You may be reading this because you’re worried about getting mouth cancer. Maybe you’re waiting for test results. Or perhaps you or someone you care about just learned they have mouth cancer.
This guide will help you understand how oral cancer is diagnosed and what your diagnosis means. Learning as much as you can may help you feel ready to talk with doctors about your care.
An oral tissue biopsy is the first step in diagnosing mouth cancer. A surgeon will remove cells or tissue to test for cancer. You’ll also get imaging tests, such as CT or MRI scans.
A mouth cancer diagnosis most often will describe where the cancer started, its type, and if it has spread. We use this information to create a care plan just for you.
Mouth cancer is often found during a routine dental exam.
Your care team will take a complete health history. If you have a mouth ulcer, they’ll ask when it started. They’ll want to know if it has changed in size or how it looks.
If something does not look right, you’ll need tests. They’ll help confirm if it’s mouth cancer.
Regular dental check-ups can help find oral cancer early, during routine dental exams. Ask your dentist to check for symptoms of oral cancer every year during your appointment. Finding cancer early makes it easier to treat and improves the chance of a cure.
Talk with an MSK Care Advisor. We're here 24 hours a day, 7 days a week.
A tumor genetic profiling test also is called genomic testing, molecular profiling, or next-generation sequencing. The test uses a sample taken from a tumor. We also consider sending blood samples as well, to learn more about the tumor’s genes.
At MSK, broad genetic testing of the tumor is a routine part of how we diagnose mouth cancer. We’re one of only a few cancer centers in the world to profile mouth tumors as part of standard care.
Genomic testing tells us which genetic changes caused the mouth cancer and made the cancer grow. The test results let us target those genes for treatment, a method called targeted therapy.
If we know which mutations (changes) you have, we know which treatments will work best on the tumor. Almost all of these genetic changes are only in cancer cells, not in normal cells. They cannot be passed on to your children.
MSK uses a testing tool developed at MSK called MSK-IMPACT®. It tests for changes in more than 500 genes. But the most common genetic mutations in mouth cancer are in the TP53, EGFR, CDKN2A, and HER2 genes.
When it comes to alcohol, less is best. Research shows that even 1 to 2 drinks a day can raise risks for some cancers. Alcohol is one of the most preventable causes of cancer, after smoking and being overweight. Learn about the risks of drinking alcohol.
Learning you have mouth (oral) cancer can be overwhelming. You’ll hear many medical terms you’ve never heard before. We’re here to help you understand what they mean and why they matter.
The information in your diagnosis describes important details about the type of mouth cancer you have. Your doctors use that information to create the best plan of care for you.
Newly diagnosed? Hear advice from our patients.
Michael:
You have a diagnosis of cancer, and there's all this fear and there's apprehension and you're nervous and you're scared. You've got surgery in front of you. You've got quality of life issues ahead of you. What I wish I had known was that you can come out the other side of this journey.
Lorena:
When I received the news that I had cancer, it was devastating and I was lost, completely lost.
Ming:
You are meeting with a lot of different people, so what I would really recommend to patients is just do your best to take notes.
Michael:
Come to the appointment prepared. Come with questions.
Norma:
I had questions about my recovery. I had questions about the possibility of chemo. I was placed on a clinical trial, and I had questions about that.
Michael:
Prior to coming to MSK, my wife and I had been to a variety of different doctors, and we got a lot of different answers and no clear direction. It was the first time that a definitive plan was put in place where I actually had a recommendation of which way to go.
Ming:
My care team consisted of doctors, social workers, nurses.
Michael:
It's not just one doctor you're dealing with. You're dealing with all of MSK and their entire team approach to your care.
Lorena:
The way they greet me, it was just overwhelming. I was so happy. It was 100% personalized for me.
Norma:
I was told to expect patient-centered care and I kind of felt that from the beginning, from that first day that I walked in.
Ming:
There were even people there just to hang out with me and to kill time. If you need something, ask. And even if it's something small like, “Nothing tastes good,” or “Everything tastes awful and I can't eat any of this,” it's important to tell someone and they can help you address your needs as a patient
Lorena:
One of the programs that I found helpful was Integrated Medicine. For example, acupuncture. It helped me to calm down; and then after the treatment, it managed the pain.
Norma:
I immediately used the nutrition program because it was amazing. I used their PT program. I used their Visible Ink program, which is wonderful and it gives you tremendous emotional support.
Lorena:
Another thing that is very helpful is the MSK Patient Portal. You can set up appointments. You can request prescriptions. You can also use the portal for a telemedicine visit. On the days that you don't have any energy, telemedicine is there for you. There is no difference at all between being seen in person or telemedicine.
