Signs and Symptoms of Oromandibular Cancer
For cancers in the mouth, you, your dentist or your general doctor can see or feel something abnormal in most cases. This is different from cancers in other parts of the head and neck, which can remain hidden for some time.
Symptoms to watch for include:
- Loose teeth or dentures that don’t fit correctly: This happens if the tumour gets into the tooth sockets or the bones in which the teeth are rooted. This is particularly concerning for oromandibular cancer.
- Numbness (for example in the lower teeth or lower lip/chin area): This means that the cancer cells have gotten into nerves that allow you to feel. The main nerve responsible for this when dealing with oral cancer runs just inside the lower jawbone, and a branch even runs in the middle of the jawbone and comes out under the skin of your chin. It is known as the mental nerve when it enters the lip, but it is designated as the inferior alveolar nerve while it travels through a canal in the bone.
- Difficulty opening the mouth: This can happen if the cancer gets into any of the muscles that help to open and close the mouth. This is called trismus.
- Painful sores in the mouth: Most commonly, an oral cancer will start as a painful sore in the mouth. In some cases, a dentist or dental hygienist will see a sore in the mouth that you didn’t even realise was there. In general, a patch or sore in the mouth that doesn’t heal after a few weeks should be evaluated in more detail by a specialist.
- A patch in the mouth: A red patch (erythroplakia) in the mouth that lasts for more than a few weeks is more likely to be cancer than a white patch. However, any lesion that doesn’t go away needs to be biopsied to determine whether it is cancer. The topic of white patches in the mouth (leukoplakia) and dysplasia (abnormal cells that are not cancer) can get complicated, and you should discuss this with a specialist.
- Difficulty speaking: This is called dysarthria, and it can occur when a tumour changes the way your tongue moves.
- Recurrent bleeding from the mouth:This can happen when the cancer makes a hole in some part of the mouth (this is called an ulcer) or if cancer cells are accidently rubbed off while brushing your teeth or eating certain foods.
- Bad breath: In rare circumstances, when cancer cells start to become necrotic, the dead cells can lead to a bad smell from the mouth. This is called halitosis.
- Pain or difficulty with swallowing: This can happen when tumours get large and either get in the way of eating or involve the muscles and nerves of swallowing.
In some cases, a dentist or oral surgeon will see something in the mouth, remove it and a week later get the report that it is a cancer.
If a lesion was removed and later found to be cancer: In this case, you should still see a specialist in head and neck cancers because it is important to review the pathology in detail to see if any more treatment is needed. Some questions to review are:
- What type of cancer was it?
- How big was it?
- How deeply did it invade?
- Was it completely removed with a rim of normal tissue around it? (This is known as having “clear margins.”)
In rare cases, the first sign of an oral cancer could be a lump in the neck.
A lump in the neck: This means that the tumour has spread to the lymph nodes in the neck. This is less common for oral cancers than other types of cancers in the head and neck because the primary cancer is usually the main problem.
But don’t jump to any conclusions. You could have one or more of these symptoms but NOT have an oral cancer. There are several non-cancerous causes of the same symptoms. That’s why you need to see a specialist.