. Omaha, Nebr.: Addicus Books, 2012.

MedlinePlus. "Oral Cancer." MedlinePlus, April 12, 2013.

Preidt, Robert. "HealthDay: 'Wake-Up Cigarette May Raise Risk for Lung, Mouth Cancers." MedlinePlus, April 5, 2013.