Buccal Mucosa Cancer (Inner Cheek Cancer)

What is buccal mucosa cancer?

Buccal mucosa cancer is a rare cancer that develops in the inner cheek in your mouth. It’s a type of head and neck cancer.

The buccal mucosa extends from the inside of your lips and cheeks to just behind your last teeth. It’s a soft, wet mucous membrane that’s made up of several layers of tissue. Its main function is to support your mouth when you’re eating and chewing. It also provides a barrier against infections and chemicals in your diet.

What are the types of buccal mucosa cancer?

Squamous cell carcinoma is the most common type. Squamous cells are thin, flat cells that make up the top layer of the buccal mucosa. Early buccal mucosa cancer that only involves this top layer is called carcinoma in situ. As the cancer progresses, it can become invasive, penetrating into deeper tissues and spreading to other parts of your body. This is called metastatic cancer.

Other types of buccal mucosa cancer are much less common and include:

• Lymphoma: Lymphoid cells are present in the lining of your mouth. Lymphoma occurs when these cells become cancerous.
• Mucosal melanoma: Similar to melanoma of your skin, cancer can occur in skin cells called melanocytes in the lining of your mouth.
• Verrucous carcinoma: This is a slow-growing and highly treatable form of cancer that can develop inside of your mouth.

How common is buccal mucosa cancer?

The American Cancer Society estimates there are about 15,000 new cases of cancers of the mouth each year. This includes buccal mucosa cancer, as well as other cancers of the teeth, gums and roof of the mouth.

The risk of oral cancer increases with age. It’s more common in people over 40.

What are the symptoms of buccal mucosa cancer?

Early signs of buccal mucosa cancer include symptoms in your mouth that last for two weeks or more. These can include:

• Painful sores or ulcers.
• Raised, white or red patches.
• Ongoing bleeding, especially after eating or brushing.

If the cancer grows larger or spreads to the surrounding tissues in your mouth or lymph nodes, you may notice:

• Bad breath.
• Difficulty opening your mouth.
• Loose teeth.
• Lump in your neck from a swollen lymph node.
• Numbness in your mouth.
• Swallowing difficulties.
• Swelling of your jaw that makes dentures fit poorly.

What causes buccal mucosa cancer?

Exposure to harmful substances causes this type of cancer. This can include:

• Tobacco, including cigarettes, cigars, pipes and smokeless tobacco.
• Heavy alcohol use.
• Betel nut, a fruit grown in Asia and Africa that contains a stimulant that people grind, wrap in a leaf and chew.

The human papilloma virus (HPV) may also cause buccal mucosa cancer. HPV is a sexually transmitted virus and some strains of it can cause cancers in the genital area and back of the throat. Its role in mouth cancers, including buccal mucosa, isn’t as clear.

Other factors that may increase your risk of buccal mucosa cancer are:

• Marijuana use.
• Poor oral hygiene.
• Unhealthy diet.

How is buccal mucosa cancer diagnosed?

Your dentist may be the first to notice changes in your buccal mucosa tissue during a routine checkup. If your dentist suspects cancer, they’ll refer you to a healthcare provider for further testing, including:

• Biopsy: This test involves the collection of a sample of tissue for laboratory analysis. If there’s a suspected tumor, your provider may perform the biopsy using a scalpel, punch tool, brush or fine needle.
• Imaging tests: Tests such as CT scans, MRIs and PET scans help your provider assess the tumor and determine if cancer has spread.

What are the grades and stages of buccal mucosa cancer?

The grade of a cancer tumor is based on the results of the biopsy. A biopsy assesses the shape and structure of the cells compared to surrounding normal, healthy cells:

• Well-differentiated cells look similar to normal tissue and are less likely to spread.
• Poorly differentiated cells look different from normal tissue and are at increased risk of spreading.

Grades of buccal mucosa cancer include:

• GX: Grade not evaluated.
• G1: Well-differentiated.
• G2: Moderately differentiated.
• G3 and G4: Poorly differentiated.

Cancer staging uses categories to help your healthcare provider understand how severe the cancer is and how to treat it. These categories include:

• Tumor size.
• Lymph node involvement.
• Metastases (cancer growths that have spread to other parts of the body).

Stages range from 1 to 4. A stage 1 tumor is small, with no lymph node involvement or metastases. Higher stages include different combinations of the categories listed above.

How is buccal mucosa cancer treated?

Your healthcare provider will develop a treatment plan based on your diagnosis and the cancer grade and stage.

Surgery is usually the primary treatment for this type of cancer. Your surgeon will remove as much of the tumor as possible. Surgeons use techniques that aim to minimize harm to surrounding tissues and protect the functioning of your mouth.

Your provider may recommend additional therapies after surgery to prevent the tumor from returning, including:

• Radiation therapy, uses beams of radiation energy to destroy cancer cells.
• Chemotherapy, involves a wide range of drugs to treat cancer.

How can I prevent buccal mucosa cancer?

You can prevent buccal mucosa cancer by avoiding heavy alcohol use, quitting smoking and discontinuing use of other tobacco products.

Routine dental visits can also help you detect any changes in the lining of your mouth early, when cancer is most treatable.

What is the prognosis for buccal mucosa cancer?

Early detection is essential for this type of cancer. The earlier you detect the cancer, the better your prognosis. But even with early detection, the prognosis for this condition isn’t good.

A study of 30 people with buccal mucosa cancer found 53% of them were alive five years after treatment. In about half of the people, the cancer returned. This is a small study and may not reflect your individual outlook.

When should I see my healthcare provider?

Talk to your dentist or healthcare provider if you notice any sores, raised patches or bleeding in your mouth that last longer than two weeks.

A note from Cleveland Clinic

Buccal mucosa cancer is a type of cancer that starts in your mouth and can be fatal. Tobacco and alcohol use are the main risk factors for this condition. If you use tobacco or alcohol, talk to your provider about how you can cut back or quit — they can suggest programs and tips for quitting. Early detection of this condition is critical. Visit your dentist regularly and let your dentist or provider know if you have symptoms that don’t go away within two weeks. If you do develop buccal mucosa cancer, your healthcare provider will recommend a treatment plan that will give you the best prognosis possible.