Oral cancer - diagnosis and treatment (2023)


Frequently asked questions about oral cancer

Oncologist Katharine Price, MD, answers common questions about oral cancer, also called oral cancer.

Hello. I'm Katharine Price, MD, from the Mayo Clinic, and I'm here to answer some of the important questions you may have about oral cancer.

There are several things you can do to prevent oral cancer. The most important thing is not to use tobacco. It is also important not to drink too much alcohol or abstain from alcohol altogether. One very simple thing that everyone can do to lower their risk of oral cancer is to increase their fruit and vegetable intake. It is very important to try to reduce stress and exercise regularly.

So, as a medical oncologist, I am often asked what my chance of being cured is. And that's a very difficult question because there's no absolute point in time when we can say he's cured of his cancer. But for oral cancer, most cancers will come back within the first two years of treatment. And if someone comes in five years after treatment with no signs of cancer, the chance of it coming back is very, very low. So we generally think of a five-year mark after cancer treatment as cured. But again, it's not an absolute limit, and sometimes we'll see recursions beyond that point. But it's highly unlikely.

It is very important that all patients know that mental illness after or during the diagnosis of oral cancer is very common. The most common things we will see are depression and anxiety. Depression is very common, especially when patients are undergoing treatment or immediately after, when they still have many symptoms from which they are trying to recover. Anxiety would be the most common thing we see. Because a cancer diagnosis highlights the uncertainty of the future. None of us know what the future holds. None of us know if we're going to survive tomorrow or a year from now or 10 years from now. But having a cancer diagnosis really brings it out. What is really important for patients to know is that help is available. This help can take many different forms, from medication to alternative therapies and treatments.

If you are caring for someone who has oral cancer and is undergoing treatment for oral cancer, the most important thing you can do is show up and be there for them in a general sense. There are many things that are affected when someone undergoes treatment for oral cancer. Some of the things we do every day are difficult: eating, sleeping, talking. They might be in pain. They can have side effects from the treatment. And unfortunately, as a caregiver, you can't take any of those things away from them, but you can support them in a general sense and just be there for them. Know that you can't fix it, but you can walk that path with them so they're not alone.

When someone is undergoing cancer treatment, their medical team does not expect them to pretend everything is fine or to put on a happy face. We know that you are going through difficult issues and we know that the treatment we are giving you can be very difficult and cause many symptoms. So the most important thing is to communicate with your team, let them know how you are doing. Never hesitate to ask your medical team about any questions or concerns you have. Being informed makes all the difference. Thank you for your time and we wish you the best.

Tests and procedures used to diagnose oral cancer include:

  • Physical exam.Your doctor or dentist will examine your lips and mouth for abnormalities: areas of irritation such as sores and white patches (leukoplakia).
  • Removal of tissue for analysis (biopsy).If a suspicious area is found, your doctor or dentist may remove a sample of cells for lab testing in a procedure called a biopsy. The doctor may use a cutting tool to cut a tissue sample or use a needle to remove a sample. In the lab, the cells are analyzed for cancer or precancerous changes that indicate a future cancer risk.

Determining the extent of cancer


Oral cancer - diagnosis and treatment (1)


Leukoplakia appears as thick, white patches on the inner surfaces of the mouth. It has several possible causes, including repeated injury or irritation. It could also be a sign of precancerous changes in the mouth or mouth cancer.

Once oral cancer is diagnosed, your doctor works to determine the extent (stage) of your cancer. Oral cancer staging tests may include:

  • Using a small camera to inspect your throat.During a procedure called an endoscopy, your doctor may pass a small, flexible camera equipped with a light down your throat to look for signs that the cancer has spread beyond your mouth.
  • Imaging exams.A variety of imaging tests can help determine whether the cancer has spread beyond the mouth. Imaging tests may include X-rays, CT scans, MRIs, and PET scans, among others. Not everyone needs every test. Your doctor will determine which tests are appropriate based on your condition.

The stages of oral cancer are indicated by Roman numerals I through IV. A lower stage, such as stage I, indicates a smaller cancer confined to one area. A higher stage, such as stage IV, indicates a larger cancer or that the cancer has spread to other areas of the head or neck or to other areas of the body. The stage of your cancer helps your doctor determine your treatment options.

Attendance at the Mayo Clinic

Our caring team of experts at the Mayo Clinic can help you with your oral cancer-related health concerns.

More information

  • Oral Cancer Care at the Mayo Clinic
  • computed tomography
  • MRI
  • Positron Emission Tomography
  • bone scan


Treatment for oral cancer depends on the location and stage of the cancer, as well as your general health and personal preferences. You may have just one type of treatment, or you may have a combination of cancer treatments. Treatment options include surgery, radiation therapy and chemotherapy. Discuss your options with your doctor.


