Mouth cancer
    Symptoms and causes

    Overview

    Mouth cancer is a growth of cells that starts in the mouth. Mouth cancer can happen in any of the parts that make up the mouth. Mouth cancer can occur on the:

    • Lips.
    • Gums.
    • Tongue.
    • Inner lining of the cheeks.
    • Roof of the mouth.
    • Floor of the mouth.

    The mouth also is called the oral cavity. Cancer that happens in the mouth is sometimes called oral cancer or oral cavity cancer.

    Mouth cancer is one of several cancers that are considered to be types of head and neck cancer. Mouth cancer and other head and neck cancers often have similar treatments.

    Mouth cancer

    Mouth cancer — white patches

    White patches in the mouth are one symptom of mouth cancer.

    Symptoms

    Signs and symptoms of mouth cancer may include:

    • A lip or mouth sore that won't heal.
    • A white or reddish patch on the inside of the mouth.
    • Loose teeth.
    • A growth or lump inside the mouth.
    • Mouth pain.
    • Ear pain.
    • Difficult or painful swallowing.
    Lip cancer

    Lip cancer

    Lip cancer may appear as a sore on the lip that doesn't heal.

    Mouth cancer

    Mouth cancer — red sore

    Mouth cancer signs may include red sores that don't heal.

    When to see a doctor

    Make an appointment with a doctor, dentist or other healthcare professional if you have any symptoms that worry you.

    Causes

    It's not always clear what causes mouth cancer. This cancer starts as a growth of cells in the mouth. It most often starts in cells called squamous cells. These are flat, thin cells that line the lips and the inside of the mouth. Most oral cancers are squamous cell carcinomas.

    Mouth cancer happens when cells on the lips or in the mouth develop changes in their DNA. A cell's DNA holds the instructions that tell the cell what to do. In healthy cells, the DNA tells the cells to grow and multiply at a set rate. The DNA also tells the cells to die at a set time.

    In cancer cells, the DNA changes give different instructions. The changes tell the cancer cells to grow and multiply quickly. Cancer cells can keep living when healthy cells would die. This causes too many cells.

    The cancer cells might form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. In time, the cancer cells can break away and spread to other parts of the body. When cancer spreads, it's called metastatic cancer.

    Risk factors

    Factors that can increase the risk of mouth cancer include:

    Using tobacco

    All forms of tobacco increase the risk of mouth cancer. This includes cigarettes, cigars, pipes, chewing tobacco and snuff.

    Drinking alcohol

    Frequent and heavy drinking increases the risk of mouth cancer. Using alcohol and tobacco together increases the risk even more.

    Excessive sun exposure to the lips

    Ultraviolet light from the sun and tanning lamps increases the risk of lip cancer.

    Being exposed to human papillomavirus

    Human papillomavirus, also called HPV, is a common virus that's passed through sexual contact. For most people, it causes no problems and goes away on its own. For others, it causes changes in the cells that can lead to many types of cancer, including mouth cancer.

    A weakened immune system

    If the body's germ-fighting immune system is weakened by medicines or illness, there might be a higher risk of mouth cancer. People with a weakened immune system include those taking medicines to control the immune system, such as after an organ transplant. Certain medical conditions, such as infection with HIV, also can weaken the immune system.

    Prevention

    There's no proven way to prevent mouth cancer. However, you may reduce your risk of mouth cancer if you:

    Don't use tobacco

    If you don't use tobacco, don't start. If you currently use tobacco of any kind, talk with your healthcare team about strategies to help you quit.

    Limit alcohol intake

    If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men.

    Avoid excessive sun exposure to your lips

    Protect the skin on your lips from the sun by staying in the shade when possible. Wear a broad-brimmed hat that shades your entire face, including your mouth. Apply a sunscreen lip product for sun protection.

    Consider the HPV vaccine

    Receiving a vaccination to prevent HPV infection may reduce your risk of HPV-related cancers, such as mouth cancer. Ask your healthcare team whether the HPV vaccine is appropriate for you.

    Have regular health and dental exams

    During your appointments, your dentist, doctor or other member of your healthcare team can check your mouth for signs of cancer.

    1. Flint PW, et al., eds. Malignant neoplasms of the oral cavity. In: Cummings Otolaryngology: Head & Neck Surgery. 7th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed Sept. 15, 2024.
    2. Head and neck cancers. National Comprehensive Cancer Network. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1437. Accessed June 14, 2024.
    3. DeVita VT Jr, et al., eds. Oral cavity cancer. In: DeVita, Hellman, and Rosenberg's Cancer: Principles and Practice of Oncology. 12th ed. ProQuest Ebook Central. Wolters Kluwer; 2023. Accessed June 14, 2024.
    4. Lip and oral cavity cancer treatment (PDQ) – Patient version. National Cancer Institute. https://www.cancer.gov/types/head-and-neck/patient/adult/lip-mouth-treatment-pdq. Accessed Sept. 15, 2024.
    5. The oral cancer exam. National Institute of Dental and Craniofacial Research. https://catalog.nidcr.nih.gov/catalog/oral-cancer-exam. Accessed Sept. 15, 2024.
    6. Cancer-related fatigue. National Comprehensive Cancer Network. https://www.nccn.org/guidelines/guidelines-detail?category=3&id=1424. Accessed June 14, 2024.
    7. Smoking cessation. National Comprehensive Cancer Network. https://www.nccn.org/guidelines/guidelines-detail?category=3&id=1463. Accessed Nov. 25, 2024.

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