Head and neck medical oncologist Dr. Anuja Kriplani sits and talks with her patient in an MSK exam room.
MSK's Guide To

Mouth (Oral) Cancer

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Overview

No one should go through mouth cancer alone. MSK’s team of mouth cancer doctors, surgeons, and other experts is here for you.

You may be reading this because you or someone you care about has learned they have mouth (oral) cancer. Or maybe you’re curious about your risk of getting mouth cancer. 

It’s important to know the signs of mouth cancer. Mouth cancer can be easier to treat when we catch it early. At MSK, we have treatment options for mouth cancer at every stage.

This guide is a good place to learn about oral cancer causes and oral cancer prevention. You also can learn about oral cancer symptoms. 

This information can help you get ready to talk with your healthcare provider and understand your next steps.   

Meet MSK’s mouth cancer experts 

What is mouth cancer?

Mouth cancer is a type of head and neck cancer that starts on the lips or in the mouth. Another name for mouth cancer is oral cavity cancer. Oral cancer includes cancer that starts in the mouth, as well as in the salivary glands and throat.

The main causes of mouth cancer are using tobacco and alcohol.

Treatment for mouth cancer can include surgery, radiation therapy, chemotherapy, targeted therapy, or immunotherapy. You may have 1 treatment, or a few treatments together. 

Head and neck surgeon Dr. Babak Givi, wearing a medical headlamp, examines a patient.
What are the signs of mouth cancer?

Mouth cancer symptoms include changes in and around your mouth. You may have a sore or lump on your lip or in your mouth. Other signs of oral cancer are bleeding, pain, or numbness in your mouth. 
 

Read more
A registered nurse with MSK’s Head and Neck service talks with a patient.
How is mouth cancer diagnosed?

Mouth cancer is often found during a routine dental exam. If something does not look normal, you’ll need other tests to tell if it’s cancer. They include a biopsy and imaging tests, such as CT scans.

Read more

Anatomy of the mouth

What’s inside your mouth? Knowing your mouth’s anatomy can help you better understand where mouth cancer starts. Anatomy (un-NA-toh-mee) means the parts of a structure, such as the mouth. 

Where does mouth cancer start?

Mouth cancer can start anywhere in the oral cavity (mouth).  

Your mouth helps you speak, chew, swallow, and breathe. It includes:

  • Your lips. Lip cancer is the most common oral cancer.
  • The inner lining of your cheeks. This is also called buccal mucosa (BUH-kul myoo-KOH-suh) cancer.
  • The front part of your tongue.
  • Your gums, which are also called your gingiva (JIN-jih-vuh).
  • The floor of your mouth that’s under your tongue.
  • The roof of your mouth, which has your hard and soft palate.
  • The small area behind your wisdom teeth in your lower jaw. This is called your retromolar trigone (reh-troh-MOH-ler TRY-gone). 

Mouth cancer often starts on the tongue, lips, and the floor of the mouth.

Cancer can also start in other nearby areas, such as the back of your throat or your salivary glands. Cancer in these areas are not mouth cancer, and may not have the same treatments.

Read more about salivary gland cancer or throat cancer. 

Illustration of the mouth, showing location of lips, teeth, gums, tonsils, palates, and the tongue.
Illustration of the mouth, showing location of lips, teeth, gums, tonsils, palates, and the tongue.

Anatomy of your mouth, including where the lips, teeth, gums, tonsils, hard and soft palates, and tongue are located. 

Anatomy of your mouth, including where the lips, teeth, gums, tonsils, hard and soft palates, and tongue are located. 

Risk factors and prevention

What causes mouth cancer?

A risk factor is anything that raises your chance of getting a disease, such as cancer.   

There are some risk factors that you cannot control. These include your age, race, or the genes you were born with.  

There are other risk factors you can change. Research shows that having healthy habits can lower your risk for cancer.  

A few risk factors can raise your risk for getting mouth cancer. Examples are:  

Tobacco, including smokeless tobacco, is a main cause of mouth cancer. You’re at higher risk for oral cancer if you:

  • Smoke cigarettes, cigars, or pipes.
  • Chew or dip tobacco.

Using tobacco puts chemicals in your mouth that harm cells. 

Researchers are studying if vaping (e-cigarettes) is a risk factor for cancer. Vaping may be risky for your health now and when you’re older.

Your chance of getting mouth cancer is even higher if you use both tobacco and alcohol. Talk with your healthcare provider about your drinking and smoking habits, now and in the past.

Learn more about cancer and tobacco use. 

Alcohol is a main cause of oral cancer. If you drink a lot of alcohol, you’re at higher risk for mouth cancer.

Your chance of getting mouth cancer is even higher if you use both tobacco and alcohol. Talk with your healthcare provider about your drinking and smoking habits, now and in the past.

Researchers aren’t sure why alcohol can cause cancer. They think it harms DNA. For example, your body breaks down the alcohol in drinks into a chemical compound called acetaldehyde. This chemical can make DNA less stable and trigger mutations (changes). 

People assigned male at birth are more likely to get mouth cancer than people assigned female at birth. This may be because men use tobacco and alcohol more than women. 

As you get older, your risk goes up, too. This is because the cells in your body become less healthy over time. It’s harder for your body to fix them.

Oral cancer often happens in people over age 40. On average, people are around age 60 when they learn they have oral cancer. 