Surgery for oral cancer may include:

  • Surgery to remove the tumor.Your surgeon may remove the tumor and a margin of healthy tissue around it to ensure that all cancerous cells have been removed. Smaller cancers can be removed by minor surgery. Larger tumors may require more extensive procedures. For example, removing a larger tumor may involve removing a section of the jaw or tongue.
  • Surgery to remove cancer that has spread to the neck.If the cancer cells have spread to the lymph nodes in the neck, or if there is a high risk of this happening based on the size or depth of the cancer, your surgeon may recommend a procedure to remove the lymph nodes and related tissues in the neck (neck dissection). ). The neck dissection removes any cancer cells that may have spread to the lymph nodes. It's also helpful in determining whether you'll need additional treatment after surgery.
  • Surgery to reconstruct the mouth.After an operation to remove the cancer, your surgeon may recommend reconstructive surgery to reconstruct your mouth and help you regain the ability to speak and eat. Your surgeon may transplant skin, muscle, or bone grafts from other parts of your body to reconstruct your mouth. Dental implants can also be used to replace natural teeth.

Surgery carries a risk of bleeding and infection. Surgery for mouth cancer often affects your appearance, as well as your ability to speak, eat, and swallow.

You may need a tube to help you eat, drink, and take medicine. For short-term use, the tube can be inserted through the nose into the stomach. Longer term, a tube may be inserted through the skin into the stomach.

Your doctor can refer you to specialists who can help you deal with these changes.


Radiation therapy uses high-energy beams, such as x-rays and protons, to kill cancer cells. Radiation therapy is usually delivered by a machine outside the body (external radiation), but it can also come from radioactive seeds and wires placed near the cancer (brachytherapy).

Radiation therapy is often used after surgery. But it can sometimes be used alone if you have early-stage mouth cancer. In other situations, radiotherapy may be combined with chemotherapy. This combination increases the effectiveness of radiation therapy, but it also increases the side effects you may experience. In cases of advanced mouth cancer, radiation therapy can help relieve signs and symptoms caused by the cancer, such as pain.

Side effects of radiotherapy to the mouth can include dry mouth, cavities and jaw damage.

Your doctor will recommend that you see a dentist before starting radiation therapy to ensure your teeth are as healthy as possible. Any diseased tooth may need treatment or extraction. A dentist can also help you understand the best way to care for your teeth during and after radiation therapy to reduce your risk of complications.


Chemotherapy is a treatment that uses chemicals to kill cancer cells. Chemotherapy drugs may be given alone, in combination with other chemotherapy drugs, or in combination with other cancer treatments. Chemotherapy can increase the effectiveness of radiation therapy, so the two are often combined.

Chemotherapy side effects depend on the drugs you receive. Common side effects include nausea, vomiting and hair loss. Ask your doctor what are the likely side effects of the chemotherapy drugs you will be given.

targeted drug therapy

Targeted drugs treat oral cancer by changing specific aspects of the cancer cells that fuel their growth. Targeted drugs can be used alone or in combination with chemotherapy or radiation therapy.

Cetuximab (Erbitux) is a targeted therapy used to treat oral cancer in certain situations. Cetuximab stops the action of a protein found in many types of healthy cells, but is more common in certain types of cancer cells. Side effects include rash, itching, headache, diarrhea and infections.

Other targeted medications may be an option if standard treatments don't work.


Immunotherapy uses your immune system to fight cancer. Your body's disease-fighting immune system may not attack the cancer because cancer cells produce proteins that blind immune cells. Immunotherapy works by interfering with this process.

Immunotherapy treatments are generally reserved for people with advanced mouth cancer that doesn't respond to standard treatments.

More information

  • Oral Cancer Care at the Mayo Clinic
  • brachytherapy
  • Chemotherapy
  • home enteral nutrition
  • integrative medicine
  • massage therapy
  • Radiotherapy
  • tracheotomy
  • Transoral robotic surgery
  • Frequently asked questions about oral cancer

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Lifestyle and home remedies.

stop smoking

Mouth cancers are closely associated with tobacco use, including cigarettes, cigars, pipes, chewing tobacco and snuff, among others. Not everyone diagnosed with mouth cancer uses tobacco. But if it does, now is the time to stop because:

  • Tobacco use makes treatment less effective.
  • Tobacco use makes it difficult for the body to recover after surgery.
  • Tobacco use increases the risk of cancer recurrence and of getting another cancer in the future.

