Oral cancer care
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Whether you or a loved one are worried about developing oral cancer, are going through treatment or are trying to stay well after treatment, we’re here for you every step of the way.
What is oral cancer?
Oral cancer refers to a group of cancers occurring anywhere in the oral region, including the mouth, tongue, gums or lips.
Oral cancers develop when normal, healthy cells in these regions begin to grow and function differently. These cancerous cells can begin to build up and form a mass called a tumor, which exists as a lump inside the body and can spread.
There are several types of oral cancers:
- Mouth– Mouth cancer typically develops after age 40, with men being at a higher risk. This type of cancer can develop anywhere within the lining of the mouth.
- Tongue– This form of cancer originates in the cells of the tongue.
- Gums– Commonly mistaken for gingivitis, gum cancer can begin in the upper or lower gums.
- Lips–Dentists are typically the first to notice signs of lip cancer during your routine dental cleaning. When detected early, lip cancer can be highly curable.
Symptoms of oral cancer
Because signs of oral cancers can be mistaken for other problems, such as a tooth infection or cold, they can sometimes be challenging to diagnose.
Oral cancer often appears as a growth or sore in the mouth that doesn’t go away. However, other symptoms may include:
- Ongoing mouth pain
- Lump or thickening in the cheek
- White or red patch on gums, tongue, tonsil or lining of the mouth
- Sore throat
- Feeling like something is “caught” in the throat
- Difficulty swallowing or chewing
- Difficulty moving tongue or jaw
- Numbness of the tongue or other area of the mouth
- Jaw swelling that makes your dentures hurt or fit improperly
- Loosening of teeth
- Pain in teeth or jaw
- Voice changes
- Lump in throat or neck
- Significant unintended weight loss
- Persistent bad breath (halitosis)
Having these symptoms does not mean you have oral cancer. However, it’s important to speak with your doctor to rule out any health issues.
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Oral cancer risk factors
Although oral cancers are less common, there are still risk factors. While some factors are out of your control, there are lifestyle choices that can increase your risk of developing oral cancer, including smoking, alcohol use and environmental factors.
Risk factors for oral cancer include:
- Tobacco use: 85% percent of head and neck cancers, including oral cancer, are linked to tobacco use. This includes smokeless tobacco, cigarettes and pipes. Tobacco use is the single largest risk factor for cancers of the head and neck.
- Alcohol use: Prolonged, heavy alcohol use greatly increases your risk of certain types of head and neck cancer, including oral cancer.
- Other risk factors: Other risk factors that can increase the risk of developing oral cancer include spending extended amounts of time in the sun, environmental exposure, human papilloma virus (HPV), age and gender.
How are oral cancers diagnosed?
Our team of cancer doctors are experienced in diagnosing and treating oral cancers at all stages, including advanced stages. Some of the diagnostic tests your doctor may perform to test for oral cancers include:
- Physical examination: If your doctor suspects you have oral cancer, he or she will perform a physical examination, feeling for lumps in the lips, gums, mouth and cheeks areas. To confirm an initial cancer diagnosis or to determine whether the cancer has spread, you may be asked to undergo further testing.
- Imaging tests: Imaging tests, such as MRIs, CT scans or PET scans, are used to produce detailed pictures of the inside of your head or neck. These methods of diagnostic testing can determine the size of tumors and whether they have grown, shrunk or spread.
- Biopsy: During a biopsy, your doctor will remove a small sample of tissue to detect whether it contains cancerous cells (also called malignant cells). The tissue will be removed using a thin needle or during a surgical procedure and will be further examined beneath a microscope.
- Blood tests: Your doctor may order blood work to look for certain indicators of oral cancer or monitor how your treatment is progressing.
- Endoscopy: This procedure will allow your doctor to examine the inside of your mouth area. During an endoscopy, your doctor will insert a small scope into your nose or mouth to examine the hard-to-see areas of your head and neck.
Treating oral cancer
At Geisinger, our highly trained oral cancer specialists include surgeons, medical oncologists, radiation oncologists, pathologists, radiologists, nurse navigators and support staff who come together to develop a personalized treatment plan around you.
Depending on the type, location and stage of your cancer, one or more of the following treatments may be recommended.
