Mouth ulcers are common. However, if the ulcers persist for several weeks even after treatment, one must not ignore the signs as it may indicate a cancerous growth, says Dr Ramesh Chandra Joshi

Mouth ulcers are quite common in all age groups and can make regular activities such as eating, drinking, and talking very uncomfortable. However, mouth ulcers can be cured with an antimicrobial or pain killing mouthwash, gel or spray.

But, if the ulcers persist for several weeks even after treatment, one must not ignore the signs as it may indicate a cancerous growth. There are many signs of mouth cancer but red sores that do not respond to treatment or heal is a telling sign. Lifestyle habits such as drinking alcohol or consuming tobacco — both smoked and smokeless — can cause cancer of mouth. Besides, human papillomavirus (HPV), known to cause sexually-transmitted infections (STI) and cervical cancer, can also cause cancer of mouth. The HPV-affected cancer of mouth is seen in the soft palate, tonsils, base of tongue, and pharyngeal wall areas.

Other symptoms of mouth cancer include:

• Persistent and unexplained lumps in the mouth or the neck
• Unexplained loose teeth or sockets
• Unexplained, persistent numbness on the tongue or lip
• White or red patches on the lining of the mouth or tongue
• Changes in speech, such as a lisp

The types of mouth cancer are categorised by the type of cell it starts to grow in. Medically, it is known as carcinoma. The most common type is squamous cell carcinoma that affects 9 out of 10 cases of mouth cancer. The less common types of mouth cancer are:

• Adenocarcinoma, in which cancer develop inside the salivary glands
• Sarcoma, in which cancer develops from the abnormalities in cartilage, bone, muscle or any other tissue
• Oral malignant melanoma, in which cancer starts in the cells that produce skin pigment (melanocytes). They often bleed and appear as dark, mottled swellings

Lymphoma, in which the cancer grows from cells in lymph glands

Mouth cancer as well as treating it can cause complications and affect the appearance of the mouth. Besides, it can cause dysphagia (problems with speaking and swallowing). Dysphagia can be a serious complication — if a small piece of food enters the airways when you try to swallow and gets lodged in lungs, dysphagia may lead to aspiration pneumonia, a kind of chest infection.

Preventing and treating mouth cancer

Cancer of oral cavity (lips,tongue,buccal mucosa, tonsils,palate)can give rise to various complications like difficulty in eating,speech,alteration in voice,inability to open mouth fully,pain in ear,bleeding etc, if not treated in time. Easy lifestyle changes and preventive measures, including, but not limited to the following can help in preventing mouth cancer in most of the people:

• Quit smoking or consuming smokeless tobacco as well as alcohol
• Get vaccinated against HPV
• Using a condom during oral sex to lower the chances of HPV infection
• Visiting a dentist regularly for screening
• Eating a balanced diet of fresh vegetables (especially tomatoes), citrus fruits, olive oil and fish with omega 3 fatty acid

Common to other cancers, chemotherapy, radiation therapy and surgery are the treatments available for mouth cancer too. If diagnosed early, mouth cancer can be completely cured in 9 out of 10 cases using surgery. For the emotional impact of the disease and treatment, therapeutic remedies for depression, such as antidepressants and cognitive behavioral therapy (CBT) may be prescribed.

The writer is Clinical Oncology, Columbia Asia Hospital, Palam Vihar, Gurgaon