Quitting smoking or chewing can be very difficult. And it's a lot harder when you're trying to deal with a stressful situation, like a cancer diagnosis and treatment. Your doctor can discuss all of your options, including medications, nicotine replacement products, and counseling.

stop drinking alcohol

Alcohol, especially when combined with tobacco use, greatly increases the risk of oral cancer. If you drink alcohol, stop drinking all types of alcohol. This can help reduce the risk of a second cancer.

alternative medicine

No complementary or alternative medicine treatment can cure mouth cancer. But complementary and alternative medicine treatments can help you deal with mouth cancer and cancer treatment side effects like fatigue.

Many people undergoing cancer treatment experience fatigue. Your doctor can treat the underlying causes of fatigue, but feelings of complete exhaustion may persist despite treatments. Complementary therapies can help you deal with fatigue.

Ask your doctor about trying:

  • Exercise.Try to do 30 minutes of light exercise most days of the week. Moderate exercise, such as brisk walking, during and after cancer treatment reduces fatigue. Talk to your doctor before you start exercising to make sure it's safe for you.
  • Massage therapy.During a massage, a massage therapist uses their hands to apply pressure to the skin and muscles. Some massage therapists are specially trained to work with people with cancer. Ask your doctor for the names of massage therapists in your community.
  • Relaxation.Activities that help you feel relaxed can help you cope. Try listening to music or writing in a journal.
  • Acupuncture.During an acupuncture session, a trained practitioner inserts fine needles into precise points on your body. Some acupuncturists are specially trained to work with people with cancer. Ask your doctor to recommend someone in your community.

handle and support

When discussing oral cancer treatment options with your doctor, you may feel overwhelmed. It can be a confusing time as you are trying to come to terms with your new diagnosis and are also under pressure to make treatment decisions. Face that uncertainty by taking control of what you can. For example, try:

  • Learn enough about oral cancer to make treatment decisions.Make a list of questions to ask at your next appointment. Bring a tape recorder or a friend to help you take notes. Ask your doctor about reliable books or websites you can turn to for accurate information. The more you know about your cancer and your treatment options, the more confident you will feel when making treatment decisions.
  • Talk to other oral cancer survivors.Connect with people who understand what you're going through. Ask your doctor about cancer support groups in your community. Or contact your local chapter of the American Cancer Society. Another option is online message boards, such as those run by the Oral Cancer Foundation.
  • Take time for yourself.Make time for yourself every day. Use this time to forget about cancer and do what makes you happy. Even a short break to relax in the middle of a day full of tests and explorations can help you cope.
  • Keep family and friends close.Friends and family can provide emotional and practical support during treatment. Your friends and family are likely to ask what they can do to help. Accept them in your offers. Think ahead about how you'd like help, whether it's asking a friend to cook you a meal or asking a family member to be there when you need to talk to someone.

Preparing for your date

Make an appointment with your doctor or dentist if you have any signs or symptoms that worry you.

If your doctor or dentist thinks you may have mouth cancer, they may refer you to a dentist who specializes in diseases of the gums and related tissues in the mouth (periodontist) or to a doctor who specializes in diseases that affect the gums. nose and mouth. throat (otolaryngologist).

Since engagements can be short and there is often a long way to go, it's a good idea to be well prepared. Here's information to help you prepare and what to expect from your doctor.

What can you do

  • Please be aware of pre-booking restrictions.When making the appointment, be sure to ask ahead of time if there is anything you need to do, such as restricting your eating.
  • Write down all the symptoms you are experiencing,including anyone that seems unrelated to the reason you booked the appointment.
  • Write down important personal information,including any major stresses or recent life changes.
  • Make a list of all medications,vitamins or supplements you are taking.
  • Consider bringing a family member or friend.It can sometimes be difficult to remember all the information provided during an appointment. Someone accompanying you might remember something you missed or forgot.
  • Write the questions to askyour doctor

Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. Please number your questions from most important to least important in case you run out of time. For oral cancer, some basic questions to ask include:

  • What is likely causing my symptoms or condition?
  • What are other possible causes of my symptoms or condition?
  • What kind of tests do I need?
  • Is my condition likely to be temporary or chronic?
  • What is the best course of action?
  • What are alternatives to the main approach you are suggesting?
  • I have these other health conditions. How can I best manage them together?
  • Are there any restrictions I must follow?
  • Should I consult a specialist? How much will this cost and will my insurance cover it?
  • Are there brochures or other printed materials that I can take with me? What sites do you recommend?
  • What will determine whether I should schedule a follow-up visit?

In addition to the questions you've prepared to ask your doctor, don't hesitate to ask any other questions that come to mind.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them can allow more time to address the points you want to address. Your doctor may ask:

  • When did you start experiencing symptoms?
  • Are your symptoms continuous or occasional?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What seems to make your symptoms worse?
  • Do you use or have you ever used tobacco?
  • You drink alcohol?
  • Have you ever had radiation therapy to the head or neck region?