At Geisinger, our surgeons use the latest techniques to treat oral cancer, including minimally invasive surgery, to offer you the best outcomes and path for healing. Our surgeons are highly trained and board certified, which means they have passed an optional national exam to demonstrate their medical expertise. Many of our surgeons are also fellowship trained, holding additional training in specific types of cancer surgery.
Whether you are a good candidate for surgery will depend on the stage and location of your cancer, as well as your overall health. Several types of cancer removal surgery are available, including:
- Surgery to remove the tumor – Your surgeon may take out the tumor and a margin of healthy tissue that surrounds it to remove all the cancerous cells. Smaller cancers may be removed through minor surgery. Larger tumors may require more extensive procedures.
- Surgery to remove cancer that has spread to the neck – If cancer cells have spread to the lymph nodes in your neck, your surgeon may recommend a procedure to remove lymph nodes and related tissue in your neck, also known as a neck dissection.
Chemotherapy is a drug-based treatment designed to slow the growth of or shrink tumors located in the mouth region.
Chemotherapy drugs can be given through an IV or taken in pill form.
Chemotherapy may be given:
- Before your surgery, to attempt to reduce the size of the tumor
- After your surgery, to destroy any cancer that still remains and reduce the chances of the cancer coming back
- Along with radiation therapy, which is known as chemoradiation or chemoradiotherapy
Our team includes doctors called medical oncologists who specialize in chemotherapy. Our patients have access to clinical trials that include testing new chemotherapy drugs and combinations of medications that aren’t widely available.
Keeping you comfortable while you undergo your treatment is important to us. Our state-of-the-art clinics, many which have been recently renovated, offer heated seats and individual TVs to help you stay comfortable during treatment.
Radiation oncology uses radiation to control or destroy harmful cancer cells, with tools to treat each unique cancer.
Our board-certified cancer doctors and highly skilled clinical team deliver conventional radiotherapy treatments that include:
- External beam radiation, which uses special technology to send radiation to the tumor from outside the body
- Internal radiation (brachytherapy), which targets the tumor using safe levels of radiation inside the body through radioactive tubes or radioactive seeds
- Intensity-modulated radiation therapy (IMRT), which uses a 3D image of the tumor to deliver high-precision radiotherapy that fits its exact outline
- Image-guided radiation therapy (IGRT), which is used to localize the radiation beam daily and treat cancers in areas of the body that move during and between treatment. This includes Cone Beam CT scans to accurately view the tumor and target it during treatment.
- Stereotactic body radiation therapy (SBRT), which uses precise conformal beams of radiation to focus high doses of radiation to just the tumor, with very little damage to surrounding healthy tissues
Oral cancer care at Geisinger
Cancer is unique to each person, which is why Geisinger’s cancer care team gets to know you along your journey. While some of our cancer specialists are trained in treating specific cancers, our entire team works together to help you fight your cancer – every step of the way.
Our oral cancer specialists are dedicated to providing innovative treatments and personalized cancer care. We offer:
- Unmatched expertise – Our cancer team consists of surgeons, doctors and specialists, many of whom are fellowship trained. This team of highly trained specialists treats many patients with oral and other cancers each year, and is focused on delivering the most personalized, excellent care that is suited to each patient’s needs.
- World-class care, close to home – With locations throughout central, northeast and south-central Pennsylvania, our experienced cancer team provides consultations and comprehensive care. We offer leading-edge treatment options and tailored-to-you care backed by the expertise and innovation of a nationally recognized health system.
- Comprehensive specialty care – From chemotherapy, radiation and minimally invasive surgery options to national clinical trials and genetic testing, our oral cancer specialists are dedicated to offering innovative treatment options and personalized care in convenient locations, so you don’t have to travel far.
- Leading-edge clinical trials – Our extensive history with cancer research and clinical trials gives you access to new treatments before they become widely available. Participating in a trial may help you get better even if standard approaches haven’t worked. Find a clinical trial.
- Genetic testing and counseling programs – Our cancer genetics programs determine whether you face a higher than normal cancer risk. Special programs such as MyCode®, which are only available at Geisinger, detect the earliest signs of certain cancers so you can start treatment right away. Our care and guidance may even help you avoid a cancer diagnosis. Learn more or sign up for MyCode
- Cancer survivorship program – Just because your treatment is complete doesn’t mean your journey has ended. We offer a variety of support resources focused on helping you live your healthiest life. Learn about patient resources.