Oral Cancer

Oral cancer is the most common type of head and neck cancer. It starts in squamous cells that start growing and multiplying too quickly. It can affect your:

• Lips.
• Gums.
• Lining inside your cheeks.
• First two-thirds of your tongue.
• Floor of your mouth under your tongue.
• First part of the roof of your mouth.
• Area behind your wisdom teeth.

This cancer often shows up as white patches or sores that bleed. And left untreated, it can spread from your mouth to other parts of your head and neck — or even other parts of your body (metastasis).

Your dentist typically looks for signs of oral cancer during a regular dental checkup. If they spot something unusual, they may do some initial testing and refer you to specialists who can confirm a diagnosis and build a treatment plan. That’s where our head and neck cancer providers can help.

What to expect at your first visit

Learning you have cancer can be a real shock. And coming to your first appointment might feel a little more than stressful. Your provider understands this and will help you ease into the appointment by taking time to get to know you.

One of the best ways to do this is by hearing your story. So, they’ll ask you to share it. They’ll want to know:

• How did you discover you may have oral cancer?
• What kind of symptoms are you having?
• How long have you had these symptoms?
• Do you use tobacco or alcohol?
• Has anyone in your family had oral cancer?

Your provider will do a physical exam and an oral cancer screening. They’ll look inside and feel around your mouth, focusing on any patches and sores. They may also look at your face, head and neck for signs of cancer.

Testing for oral cancer

You’ll likely have one or more tests to help us learn if you have oral cancer or rule out other causes for mouth sores, like lichen planus and injuries from dental issues. Tests may include:

• Cytology.
• Biopsy.
• Laryngoscopy.

You may also have imaging tests like a CT scan or PET scan so we can see if cancer has spread to other parts of your body.

Second opinions for oral cancer

Learning you may have oral cancer can make you feel all kinds of things. Fear. Worry. Stress. But one thing is likely clear — you want a team of healthcare providers you trust to give you the best possible care. That’s why we encourage second opinions.

Our expert oral cancer specialists are here to help you better understand your diagnosis and your best treatment options. We also know that cancer doesn’t wait, so we always try to get an appointment for you as quickly as possible. Getting a second opinion can help you feel more in control of your care. And give you peace of mind, knowing you’re in the most capable hands.

Meet Our Oral Cancer Team

When you come to Cleveland Clinic, you’ll have a care team of different providers from different specialties. We choose them based on your diagnosis, needs and goals. This team could include:

• Otolaryngologists.
• Medical and radiation oncologists.
• Plastic surgeons.
• Maxillofacial surgeons.
• Oral surgeons.
• Dentists.
• Radiologists.
• Pathologists.
• Anesthesiologists.
• Physician assistants.
• Nurse practitioners.
• Speech-language pathologists (SLPs).

Your care team works together to create a personalized treatment plan that focuses on you. They’ll consider where the cancer is, if it’s spread, your general health, your age and your recovery goals.

The three main treatments for oral cancer are surgery, radiation therapy and systemic therapy.

Oral cancer surgery

Treatment often involves surgery to remove the cancer. Oral cancer surgeries include:

• Primary tumor surgery: Removes only the tumor.
• Glossectomy: Removes part or all of the tongue.
• Mandibulectomy: Treats oral cancer in the jawbone.
• Maxillectomy: Removes all or part of the bony roof of the mouth (hard palate).
• Sentinel node biopsy: Checks to see if cancer has spread.
• Neck dissection: Removes lymph nodes from the neck.

Depending on the tumor’s size and where it is, you may also need reconstructive surgery. This surgery fills in gaps left by the tumor. Or it may replace part of your lips, tongue, jaw or palate. We may be able to do this by grafting healthy bone or tissue from other areas of your body. Reconstructive surgery can help you look and feel more like yourself again.

Radiation therapy for oral cancer

After surgery, you may benefit from radiation therapy, which eliminates trace levels of cancer around the area where the tumor was. We may combine radiation therapy with other treatments.

Systemic therapy for oral cancer

Systemic treatments use medications to destroy cancer cells throughout your body. This can lower the chance of cancer coming back (recurrence). Treatments include:

• Chemotherapy.
• Immunotherapy.
• Targeted therapy.

Follow-Up Care for Oral Cancer

Once you’ve been treated for oral cancer, you’ll have regular follow-up appointments with your care team providers, including your dentist. We keep an eye on your ongoing health and do testing to make sure cancer doesn’t recur. If it does, we’ll be able to start treatment right away.

Taking the Next Step

An oral cancer diagnosis can leave you bracing for the worst. But when you catch it early, it can be treated successfully. Our trusted experts are here to help calm your fears and offer highly individualized treatments to remove the tumor and destroy the remaining cancer cells. Your quality of life is important, so we make sure this plan not only treats your cancer but also helps you feel better and move forward with your life.