Oral Cancer

Oral cancer includes cancers that develop in the lips and oral cavity, including the front two-thirds of the tongue, gums, inner lining of the cheeks, floor of the mouth, hard palate and the area behind the wisdom teeth. Most oral cancers originate in the squamous cells lining the mouth and are therefore classified as squamous cell carcinomas.[1]

Tobacco use, alcohol consumption and areca nut (betel quid) use are among the leading causes of oral cancer.[2] Oral cancer can spread into deeper tissues and nearby lymph nodes as the disease progresses.[1]

Global Impact

Oral cancer is an important contributor to the global cancer burden. In 2022, approximately 389,846 new cases of lip and oral cavity cancer and 188,438 deaths were estimated worldwide. Oral cancer is more common among men and older adults, and its occurrence varies considerably across geographical regions and socioeconomic groups.[2]

The burden is particularly associated with exposure to preventable risk factors, especially tobacco, alcohol and areca nut use.[2]

Impact in India

Oral cancer represents a particularly significant cancer burden in India. According to IARC GLOBOCAN 2024 estimates, approximately 205,878 new cases of lip and oral cavity cancer occurred in India, accounting for 13.2% of all new cancer cases. It was the second most commonly diagnosed cancer overall in India, after breast cancer.[3]

The burden is particularly high among Indian men. Approximately 159,734 new cases occurred among men in 2024, representing 20.4% of all cancers diagnosed in males. Lip and oral cavity cancer was the most commonly diagnosed cancer among Indian men. Among women, approximately 46,144 new cases occurred, accounting for 5.9% of cancers in women.Oral cancer was responsible for approximately 86,307 deaths in India in 2024, making it the third leading cause of
cancer death overall in the country.[3]

The NCRP also demonstrates important geographical variation in oral cancer within India. Mouth cancer incidence was particularly high in PBCRs from western and central India. The NCRP projected approximately 79,863 cases of mouth cancer in 2020, increasing to about 90,060 cases by 2025.[4]


Signs and Symptoms

Oral cancer may initially produce few or no symptoms and can sometimes be identified during a routine dental examination. Common signs and symptoms include:[1]

  • A sore on the lip or inside the mouth that does not heal
  • A lump or thickening on the lips, gums or inside the mouth
  • A persistent white or red patch in the mouth
  • Unexplained bleeding, pain or numbness of the lip or mouth
  • Loose teeth or dentures that no longer fit properly
  • Difficulty chewing or swallowing
  • Difficulty moving the tongue or jaw
  • Swelling of the jaw
  • Persistent sore throat or a feeling that something is caught in the throat
  • Changes in the voice.[1]

These symptoms can also occur with conditions other than cancer. Persistent or unexplained changes in the mouth should therefore be evaluated by a healthcare professional or dentist.[1]

Treatment Modalities

Treatment of oral cancer depends on the location and size of the tumour, stage of the disease, involvement of lymph nodes, and the individual's overall health. Treatment may involve surgery, radiation therapy, immunotherapy or a combination of approaches.[1]

i. Surgery: Surgery is a common treatment for oral cancer and involves removal of the tumour along with a margin of surrounding healthy tissue. If cancer has spread to nearby lymph nodes, a neck dissection may also be performed. Extensive surgery may require reconstructive procedures to restore the appearance and function of the mouth, jaw or neck.[1]

ii. Radiation Therapy: Radiation therapy uses high-energy radiation to destroy cancer cells or prevent them from growing. It may be used as the primary treatment for selected cancers or in combination with surgery. Both external-beam radiation therapy and internal radiation therapy (brachytherapy) may be used for oral cancer.[1,5]

iii. Chemotherapy: Chemotherapy may be combined with radiation therapy in selected patients with locally advanced oral cancer. It may also form part of treatment for advanced disease depending on the extent of the cancer and the overall treatment plan.[5]

iv. Immunotherapy: Immunotherapy helps the immune system recognize and attack cancer cells. It may be used for selected patients with metastatic or recurrent oral cancer.[1]

Early Detection

Early detection is particularly important because cancers of the lip and oral cavity diagnosed at an early stage can often be successfully treated with surgery or radiation therapy.[4] Examination of the lips and oral cavity can help identify suspicious lesions, including persistent ulcers, lumps, red or white patches and other abnormal changes.[1]

Regular oral examinations are especially important for people with major risk factors such as tobacco, alcohol or areca nut use. Persistent abnormalities of the mouth should be investigated promptly.[1,2] Screening of Oral Cancer Video Link: https://drive.google.com/file/d/1X17U8fKlmuWX5XNYfBGWf-InW7nKGi0X/view

References

    1. National Cancer Institute. Lip and oral cavity cancer treatment (PDQ®)–patient version. Bethesda (MD): National Cancer Institute; 2025 May 14. Available from: https://www.cancer.gov/types/head-and-neck/patient/adult/lip- mouth-treatment-pdq
    2. World Health Organization. Oral health. Geneva: World Health Organization; 2025 Mar 17. Available from: https://www.who.int/news-room/fact-sheets/detail/oral-health
    3. International Agency for Research on Cancer. Global Cancer Observatory: India fact sheet. GLOBOCAN 2024. Lyon: International Agency for Research on Cancer; 2026 Jul. Available from: https://gco.iarc.who.int/media/globocan/factsheets/populations/356-india-fact-sheet.pdf
    4. Indian Council of Medical Research-National Centre for Disease Informatics and Research (ICMR-NCDIR). Report of National Cancer Registry Programme 2020. Bengaluru: ICMR-NCDIR; 2020. Available from: https://www.ncdirindia.org/All_Reports/Report_2020/resources/NCRP_2020_2012_16.pdf
    5. National Cancer Institute. Lip and oral cavity cancer treatment (PDQ®)–health professional version. Bethesda (MD): National Cancer Institute; 2025 May 14. Available from: https://www.cancer.gov/types/head-and-neck/hp/adult/lip-mouth-treatment-pdq