Your mouth or oral cancer risk may be higher if you’ve had any of these health issues:

  • You do not eat plenty of fruits and vegetables.
  • You use tanning beds, which can cause skin cancer on your lips.
  • You do not protect your lips from the sun, which can cause skin cancer.
  • You chew betel quid or gutka, which is more common in parts of Asia. 
You wouldn’t ask someone with cancer or another disease like diabetes or a heart condition to treat themselves. So why should someone with a tobacco addiction be expected to quit without help from the latest and best treatments?  
Psychologist Chris Kotsen, Associate Director of MSK’s Tobacco Treatment Program.  
THE MSK DIFFERENCE

Our Tobacco Treatment Program has experts who can help you quit smoking. It’s open to people who never had cancer or a disease linked to tobacco. It also welcomes anyone who has cancer, and cancer survivors. Our program offers treatment options to help you quit, such as counseling and medicine. 

Can I lower my risk for mouth cancer?

There are some steps you can take to lower your risk for mouth cancer. There also are some risk factors that you cannot control. 

Research shows that some healthy habits can lower your risk. Making healthier choices in your everyday life can help. 

Lower your risk by taking care of your health in these ways:
MSK RECOMMENDS

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. 

Screening for mouth cancer

What is mouth cancer screening?

Screening means getting routine tests to find cancer even before you have any signs or symptoms. The goal of regular screening is to find cancer at an early stage, when it’s easier to treat.  

Your healthcare provider and dentist should check for signs of oral cancer. They can do this during your regular check-ups each year. 

Head and neck medical oncologist Dr. Winston Wong examines the throat of a patient.

Head and neck medical oncologist Dr. Winston Wong treats people with mouth cancer in NYC and at MSK Monmouth. 

What are the screening tests for mouth cancer?

There’s no solid scientific evidence about whether screening prevents deaths from head and neck cancer. Researchers are studying this in clinical trials, also known as research studies. 

Here are MSK’s latest guidelines for head and neck cancer. They may be different from those of other groups of experts.

If you’re at average risk for head and neck cancer:

  • MSK recommends your primary care provider examine your head and neck every year. They also should inspect your oropharynx (OR-oh-FAYR-inx). That’s the middle section of your throat, including your soft palate, base of your tongue, and tonsils. Your provider will look for lumps and abnormal (not normal) spots.
  • We also recommend your dentist inspects your oropharynx, mouth, and neck each year.

If you’re at higher risk for head and neck cancer:

  • Talk with your healthcare provider about getting screened. 
MSK RECOMMENDS

You can get oral cancer even if you do not use tobacco or alcohol. Signs of mouth cancer include red or white spots, or mouth pain. Symptoms can be caused by other health problems. Talk with your healthcare provider or dentist right away if you notice changes in and around your mouth. 

MSK treated Steve Harrold, sitting with his wife, Sara, for throat cancer.
It was like a cosmic punch to be told at age 63 and in excellent health that I had throat cancer, and it shook the ground under my feet. 
Steve Harrold had trouble swallowing, the first sign of head and neck cancer. He chose to travel from the Boston area to get treated at MSK. His doctor “made us feel comfortable knowing MSK was experienced in treating the specific type of tumor I had.”   
Read his story
THE MSK DIFFERENCE

MSK has more than 70 head and neck cancer experts. We see more people with rare types of head and neck cancer than many other cancer centers. We’re experts in diagnosing and treating rare salivary gland, mouth, and thyroid cancers. That’s why 1,100 people with rare head and neck cancers come to MSK each year.  

Signs and symptoms

What are the signs and symptoms of mouth cancer?

Changes in and around your mouth could be signs of cancer. They also can be caused by other things. Talk with your healthcare provider and dentist if you have any of these oral cancer symptoms: 

Early mouth cancer signs and symptoms

Early and common symptoms of mouth cancer include: 

  • An ulcer (sore or lump) in your mouth that does not heal.  
  • Leukoplakia (white) or erythroplakia (red) patches on the lips or in your mouth.
  • Erythroleukoplakia (mixed red and white) patches on the lips or in your mouth.
  • Your buccal mucosa (inner cheek lining) gets thicker. 
Advanced oral cancer signs and symptoms

Later-stage symptoms of oral cancer include:

  • Pain in your mouth that does not go away.
  • Numbness of the jaw, lips, tongue, mouth, or larger areas.
  • Unusual (not usual) bleeding in your mouth.
  • Loose teeth, but you do not know why.
  • Dentures that no longer fit. 
  • Tooth socket that does not heal.
  • Trouble moving your jaw or mouth.
  • Trouble chewing or swallowing.
  • Speech changes. Your voice sounds quieter, or you have trouble speaking clearly. Or, it sounds like you have a cold all the time.   
  • A lump in your neck or throat.
  • A lump or thickness on your lips.
  • Jaw or tongue swelling.
  • Swollen salivary glands.
  • Swollen lymph nodes in your neck.   
  • Weight loss because of loss of appetite (you do not feel hungry). 
Joanna, sitting on rocks by water, was able to afford cancer care at MSK, which accepts most insurance plans.  
I’m so glad that I consulted with a financial expert at MSK. Not having to worry about the costs of treatment made the stressful situation of having cancer a little less stressful. 
Joanna, retired and living on a fixed income, worried about paying for cancer treatment. MSK accepts most health plans. Our financial and insurance experts suggested she purchase a Medicare supplement plan. Joanna was able to easily afford MSK’s cancer care. 
Up Next
Mouth and Oral Cancer Types, Stages 0, 1, 2, 3, and 4, and How They're Diagnosed
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