Each year, approximately 53,000 Americans are diagnosed with oral (mouth) cancer. But experts worry this number will grow following the COVID-19 pandemic.
The concern stems from the recent increase in alcohol and tobacco use. These are the two biggest risk factors for cancer in the oral cavity, which includes the lips and all the pink areas in your mouth back to, but not including, your tonsils.
According to Abie Mendelsohn, MD, a UCLA Health ear, nose and throat (ENT) specialist, the heightened risk isn’t the only problem. “In addition to an increase in smoking and alcohol use during the pandemic, we’ve seen a big decrease in health maintenance,” he says. “That means people are increasing their risk of oral cancer and not scheduling routine care with their dentist or doctor.”
Oral cancer is harder to detect early without regular screening, and late-stage oral cancer can be lethal. The five-year survival rate is 67% if the cancer spreads locally and 40% if it spreads to distant parts of the body.
Preventing mouth cancer
Fortunately, these steps may help prevent cancer in your oral cavity. Follow this advice from Dr. Mendelsohn to keep your mouth as healthy as possible:
1. Understand the oral cancer risk factors
Some risk factors for mouth cancer cannot be changed, but the biggest risk factors are lifestyle choices. Risk factors for oral cavity cancer include:
- Tobacco use, including cigarettes, cigars and all forms of smokeless tobacco
- Alcohol use, which multiplies the risk when used alongside tobacco
- Betel quid and gutka (betel nut), chewed by people in Southeast Asia, South Asia and other parts of the world
- Age, with people over 50 at a higher risk
- Gender, with oral cancer twice as common in men as in women
- Human papillomavirus (HPV), accounting for a small portion of oral cavity cancers
- Sun exposure, for oral cancer that develops on the outer lip
Even without risk factors, you should still be on the lookout for mouth cancer. According to Dr. Mendelsohn, a growing rate of people (mostly women) age 40 to 60 who have no additional risk factors are developing mouth cancer.
“Just because you’ve done the right thing by never smoking and simply being a social drinker, that doesn’t preclude you from oral cavity cancer,” he says. “Oral cavity health is critical for all adults.”
2. Know the symptoms of mouth cancer
The most common symptom of oral cavity cancer is a mouth sore or lesion that does not heal and is white (where it should normally be pink). But a wide range of abnormalities can signal cancer, including:
- A white, red or black discoloration in the soft tissues
- A lump or hard spot in the tissue (usually at the edge of the tongue)
- A growth in the tissue that protrudes and may resemble the head of cauliflower
- Any mouth abnormality that bleeds easily when touched
A cancerous or precancerous ulcer is an actual change in the color of the mouth’s tissue, and not just a white coating (which may signal bacteria or infection). If a biopsy (tissue sample) of the ulcer shows that it’s precancerous (called leukoplakia), your doctor may offer treatment to prevent cancer from developing.
3. Avoid or stop tobacco use
Tobacco use, both smoking and smokeless forms, is the top risk factor for oral cavity cancer. Certain forms of tobacco, such as cigars and chewing tobacco, do not affect the risk of lung cancer but greatly increase your chance of developing mouth cancer. Your primary care provider (PCP) can connect you with the resources you need to quit smoking or using tobacco.
Keep in mind, even if you stopped using tobacco years ago, your risk for oral cancer may still be high. Discuss your health history with your doctor and don’t wait to get symptoms checked.
4. Limit alcohol consumption
Your risk for oral cancer increases with the amount of alcohol you consume and, according to the American Cancer Society, multiplies by 30 times if you drink and smoke heavily.
“When alcohol is used along with any tobacco products, the two together promote the development of oral cancer,” Dr. Mendelsohn says. “Having a drink while smoking a cigar or cigarette creates an extremely high-risk situation.”
5. Check your mouth for signs of oral cancer
Oral cavity cancer is a very slow-developing and slow-progressing cancer. But if ulcers go unnoticed and routine health maintenance is ignored, cancer may present at a more advanced stage. Dr. Mendelsohn recommends that when you brush your teeth, take an extra few seconds after rinsing to check out your mouth in the mirror.
6. See your dentist regularly
Dentists are required to do an oral cavity screening with every examination, according to Dr. Mendelsohn. Seeing your dentist every six to 12 months, as recommended by the American Dental Association, means you’ll have a full oral cancer screening at least once a year.
7. Don’t wait to get symptoms checked out
Whenever you notice an abnormal sore or growth in your mouth, it’s best to have it looked at by a professional.
“The mouth heals very quickly,” Dr. Mendelsohn says. “If you have a sore that doesn’t heal within a week, make an appointment with your PCP, dentist or ENT specialist. Three weeks of a non-improving lesion should be considered urgent.”
If you have an abnormal growth or sore in your mouth that lasts for more than a week, make an appointment with a UCLA Health primary care provider.
