by Justin Lee

Created on: February 22, 2009

Oral Cancer Detection

Oral cancers are cancers of the oral cavity or of the oropharynx (area just behind the oral cavity). Almost all oral cancers begin in squamous (flat) cells that cover the surfaces of the mouth, tongue, and lips, and they are thus considered "squamous cell carcinomas." Oral cancers usually start as tumors in the tongue or the floor of the mouth, and if left undetected for long enough, they will metastasize through the lymphatic system to invade lymph nodes in the neck or more distant lymph nodes and organs.

Oral cancer that has spread to other parts of the body is still considered "oral cancer." For instance, if a patient's oral cancer has metastasized to his lungs, then his disease would be termed "metastatic oral cancer," not lung cancer. This is because the tumor cells in the lungs are actually oral cancer cells; they have similar characteristics to the primary oral cavity tumor, and they should not be treated the same way as cancer cells that originate in the lung.

Diagnosis of oral cancer

To check for oral cancer, doctors and dentists examine patients' mouths and throats for red or white patches, lumps, or swelling. Dentists will feel for any lumps or irregular tissue changes (e.g., sores or discolored tissue) in the neck, head, face, and oral cavity. They look carefully at the roof of the mouth, back of the throat, and insides of the cheeks and lips. The doctor or dentist also gently pulls out the tongue to check its sides and underside. The floor of the mouth is inspected, and the lymph nodes in the neck are palpated. This oral cancer screening exam usually occurs as a part of routine dental examinations, so it is important to visit the dentist on a regular basis.

If an exam reveals an abnormality, then the dentist/physician may order an oral brush biopsy. This test is painless and involves swabbing a small sample of the tissue and analyzing it for abnormal cells. Alternatively, if the tissue looks more suspicious, a dentist/physician may perform a scalpel biopsy. This biopsy is usually done with local anesthesia, but sometimes general (whole-body) anesthesia is used. After a tissue sample is obtained, pathologists look at the cells under a microscope to check for the presence or absence of cancer (or pre-cancer).

A biopsy is the only definitive way to determine whether an abnormal area of the oral cavity is cancerous or not. Early detection and confirmation of cancer is necessary so that oral cancers can be treated before they get a chance to progress and spread.

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