Diagnosis & staging
The mouth includes:
- Front two-thirds of your tongue (the part you can move).
- Hard palate (the front, hard part in the roof of your mouth).
- Floor of your mouth.
- Lining of your cheeks.
- Salivary glands (make the saliva that keeps your mouth moist and helps digest food).
Mouth cancer may also be called oral cancer, oral cavity cancer, tongue cancer, or lip cancer.
The most common symptom is an ulcer (a sore) or swelling in your mouth that does not heal.
Other symptoms include:
- Lump, thickening or rough spot in your mouth that does not go away or is growing.
- New, different coloured spots in your mouth or on your lips. These may feel different.
- White spots are called leukoplakia.
- Red spots are called erythroplakia.
- Pain, numbness, tenderness in your lips, mouth, jaw or ear.
- Difficulty swallowing or chewing.
- A change in the way your teeth fit together.
- A change in your voice.
Your dentist will check your mouth for these signs each time you see them. If any of these symptoms last for more than two weeks, please see your doctor, nurse practitioner or dentist.
If you have any signs or symptoms that you are worried about, please talk to your family doctor or nurse practitioner.
Tests that may help diagnose mouth cancer include:
- Biopsy: This is when a doctor takes a sample of your tissue. A specialty doctor (pathologist) then examines the tissue for cancer.
- Imaging: to see the tumour and if cancer has spread
- CT (Computed Tomography) scan
- MRI (Magnetic Resonance Imaging)
- PET (Positron Emission Tomography) scan
For more information on tests used to diagnose cancer, see BC Cancer Library screening and diagnosis pathfinder.
- The most common type of mouth cancer is squamous cell carcinoma. This cancer starts in the cells that line your mouth.
- Less common types are adenocarcinomas, sarcomas and melanomas.
Staging describes the cancer. Staging is based on how much cancer is in the body, where it was first diagnosed, if the cancer has spread and where it has spread to.
The stage of the cancer can help your health care team plan your treatment. It can also tell them how your cancer might respond to treatment and the chance that your cancer may come back (recur).
- Stage 1: The tumour is 2 cm (0.75 inches) or less.
- Stage 2: The tumour is more than 2 cm but less than 4 cm (1.5 inches).
- Stage 3: One of the following:
- The tumour is more than 4 cm.
- The cancer has spread to one lymph node in the neck on the same side as the tumour. Lymph node is 3 cm (about 1 inch) or smaller
- Stage 4: Lip cancer – tumour has grown into nearby structures.
- Stage 4A: Oral cavity – tumour has grown into nearby structures such as bone, deep muscles of the tongue, or skin of the face.
- Stage 4B: Tumour has grown into the base of the skull or is growing around the carotid artery.
The grade of the cancer describes how different the cancer cells look from normal cells and how fast the cancer cells are growing.
A pathologist will give the cancer a grade after looking at the cells under a microscope. Mouth cancer can be grade 1, 2, 3 or 4. The lower the number, the lower the grade.
Low grade: cells are abnormal but look a lot like normal cells. Low grade cancers usually grow slowly and are less likely to spread.
High grade: cells are abnormal and do not look like normal cells. High grade cancers usually grow more quickly and are more likely to spread.
The grade of the cancer can help your health care team plan your treatment.