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Evening Standard
Evening Standard
World
Lowenna Waters and Tamara Davison

Mouth cancer deaths rise: Causes, symptoms and how to get a check-up for it

A shortage of dentists and poor access to dental health means that more cases of mouth cancer are reportedly going undetected

According to the latest research, 3,034 people died in 2021 as a result of mouth cancer. 

While it is uncommon, there’s been a sharp rise in deaths from it compared with a decade earlier. 

According to the BBC, this may be linked to ongoing shortages of dentists who may otherwise spot oral cancers and tumours.

The outlet also found that 90 per cent of NHS dental surgeries weren’t accepting new adult patients in 2022. This suggests that many people are potentially unable to get the dental care they need.

Long waiting lists and expensive private dental fees may push the number of mouth cancer fatalities up. 

Dr Nigel Carter, the chief executive of the Oral Health Foundation, said: “While most cancers are on the decrease, cases of mouth cancer continue to rise at an alarming rate. Traditional causes like smoking and drinking alcohol to excess are quickly being caught up by emerging risk factors like the human papillomavirus.

“The stigma around mouth cancer has changed dramatically. It’s now a cancer that really can affect anybody. We have seen first-hand the devastating affect mouth cancer can have on a person’s life. It changes how somebody speaks, it makes eating and drinking more difficult, and often changes a person’s physical appearance.

“We urge everybody to become more ‘mouth-aware’ by being able to recognise the early warning signs of mouth cancer and to be aware of the common causes.”

So what is mouth cancer, what causes it, and what are the symptoms?

Here’s what you need to know.

What are the causes of mouth cancer?

Factors that can increase your risk of mouth cancer include:

  • Tobacco use of any kind, including cigarettes, cigars, pipes, chewing tobacco and snuff;

  • Heavy alcohol use;

  • Excessive sun exposure to your lips;

  • A sexually transmitted virus called human papillomavirus (HPV);

  • A weakened immune system.

What are the symptoms of mouth cancer?

In the early stages of the disease, mouth cancer symptoms can be subtle and painless, making it easy to miss. These include a mouth ulcer that doesn’t heal within three weeks, white or red patches in the mouth, or unusual lumps or swellings in the mouth, neck or head. Other symptoms include a persistent hoarseness in the voice.

Other signs and symptoms of mouth cancer may include:

  • A lip or mouth sore that doesn’t heal;

  • A white or reddish patch on the inside of your mouth;

  • Loose teeth;

  • A growth or lump inside your mouth;

  • Mouth pain;

  • Ear pain;

  • Difficult or painful swallowing.

What are the types of mouth cancer?

Mouth cancer is categorised by the type of cell that cancer (carcinoma) starts to grow inside. Squamous cell carcinoma is the most common type of mouth cancer, accounting for nine out of 10 cases. The cells are found in many areas of the body, including the inside of the mouth, as well as the skin.

One in three mouth cancers are found on the tongue and 23 per cent are found on the tonsils. The other places they can occur include the lips, gums, inside of the cheeks and the floor and roof of the mouth.

Less common types of mouth cancer include:

  • Adenocarcinoma, which is a cancer that develops inside the salivary glands;

  • Sarcoma, which grows from abnormalities in bone, cartilage, muscle or other tissue;

  • Oral malignant melanoma, where cancer starts in the cells that produce skin pigment or colour (melanocytes). These appear as very dark, mottled swellings that often bleed;

  • Lymphoma, which grows from cells usually found in lymph glands, but can also grow in the mouth.

How can I get my symptoms checked out?

To determine if you’ve got oral cancer, your doctor or dentist will perform a physical exam to inspect areas of irritation, such as sores or white patches. If they suspect something is abnormal, they may conduct a biopsy where they take a small sample of the area for testing.

The main methods used to do a biopsy in cases of suspected mouth cancer are:

  • an incision or punch biopsy;

  • a fine needle aspiration with cytology;

  • a nasendoscopy (also known as nasoendoscopy or nasal endoscopy, which is a medical procedure that involves the use of an endoscope to examine the inside of the nasal passages and the back of the throat)

  • a panendoscopy ( short for "panendoscopic examination" or "panendoscopic procedure," which is a medical procedure in which various endoscopic techniques are used to examine multiple areas of the upper aerodigestive tract)

If your biopsy confirms you might have cancer, you may then have to undergo further tests to see if it has spread further throughout your body, including:

  • an X-ray;

  • an ultrasound scan;

  • an MRI scan;

  • a CT scan;

  • a PET scan.

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