Oral cavity cancer starts in the mouth. It might also be called oral cancer. Oropharyngeal cancer starts in the middle part of the throat just behind the oral cavity that can be seen when the mouth is open.
The oral cavity includes the lips, the inside lining of the lips and cheeks (buccal mucosa), the teeth, the gums, the front two-thirds of the tongue, the floor of the mouth below the tongue, the bony roof of the mouth (hard palate) and the area behind the wisdom teeth (called the retromolar trigone).
The oropharynx is the middle part of the throat just behind the oral cavity. It can be seen when your mouth is wide open. It includes the base of the tongue (the back third of the tongue), the soft palate (the back part of the roof of the mouth), the tonsils, and the side and back walls of the throat.
The oral cavity and oropharynx help you breathe, talk, eat, chew, and swallow. Minor salivary glands all over the oral cavity and oropharynx make saliva (spit) that keeps your mouth and throat moist and helps you digest food.
The American Cancer Society’s most recent estimates for oral cavity and oropharyngeal cancers in the United States for 2022 are:
Oral cavity and oropharyngeal cancers occur most often in the following sites:
The rest are found in the lips, the minor salivary glands (which often occur in the roof of the mouth), and other sites.
As oral cancer is typically discovered later in its process, the death rate is particularly high. It is most likely discovered after it has spread to another location, like the lymph nodes of the neck. When oral cancer reaches an intra-oral area, the prognosis becomes worse. During later stages, the primary tumor has had time to go deep into local structures. Oral cancer may not be noticed at first as the patient may not have any pain or symptoms. Oral cancer also has a high risk of producing second primary tumors. This means that patients who survive a first encounter with the disease have up to 20 times higher risk, throughout 5 to 20 years, of developing a second form of cancer. There are many forms of oral cancers, but 90% of them are squamous cell carcinomas.
Oral cancer patients improve their survival rate by 80-90 percent with early detection. throughout its development, oral cancer may not have noticeable pain or symptoms, which is why it can go undetected until it has spread to another location.
Sadly, there is no standard or routine screening test for oral cancer. There is, however, a fairly traditional exam for abnormalities in the mouth. Your dentist should carefully examine the inside of your mouth, tongue, and throat. In some patients abnormalities such as a flat, painless, white or red spot or a small sore are detected. Most of these are harmless, however, some are not. Harmful spots and sores often look identical to those that are harmless, but professional testing can tell them apart.
Your dentist should give you a visual examination of the soft tissues of the mouth, including the manual extension or pulling of the tongue (often to the point of gagging) to examine the base, a manipulation of the floor of the mouth, an examination of the cheeks, gums, the area behind the teeth and the tongue’s borders. The dentist should also feel the lymph nodes of the neck and those surrounding the oral cavity (sometimes the first visible sign of oral cancer). Your dentist will look for lesions, including areas of leukoplakia (an abnormal white patch of cells) and erythroplakia (an abnormal red patch of cells). These types of lesions on the mucous membranes can become cancerous.
Medical companies are aggressively marketing several new screening tests and devices that they claim will vastly improve the early detection of oral cancer. These devices use rinses, dyes and different types of lights to detect abnormal cells. Some of these devices have more cutting-edge technology than others, and we believe can aid in the discovery process of oral cancer, but do not replace a good manual exam. These “adjunctive” devices are good only if used in concert with a traditional manual exam. In small studies, the devices have successfully detected potentially malignant lesions that experienced specialists missed with the naked eye. Screening tests may cost $35 to $65, however, some dentists offer the test free of cost. Some insurers can even cover the cost of these devices.
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