The information on this website is not intended for diagnosis or treatment. Please consult your physician for health concerns.

+90 850 321 50 00

Oral Cavity Cancer

Squamous cell carcinoma of the lips, tongue, floor of mouth, and oral mucosa.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Onkoloji department. Book Appointment →

What is Oral Cavity Cancer?

Oral cavity cancer encompasses malignancies of the lips, anterior two-thirds of the tongue, floor of mouth, buccal mucosa, hard palate, gingiva, and retromolar trigone. Over 90% are squamous cell carcinomas (OSCC). Worldwide incidence is rising, with high prevalence in South-Central Asia (paan, betel quid use) and parts of Europe.

Tobacco (smoked and smokeless) and alcohol are dominant risk factors with multiplicative interaction. Areca nut and betel quid chewing are major contributors in Asia. HPV-driven oral cavity cancers are far less common than HPV-driven oropharyngeal cancers but exist. Premalignant lesions include leukoplakia, erythroplakia, oral submucous fibrosis, and oral lichen planus.

Patients present with non-healing ulcers, mucosal masses, pain, dysphagia, otalgia, or neck nodes. Workup includes incisional biopsy, contrast CT or MRI of the head and neck, PET-CT for advanced disease, and dental evaluation. Treatment is surgical resection with appropriate neck dissection. Adjuvant radiotherapy or chemoradiation depends on margins, lymph nodes, perineural and lymphovascular invasion.

Symptoms

Non-healing oral ulcer beyond 3 weeks
Persistent mouth pain or burning
Lump on tongue, lip, gum, or cheek
White (leukoplakia) or red (erythroplakia) patches
Bleeding from oral lesion
Loose teeth without dental cause
Difficulty chewing, swallowing, or moving tongue
Numbness of tongue, lip, or chin
Voice changes
Otalgia (referred ear pain)
Painful jaw movement
Cervical lymphadenopathy
Halitosis (advanced lesions)
Weight loss
Trismus (advanced or pterygoid invasion)

Risk Factors

Tobacco smoking (cigarettes, pipes, cigars)
Smokeless tobacco (chewing, snuff)
Areca nut and betel quid
Heavy alcohol use
Combined tobacco and alcohol (synergistic)
HPV (small subset)
Oral submucous fibrosis
Leukoplakia, erythroplakia
Oral lichen planus
Poor oral hygiene
Chronic mucosal trauma (sharp tooth, poor dentures)
Immunosuppression
Plummer-Vinson syndrome
Fanconi anemia, dyskeratosis congenita
Sun exposure (lip cancer)
Male sex (2:1)
Age over 50

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Mouth sore not healing in 3 weeks
  • Persistent oral pain or burning
  • Lump or thickening in mouth
  • White or red mucosal patches
  • Loose teeth without obvious cause
  • Difficulty swallowing or moving tongue
  • Numbness of tongue, lip, or chin
  • Persistent cervical lymphadenopathy
  • Bleeding from mouth without trauma
  • Voice changes lasting weeks
  • Long-term tobacco user with new oral symptoms

Treatment Methods

01
Head and neck surgical oncology referral
02
Incisional or punch biopsy of suspicious lesions
03
Contrast-enhanced CT or MRI of head and neck
04
PET-CT for stage III-IV staging
05
Dental and nutritional evaluation pre-treatment
06
Multidisciplinary tumor board (surgery, RT, medical onco, speech, dental)
07
Wide local excision with adequate margins (1 cm clinical, 5 mm pathologic)
08
Selective or modified radical neck dissection based on T stage and depth of invasion
09
Sentinel node biopsy for cN0 with depth over 4 mm
10
Mandibulotomy or marginal/segmental mandibulectomy when bone involved
11
Free flap reconstruction (radial forearm, fibula osteocutaneous, ALT)
12
Adjuvant radiotherapy 60-66 Gy for high-risk pathology
13
Concurrent cisplatin chemoradiation for positive margins or extranodal extension
14
Cetuximab for cisplatin-ineligible patients
15
Pembrolizumab or nivolumab for recurrent or metastatic disease (PD-L1 testing)
16
Salvage surgery for recurrence
17
Speech and swallow rehabilitation
18
Tobacco and alcohol cessation programs
19
Dental rehabilitation post-radiation
20
Long-term surveillance: q3 months for 2 years, then biannual to year 5
21
Premalignant lesion management: leukoplakia excision, betel quid cessation
22
Routine oral cancer screening in high-risk groups

Which Department to Visit?

You can visit our Onkoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Onkoloji Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

Book AppointmentContact Us

Related Health Topics

Other articles from the same department you may want to explore.

Anaemia

Dahiliye (İç Hastalıkları)

Anaemia is a low haemoglobin level that reduces oxygen delivery, causing fatigue, pallor, and shortness of breath. It is not a disease itself but a sign of many underlying conditions. Most cases are correctable with appropriate diagnosis and treatment.

Iron Deficiency Anaemia

Dahiliye (İç Hastalıkları)

Iron deficiency anaemia develops when dietary intake, absorption, or losses create an iron shortfall, most often affecting women and children. Identifying the underlying cause is the core of management, alongside iron replacement.

Vitamin B12 Deficiency

Dahiliye (İç Hastalıkları)

Vitamin B12 deficiency can cause megaloblastic anaemia, neurological symptoms, and cognitive impairment. Early treatment with intramuscular or oral B12 largely prevents irreversible complications.

Hypertension (High Blood Pressure) Management

Dahiliye (İç Hastalıkları)

Hypertension is often called the silent killer because it progresses symptom-free for years and can damage the heart, brain, kidneys, and eyes. Regular monitoring, lifestyle change, and evidence-based drug therapy dramatically reduce cardiovascular risk.

Chronic Kidney Disease

Dahiliye (İç Hastalıkları)

Chronic kidney disease is one of the most common complications of chronic conditions such as diabetes and hypertension, and can be silent in its early stages.

Hepatitis B (HBV)

Dahiliye (İç Hastalıkları)

Hepatitis B is a DNA virus infection causing acute and chronic hepatitis with risk of cirrhosis and hepatocellular carcinoma; diagnosis integrates HBsAg, HBeAg, anti-HBc, and HBV DNA with management based on disease phase using nucleos(t)ide analogues (entecavir, tenofovir) and universal infant vaccination.

Hepatitis C (HCV)

Dahiliye (İç Hastalıkları)

Hepatitis C is an RNA virus causing chronic hepatitis that may progress to cirrhosis and hepatocellular carcinoma; modern direct-acting antiviral (DAA) pangenotypic regimens (sofosbuvir/velpatasvir, glecaprevir/pibrentasvir) achieve sustained virologic response over 95% in 8–12 weeks with universal adult screening and cure for nearly all patients.

Fatty Liver Disease

Dahiliye (İç Hastalıkları)

Non-alcoholic fatty liver disease (NAFLD) is closely related to obesity and metabolic syndrome and is largely reversible with early treatment.

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.