One of the real dangers of this cancer, is that in its early stages, it can go unnoticed. It can be painless, and little in the way of physical changes may be obvious. The good news is however, that your dentist or doctor can see or feel the precursor tissue changes, or the actual cancer while it is still very small, or in its earliest stages. It may appear as a white or red patch of tissue in the mouth, or a small indurated ulcer which looks like a common canker sore. Because there are so many benign tissue changes that occur normally in your mouth, and some things as simple as a bite on the inside of your cheek may mimic the look of a dangerous tissue change, it is important to have any sore or discolored area of your mouth, which does not heal within 14 days, looked at by a professional. Other symptoms include; a lump or mass which can be felt inside the mouth or neck, pain or difficulty in swallowing, speaking, or chewing, any wart like masses, hoarseness which lasts for a long time, or any numbness in the oral/facial region. Other than the lips, the most common areas for oral cancer to develop are on the tongue and the floor of the mouth. Individuals that use chewing tobacco, are likely to have them develop in the sulcus between the lip or cheek and the soft tissue (gingiva) covering the lower jaw (mandible). In the US, cancers of the hard palate are uncommon, though not unknown. The base of the tongue at the back of the mouth, and on the pillars of the tonsils, are other sites where it is commonly found. If your dentist or doctor decides that an area is suspicious, the only way to know for sure is to do a biopsy of the area. This is not painful, is inexpensive, and takes little time. It is important to have a firm diagnosis as early as possible. It is possible that your general dentist or medical doctor, may refer you to a specialist to have the biopsy performed. This is not cause for alarm, but a normal part of referring that happens between doctors of different specialties.
Any discussion of diagnosis must be prefaced with the issue of discovery. While an annual screening for oral cancer is important, it is possible that you will notice some change in your mouth or throat that needs examination between your annual screenings. You are the most important factor in an early diagnosis. You should always contact your doctor or dentist immediately if you notice the following symptoms in yourself or a loved one:
- A sore or lesion in the mouth that does not heal within two weeks.
- A lump or thickening in the cheek.
- A white or red patch on the gums, tongue, tonsil, or lining of the mouth.
- A sore throat or a feeling that something is caught in the throat.
- Difficulty chewing or swallowing.
- Difficulty moving the jaw or tongue.
- Numbness of the tongue or other area of the mouth.
- Swelling of the jaw that causes dentures to fit poorly or become uncomfortable.
These symptoms may be caused by other, less serious problems, but they also indicate the possible presence of oral cancer. Only a professional will be able to tell you definitively. Some think that a visit to their medical doctor is the appropriate course of action. But remember that dentists are trained in this simple, quick screening, which involves the examination of the oral cavity as a whole and not just your teeth. Besides a visual examination of all the tissues in your mouth, your doctor will feel the floor of your mouth and portions of the back of your throat with his fingers, in the search for abnormalities. A thorough oral screening also includes indirect examination of the nasopharynx and larynx, and involves manually feeling the neck for swollen lymph nodes, and other abnormalities such as hardened masses. Your doctor will also check the mouth for white patches, red patches, ulcerations, lumps, loose teeth, and review your dental x-rays for abnormalities. Be sure to tell the doctor if you have been a tobacco user in any form. Tobacco use is implicated in more than 75% of all oral cancers. After the physical examination of your mouth, if your doctor finds any areas that are suspicious, he may recommend a biopsy. This is simply taking a small portion of the suspicious tissue for examination under a microscope.