Cancer begins when cells grow out of control, forming lumps known as tumors, which may either be benign (non-cancerous) or malignant (cancerous). Mouth (oral cavity) and throat (oropharyngeal) cancers start in the opening of the mouth and the middle part of the throat just behind the oral cavity. They can often be seen when the mouth is open.
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The oral cavity is composed of the following:
The oropharynx or the throat is the mid part of the throat just below the oral cavity. This can easily be seen when the mouth is open. It includes the base of the tongue, soft palate, tonsils, and the side and back walls of the throat.
The mouth and throat help in breathing, chewing, eating, talking, and swallowing. These areas also have minor salivary glands which help lubricate the area and aid in digestion.
The type of cancer will depend on which part of the mouth or throat it starts to develop. These distinctions are important because they can affect both treatment and outlook.
Most cancers in this region are squamous cell carcinomas, which are cancers that develop from thin, flat cells that line the mouth and throat. This is called ‘carcinoma in situ’ when the cancer cells are only at the epithelium layer. When they reach deeper into the layers of the mouth and throat, it is called ‘invasive squamous cell cancer’ and becomes harder to treat.
Verrucous carcinoma is a rare squamous cell cancer in the gums and cheeks. It grows slowly and rarely spreads to the rest of the body.
Some squamous cell carcinomas in the mouth and throat may also develop from HPV infection. Human papillomavirus often causes throat cancer and is rarely associated with mouth cancer. These are mostly found in younger populations with no history of tobacco or alcohol consumption. They also have better prognosis than most mouth and throat cancers because HPV-positive cancers tend to shrink with chemotherapy and radiation treatment.
There are minor salivary glands in the mouth. Rarely, cancer may also start from these, such as adenoid cystic carcinomas, mucoepidermoid carcinomas, and polymorphous low-grade adenocarcinoma. The tonsils can also be infected with lymphomas since they contain lymphoid tissue.
Leukoplakia and erythroplakia are tissue changes that happen in the mouth or throat. Leukoplakia is a gray or white area that does not come off despite being scraped. Erythroplakia is a slightly raised or flat red area that easily bleeds when scraped. They may also be combined in a single patch called erythroleukoplakia.
These changes are often first spotted by a dentist during general oral examinations. They may either be benign, already cancer, or a precancerous condition called ‘dysplasia’. There may be no clear cause for these to appear. But they are often found in people who have a habit of chewing tobacco, smoking, or have ill-fitting dentures that rub against the cheek and tongue.
While these conditions may go away on their own, if the doctor suspects dysplasia or cancer, a biopsy will be recommended. However, most mouth and throat cancers do not often develop from pre-existing lesions.
There are tumors and tumor-like changes that can occur in the throat or mouth that do not become cancer and are potentially harmless. These may be:
They are not life-threatening, but they may also need to be removed surgically, especially if they result in blockages or discomfort.
While these symptoms may very well be caused by other diseases, it is important to get them checked by a doctor, especially if you have any of the risk factors for mouth and throat cancer:
Risk factors are things that may increase your likelihood of getting cancer. They can be immutable like sex and age, but they can also be lifestyle-related. There are also hereditary factors, like genetic changes in your family that may make you more susceptible to certain types of cancer.
Men are more likely to have mouth and throat cancer than women. The characterization of this as an immutable factor is debated. However, many doctors believe that this is only so because men are more likely to engage in tobacco consumption. In Southeast Asia, betel nut consumption is a popular vice that is also associated with higher rates of mouth and throat cancer in men. Age is also a risk factor since these types of cancer are generally slow-growing, with 55 being the average age for mouth and throat cancer diagnosis. Mouth and throat cancer in younger people are often related to HPV infections.
People who have inherited mutations or syndromes may be more susceptible to mouth and throat cancer.
Fanconi anemia is a hereditary syndrome that often causes blood problems starting at a young age. This may lead to the development of leukemia, or mouth and throat cancer.
Dyskeratosis congenita is another inherited syndrome that can cause aplastic anemia, rashes, and abnormalities in the nails. This syndrome greatly increases the risk of developing head and neck cancers, and mouth and throat cancers at a young age.
Tobacco and alcohol use are the primary culprits seen to increase the risk of mouth and throat cancers. Smokers are 10 times more likely to develop mouth cancers than non-smokers. Consumption of oral tobacco products like snuff, dip, chew, or spit, is also linked with cancer in the gums and cheeks. Alcohol use, especially combined with smoking, is also linked to an increased risk of developing mouth and throat cancers.
Poor nutrition due to low consumption of fruits and vegetables is linked with an increased risk for mouth and throat cancer. Obesity is also shown to increase the risk of developing these cancers.
Blue-collar work with frequent sun exposure can lead to more UV radiation exposure in the lips. They have also been linked with increased rates of mouth cancer beginning in the lips.
Frequent unprotected sex, especially oral sex, can increase the risk of HPV infection, which in turn increases the risk of mouth and throat cancer. HPV-positive cancers, however, have a better prognosis because they respond better to radiation and chemotherapy treatment.
If you or a loved one have suffered from a misdiagnosis or delayed diagnosis for your mouth and throat cancer or from negligence during your treatment that caused you more harm, contact us at 833-PORTER9, or e-mail us at info@porterlawteam.com to discuss the details of our experience representing other clients and the results we were able to obtain in the past for clients who are suffering as you are. In many ways, our results speak for themselves, and we will stand ready to help you and your family in your time of greatest need.