What can you do in the meantime

Avoid doing things that make your signs and symptoms worse. If you have a sore mouth, avoid spicy, hard, or acidic foods that can cause further irritation. If you have trouble eating due to pain, consider drinking nutritional supplements. These can provide you with the nutrition you need until you can meet with your doctor or dentist.

By the staff at the Mayo Clinic

October 26, 2022


How is oral cancer diagnosed? ›

To determine if you have oral cancer, your doctor or dentist will usually perform a physical exam to inspect any areas of irritation such as sores or white patches. If they suspect something is abnormal, they may conduct a biopsy where they take a small sample of the area for testing.

What happens when you are diagnosed with oral cancer? ›

Oral cancer is treated the same way many other cancers are treated -- with surgery to remove the cancerous growth, followed by radiation therapy and/or chemotherapy (drug treatments) to destroy any remaining cancer cells.

What is the most common treatment for oral cancer? ›

In general, surgery is the first treatment for cancers of the oral cavity and may be followed by radiation or combined chemotherapy and radiation. Oropharyngeal cancers are usually treated with a combination of chemotherapy and radiation.

What are the treatment options for oral cancer? ›

There are 3 main treatment options for oral and oropharyngeal cancer: surgery, radiation therapy, and therapies using medication. These types of treatment are described below. Your care plan may also include treatment for symptoms and side effects, an important part of cancer care.

What does Stage 1 mouth cancer look like? ›

Early signs of mouth cancer one should look out for include: Mouth sores that easily bleed and do not heal. Loose teeth. Red or white patches on the tonsils, gums, tongue, or the mouth lining.

How is first stage of mouth cancer diagnosed? ›

Symptoms of mouth cancer

unexplained loose teeth or sockets that do not heal after extractions. unexplained, persistent numbness or an odd feeling on the lip or tongue. sometimes, white or red patches on the lining of the mouth or tongue These can be early signs of cancer, so they should also be checked.

How quickly does oral cancer spread? ›

There aren't any hard and fast timelines for whether or when oral cancer will spread. Size is more a determinant. For a moderate-sized oral cancer, there is roughly a 20 to 30 percent chance that it has already spread to the lymph nodes at the time of diagnosis.

What is the life expectancy after mouth cancer? ›

For all mouth (oral cavity) cancers:

more than 75 out of 100 people (more than 75%) survive their cancer for 1 year or more after they are diagnosed. around 55 out of 100 people (around 55%) survive their cancer for 5 years or more after diagnosis.

Can you live a long life with oral cancer? ›

Overall, 60% of people with oral cancer survive for 5 years. Oral cancer survival rates are significantly lower for Black men and women. Diagnosing oral cancer at an early stage significantly increases 5-year survival rates.

Which stage of mouth cancer is curable? ›

Stages I and II oral cavity cancer

Most patients with stage I or II oral cavity cancers do well when treated with surgery and/or radiation therapy. Chemotherapy (chemo) given along with radiation (called chemoradiation) is another option. Both surgery and radiation work equally well in treating these cancers.

Does oral cancer progress quickly? ›

Most oral cancers are a type called squamous cell carcinoma. These cancers tend to spread quickly.

Can you fully recover from oral cancer? ›

If the cancer has not spread beyond the mouth or the part of your throat at the back of your mouth (oropharynx) a complete cure may be possible using surgery alone. If the cancer is large or has spread to your neck, a combination of surgery, radiotherapy and chemotherapy may be needed.

Where does mouth cancer usually start? ›

Mouth cancer, also known as oral cancer or cancer of the oral cavity, is often used to describe a number of cancers that start in the region of the mouth. These most commonly occur on the lips, tongue and floor of the mouth but can also start in the cheeks, gums, roof of the mouth, tonsils and salivary glands.

Can a dentist tell if you have oral cancer? ›

Mouth cancer is often be spotted in its early stages by your dentist during a thorough mouth examination. This happens during your routine dental check-up.

Can a dentist detect oral cancer on xray? ›

Dental X-rays may not reveal all instances of mouth cancer, but they can be helpful during an oral cancer screening. Specifically, dental X-rays can show if there is any cancer in the jaw that has spread from another area of the mouth or originated in the jaw.

Can your doctor diagnose oral cancer? ›

Tests and procedures used to diagnose mouth cancer include: Physical exam. Your doctor or dentist will examine your lips and mouth to look for abnormalities — areas of irritation, such as sores and white patches (leukoplakia). Removal of tissue for testing (biopsy).


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