Important: This page is for general information only and is not a diagnosis. Please see a doctor or dentist if you are worried about possible cancer symptoms.
What is oral cancer?
Oral cancer is a cancer that starts in the lips or mouth. It can affect the lips, the front part of the tongue, the gums, the lining of the cheeks, the floor of the mouth, or the roof of the mouth. It is one type of head and neck cancer. Most oral cancers begin in the thin, flat cells lining the mouth and are called squamous cell carcinomas. Squamous cell carcinoma often develops in areas of leukoplakia — white patches of cells that do not rub off.
In India, the use of tobacco in chewed forms — gutka, paan masala, and khaini — and smoked forms such as bidi and cigarettes is closely linked to oral cancer risk.
Common warning signs
Possible warning signs of oral cancer include:
- A sore on the lip or in the mouth that does not heal
- A lump or thickening on the lips, gums, or in the mouth
- A white or red patch on the gums, tongue, or lining of the mouth
- Bleeding, pain, or numbness in the lip or mouth
- A change in voice
- Loose teeth, or dentures that no longer fit well
- Trouble chewing or swallowing, or trouble moving the tongue or jaw
- Swelling of the jaw
- A sore throat or feeling that something is caught in the throat
These symptoms are not always cancer. Many mouth problems are caused by infection, irritation, or dental issues. But symptoms that persist should not be ignored — please see a doctor or dentist for evaluation.
Risk factors
Things that can increase the chance of getting oral cancer include:
- Using tobacco products, including gutka, paan masala, khaini, bidi, and cigarettes
- Heavy alcohol use
- Long-term exposure to natural sunlight or artificial sunlight (such as tanning beds)
- Being male
Having one or more risk factors does not mean you will get oral cancer. Many people with risk factors never develop the disease, while some people with no known risk factors do. If you use tobacco in any form, talk to a doctor or dentist about your risk and about ways to stop.
When to seek medical attention
Please seek medical evaluation if you have any of the following:
- A mouth ulcer or sore that lasts more than 2 to 3 weeks
- A lump or thickening in the mouth or neck that does not go away
- A red or white patch in the mouth that has been there for more than 2 weeks
- Persistent pain, bleeding, or numbness in the lip or mouth
- Difficulty swallowing or speaking that lasts more than 2 weeks
Oral cancer may not always cause symptoms in early stages and is sometimes found during a routine dental exam. A regular dental visit every 6 to 12 months is a good idea, especially if you use tobacco.
How is oral cancer diagnosed?
If you have signs that suggest oral cancer, your doctor will ask about your symptoms, your tobacco and alcohol use, and your medical history, and will do a physical examination. Tests that may be used to diagnose and stage oral cancer include:
- Physical exam of the lips and mouth — the doctor or dentist looks and feels inside the mouth and along the neck for swollen lymph nodes
- Biopsy — a small tissue sample is removed from a suspicious area and examined under a microscope; this is the test that confirms or rules out cancer
- Endoscopy — a thin tube with a light and lens is used to look at organs and tissues inside the body
- Imaging tests such as CT scan, MRI, or PET scan to see the size of the cancer and whether it has spread
- Exfoliative cytology — cells are gently scraped from a suspicious area and viewed under a microscope
A biopsy is the only test that can confirm oral cancer. If your doctor recommends a biopsy, it is to rule out cancer or to plan treatment — not because cancer has been confirmed.
Treatment basics
Treatment for oral cancer depends on the stage of the cancer, the size and location of the tumor, and the patient’s overall health. Common treatments may include:
- Surgery to remove the cancer and a small area of healthy tissue around it
- Radiation therapy to kill cancer cells using high-energy rays
- Chemotherapy — medicines used to treat cancer, sometimes combined with radiation
- A combination of surgery, radiation, and/or chemotherapy depending on the stage
For people who use tobacco, the chance of recovery is better if they stop using tobacco before beginning radiation therapy. Treatment plans are individualized — what is best for one person may not be best for another.
In India, much of the cost of cancer surgery, chemotherapy, radiation therapy, and diagnostic procedures including biopsy may be covered by Ayushman Bharat (PM-JAY) for eligible families, up to Rs. 5 lakh per family per year. Ask the hospital’s PMJAY desk before paying out of pocket.
Questions to ask your doctor
When you visit a doctor about possible oral cancer, you may want to ask:
- What do you think is causing my symptoms?
- Do I need a biopsy? If yes, when will it happen and when will I get the results?
- If it is cancer, what stage is it and what does that mean?
- What are my treatment options, and what are the side effects of each?
- Will I need surgery, radiation, chemotherapy, or a combination?
- How long will treatment take, and will I be able to eat and speak normally afterwards?
- Should I get a second opinion? People often choose to get a second opinion to confirm the diagnosis and treatment plan.
- Is my treatment covered under PMJAY or any other scheme?
Bring a family member or trusted person to the visit. Write the answers down — it is normal to feel overwhelmed.
When urgent care is needed
Please seek urgent medical help — go to the nearest hospital or call an ambulance — if you have:
- Severe bleeding from the mouth that does not stop within 15 minutes of pressure
- Serious difficulty breathing
- Inability to swallow even small amounts of fluid
- Rapidly growing swelling in the mouth, jaw, or neck
- A high fever (over 100.4°F / 38°C) during cancer treatment, especially during chemotherapy
In India, you can call 108 or 112 for ambulance services. The Indian Cancer Society helpline is 1800-22-1951 for non-emergency questions and support.
If you live in Bihar and need a starting point for cancer evaluation, Mahavir Cancer Sansthan in Phulwarisharif, Patna is Bihar’s super-specialty cancer centre and has surgical, medical, and radiation oncology departments. AIIMS Patna also has a developing oncology department that runs head-and-neck clinics.
