Every puff of smoke fills a smoker’s mouth before being inhaled by the lungs. The highest concentration of toxic substances is therefore found in the mouth, where the mucous membranes come under attack. Most oral cancers begin in the cells that line the inside of the mouth.
In France, 20 000 people are affected by oral cancer every year. 95% of cases are contracted by males and the average age at the onset of the illness is 55. Oral cancer accounts for 2.5% of all cancers contracted in France, but in some countries, such as India, this percentage is much higher because many men chew tobacco instead of smoking it. 95% of oral cancers are effectively caused by excessive smoking and alcohol consumption combined. This double intoxication is also heightened by deficient dental hygiene or certain eating habits, such as chewing coca leaves in South America.
Most oral cancers have their origins in the cells that line the inside of the mouth. Repeated abrasions by chemical products (cigarettes) or rubbing (from pipes, or chewing tobacco) can cause ulcers or painful wounds (precancerous lesions) which can develop into full-blown cancer. Oral cancer can appear on the lips, the inside of the lips and the cheeks (oral mucosa), the gums, the tongue, the tissues under the tongue (floor of the mouth), the tissues behind the wisdom teeth, and the bone part of the mouth (hard palate or roof of the mouth). The risk is higher for pipe and cigar smokers than for cigarette smokers.
- White or red patches on the roof of the mouth
- Ulcers or wounds inside the mouth that do not heal
- Wounds or spots similar to warts on the lips
- Persistant sore throat
- A lump on the lips, tongue or inside the neck
- Difficulty chewing, swallowing or speaking
- Painless outgrowth on the lip, forming a dry scab that bleeds when it is removed
- Pain in the ear or cheek
Any wound, irritation or swelling in the mouth or lump in the neck which lasts for more than two weeks should be examined by a doctor or dentist without delay.
Causes of cancer
- Smoking, especially when accompanied by alcohol abuse, and chewing tobacco (80 to 90% of oral cancers are linked to tobacco usage)
- Excessive exposure of the lips to sunlight
- Some medical problems which affect oral tissues
- Chewing betel (a mixture of pepper plant leaves, calcium hydroxide and areca nuts)
The prognosis for oral cancer depends on the area affected (the base of the tongue is more serious), but also on the speed of diagnosis and whether or not cervical nodes are present. Five years after the discovery of oral cancer, two thirds of patients are still alive. It is sometimes during a visit to the dentist that the cancer is discovered in its early stages – another good reason to see your dentist regularly!
Method of diagnosis
Tests carried out by x-rays, ultrasound, MRI or bone scans allow the tissues, organs and bones to be examined in depth. Biopsy (analysis of a sample of the wound) may enable a definitive diagnosis.
Every case is unique. The doctor’s decision depends on the following points: the type of cancer diagnosed, its degree of malignancy, its stage of extension, the patient’s general health and the scientific evidence available with regard to the effectiveness of this treatment for this type of cancer. Surgery (the removal of all or part of a tumor and some surrounding tissue) – Radiotherapy (destruction of cancerous cells by high energy x-rays) – Chemotherapy (drugs which prevent the development and spread of cancerous cells).
Oral, throat and laryngeal cancers represent 5.5% of all cancers contracted by adults (8.1% for men and 2.8% for women). Their rate of occurrence is 33 in 100 000 in Switzerland, which is the equivalent of 1452 new cases per year.
Oral, throat and laryngeal cancers represent 17% of the total deaths caused by cancer (6% for men and 1.9% for women). In Geneva, Switzerland, they are the 14th biggest cause of death from cancer in women and the 4th biggest cause for men.
Find out more
- Ligue suisse contre le cancer
- Ligue nationale contre le cancer (France)
- Belgian federation against cancer: http://www.cancer.be/
- Eat healthily to reduce your risk of cancer: document PDF (in French)
- "Risquez-vous de développer un cancer de la bouche ?": http://www.smokefreeottawa.com/pdf/quizF.pdf :
- Raymond, Luc and all. Les cancers ORL à Genève : bilan épidémiologique . Médecine et Hygiène, 2001, Vol. 59, n° 2364, p. 2013-2014, 2016-2018, 2010
- W. Lehmann. Le cancer de la bouche, du pharynx et du larynx : causes, symptômes, diagnostic, traitement, pronostic : une information de la Ligue contre le cancer. Berne : Schweizerische Krebsliga, cop. 1995
Mouth cancer – Tastebuds on a healthy tongue
Tastebuds on the healthy tongue of a non-smoker. Saliva containing tastable substances can flow between the tastebuds.
Mouth cancer – Tastebuds on the tongue of a smoker
Part of the tongue of a smoker. Between the tastebuds, tissue has been deformed by the toxicity and heat of cigarette smoke. Heavy smokers often suffer an impaired sense of taste and smell!
On the left, we see healthy tastebuds on the tongue of a non-smoker. Saliva containing testable substances can flow between the taste buds.
On the right, we see a part of the tongue of a smoker. Between the tastebuds, tissue has been deformed by the toxicity and heat of cigarette smoke. Heavy smokers often suffer an impaired sense of taste and smell!
Photos : Cipret Fribourg