Norma:
I never felt that I couldn't call someone, even if it was the doctor's nurse, and just talk.
Ming:
The silver lining from being diagnosed with cancer is I taught myself how to be positive.
Lorena:
This experience taught me to live in the moment, and you learn how to live life in a better way.
When you learn you have oral cancer, you’ll have many questions for your cancer doctor at your first visit. Talking about treatment options with your doctor can help you feel better prepared to make decisions about your care.
There are many types of mouth cancer, and MSK has experience treating every kind, from most common to rare. This information describes each type of mouth cancer and explains how we classify (sort) them.
The type of mouth cancer depends on the type of cell where cancer started. Some 9 out of every 10 mouth cancers are squamous cell carcinoma (SKWAY-mus sel KAR-sih-NOH-muh) of the oral cavity. Carcinoma means cancer.
Squamous cells are thin, flat cells that look like fish scales. They’re in many kinds of tissues, including the lining of the throat and mouth.
Squamous cell carcinoma can start in the mouth. Most often, it’s in places that are in the sun a lot, such as your face.
Oral verrucous carcinoma is a rare type of squamous cell carcinoma that can grow in the mouth.
Melanoma of the head and neck can start inside the nose or oral cavity. Learn more about melanoma treatment.
Most mouth cancers are squamous cell carcinoma, but treatment depends on the cancer’s location.
This information describes each type of mouth cancer.
Buccal mucosa means the cheeks’ inner lining. Inner cheek cancer is a squamous cell carcinoma.
This cancer often starts in the squamous cells that line the buccal mucosa. Cells in the inner cheek can grow out of control and form tumors or lesions.
These are the common symptoms of buccal mucosa cancer. When found early, inner cheek cancer is very curable.
Surgery is the most common treatment. For more advanced cancer, treatments are radiation therapy, chemotherapy, or both. Targeted therapy and immunotherapy are also treatments.
Cancer that’s on the outer cheeks is skin cancer.
The floor of your mouth is under your tongue, shaped like a horseshoe. Cancer starts when the cells there grow out of control and form tumors or lesions.
The most common symptom is a sore in your mouth that keeps growing larger. That’s why this cancer is often mistaken for canker sores.
When found early, floor of mouth cheek cancer is very curable, most often with surgery.
For more advanced cancer, you may need radiation therapy, chemotherapy, or both. Targeted therapy and immunotherapy are also treatments.
Gum cancer is often mistaken for gingivitis, a type of gum disease. Treatment depends on where the cancer starts:
For more advanced cancer, you may need radiation therapy, chemotherapy, or both. Targeted therapy and immunotherapy are also treatments.
The hard palate is a barrier between the mouth and the nasal cavity. Advanced roof of mouth cancer tends to spread into the nasal cavity.
The most common symptom is an ulcer, a broken area on the roof that does not heal. The ulcer may bleed as the hard palate cancer grows.
Here are other common symptoms of roof of mouth cancer.
When found early, roof of mouth cancer is very curable, most often with surgery. For more advanced cancer, you may need radiation therapy, chemotherapy, or both. Targeted therapy and immunotherapy are also treatments.
Tongue cancer starts when the cells that make up the tongue grow out of control and form lesions or tumors.
The oral tongue is the front 2/3 of the tongue. It’s what you see when you stick out your tongue.
Surgery is the most common treatment for tongue cancer. For advanced tongue cancer, you may have radiation therapy, chemotherapy, or both. Targeted therapy and immunotherapy are also treatments.
Lip cancer is the most common oral cancer. There are 2 types:
Treatment for early-stage lip cancer often includes surgery, such as Mohs surgery. This procedure removes the tumor in thin layers until there are no signs of cancer.
Your surgeon will move the least amount of tissue possible. This can help keep the shape of your lips. It can also lower the chance of speech trouble. Your MSK care team offers support for speech, chewing, and swallowing.
For more advanced cancer, you may need radiation therapy, chemotherapy, or both. Targeted therapy and immunotherapy are also treatments.
A cancer stage tells us how advanced the cancer is. Staging describes traits such as the tumor’s size, location, and whether it has spread.
There are 5 stages of mouth cancer, from 0 to 4 (0 to IV). The lower the number, the less the cancer has spread. Your doctor may add a letter (A, B, or C) to these stages to give even more information.
Staging helps your doctor choose the best treatment options for you. The stage also helps them predict the outcome (result) of your treatment. Based on the stage, you may also be able to join a clinical trial.
The stage is based on:
Your doctor may use letters and numbers from the TNM system to describe the stage:
N0 means cancer is not in lymph nodes. N1, N2, or N3 means it’s spread to nodes.
M0 means cancer has not spread. M1 means it’s spread to distant organs, muscles, or bones.
