Oral Cancer · Head & Neck Surgical Oncology
Oral Cancer: Screening, Diagnosis & Treatment
Oral cancer is highly treatable when caught early, and often silent in its earliest stages. This page covers what to watch for, how it's diagnosed, and what treatment as a head and neck surgical oncologist typically involves.
Warning Signs to Watch For
- A mouth ulcer or sore that hasn't healed within two to three weeks
- A white patch (leukoplakia) or red patch (erythroplakia) on the tongue, cheek, or gums
- A lump or thickening in the cheek, neck, or floor of the mouth
- Persistent numbness of the tongue, lip, or mouth
- Unexplained loosening of teeth, or a denture that no longer fits
- Difficulty chewing, swallowing, or moving the jaw or tongue
Diagnosis
Assessment begins with a thorough clinical examination of the mouth, jaw, and neck, followed by biopsy of any suspicious lesion. Imaging (CT, MRI, or PET-CT depending on the case) is used to map the extent of disease before treatment planning.
Treatment Approach
Surgical resection with clear margins is the backbone of treatment for most oral cancers, often combined with neck dissection when there is risk of lymph node involvement. Radiotherapy and chemotherapy are added where the stage of disease calls for it. Reconstruction — including free flap and patient-specific implant options — is planned as part of the same surgical pathway, not as an afterthought.
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What are the early warning signs of oral cancer?
A mouth ulcer that hasn't healed within two to three weeks, a persistent white or red patch, an unexplained lump, or numbness in the mouth or lip are the classic early signs. Persistent hoarseness or difficulty swallowing also warrants review.
Who is most at risk?
Tobacco use (smoked or chewed), heavy alcohol use, and betel/areca nut chewing are the leading risk factors, particularly in combination. HPV infection is an emerging risk factor for oropharyngeal cancers. Regular screening matters more, not less, if any of these apply to you.
Is a biopsy always needed?
Not every mouth ulcer or patch needs a biopsy, but any lesion that hasn't resolved within two to three weeks should be examined, and a biopsy is the only way to confirm or rule out cancer with certainty when a lesion looks suspicious.
What does treatment involve?
Treatment is planned around the stage and site of disease and typically involves surgery, often combined with radiotherapy and/or chemotherapy for more advanced cases. Reconstruction is planned alongside resection whenever removal will affect appearance or function.
Can oral cancer be prevented?
Avoiding tobacco and areca nut products, moderating alcohol, and attending routine dental check-ups (where early lesions are often first spotted) meaningfully lower risk. Early detection remains the single biggest factor in good outcomes.