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Mouth Cancer: The key signs, symptoms and causes

13 November 2023

More than 300 people in Wales are diagnosed with mouth cancer each year, and unfortunately most are found to have the disease at a later stage when it’s harder to treat.

The number of people getting mouth cancer each year in Wales has doubled since 2002, creating additional pressure on cancer services and the Welsh NHS as a whole.

These figures outline why it’s so important to be familiar with the signs and symptoms of mouth cancer, as well as the most common risk factors associated with the condition.

Mouth Cancer Action Month, which runs throughout November, aims to promote, protect and educate the public on mouth cancer so we can catch it sooner and reduce its prevalence.

What causes mouth cancer?

Tobacco: Smoking is still considered the main cause of mouth cancer. According to the World Health Organisation, up to half of current smokers will die of a tobacco-related illness – including mouth cancer. Tobacco users are six times more likely to develop head and neck cancer than the rest of the population, and around three-quarters of mouth and throat cancers occur in tobacco users.

Alcohol: Alcohol is another common cause of mouth cancer. Drinking to excess can increase the risk of mouth cancer by four times.

Poor diet: Poor diet is linked to a third of all mouth cancer cases.

HPV: Did you know the human papillomavirus (HPV) can increase your risk of mouth cancer? HPV is very common and for a small number the virus can cause changes in the mouth and throat that can lead to cancer. Children aged 12 to 13 years old, and people at higher risk from HPV, are offered the HPV vaccine which offers strong protection against the virus.

What are the symptoms of mouth cancer?

Symptoms of mouth cancer can affect any part of your mouth including the gums, tongue, inside the cheeks, or lips.

Symptoms can include:

  • an ulcer in your mouth that lasts more than three weeks
  • a red or white patch inside your mouth
  • a lump inside your mouth or on your lip
  • pain inside your mouth
  • difficulty swallowing
  • difficulty speaking or a hoarse (croaky) voice
  • a lump in your neck or throat
  • losing weight without trying.

See a GP if:

  • you have a mouth ulcer that has lasted more than three weeks
  • you have a lump in your mouth, on your lip, on your neck or in your throat
  • you have a red or white patch in your mouth
  • you have pain in your mouth that's not going away
  • you're having difficulty swallowing or speaking
  • you have a hoarse (croaky) voice that does not go away. You can find out more about the signs and symptoms on the NHS 111 website here.

Mouth Cancer Self-Check

The Mouth Cancer Foundation has a two-minute mouth cancer self-check that could prove life-saving. All you need is a mirror, a good light source and clean fingers.

1. Face

Look at the whole face. Are there any swellings you haven’t noticed before? Inspect your skin. Has anything changed recently? Have moles become larger or started to itch or bleed? Turn your head from side to side. This stretches the skin over the muscles making lumps easier to see.

2. Neck

Run the fingers under your jaw and feel along the large muscle either side of neck using the balls of your fingers. Are there any swellings? Does everything feel the same on both sides?

3. Lips

Using your index, middle fingers and thumb to feel the inside of your mouth. Pull your upper lip upwards and bottom lip downwards to look inside for any sores or changes in colour. Use your thumb and forefinger to feel around and inside your lips checking for any lumps, bumps or changes in texture.

4. Gums

Use your thumb and forefinger on the inside and outside of the gum, working your way around the gum to feel for anything unusual.

5. Cheeks

Open your mouth and pull your cheeks away, one side at a time, with your finger to look inside. Look for any red or white patches. Use your finger in the cheek to check for ulcers, lumps or tenderness. Repeat on the other side. Your tongue can be helpful to locate sore areas, ulcers or rough patches.

6. Tongue

Gently pull out your tongue and look at one side first and then the other. Look for any swelling, ulcer or change in colour. Examine the underside of your tongue by lifting the tip of your tongue to the roof of your mouth.

7. Floor of mouth

Lift your tongue up and look underneath then look at the floor of your mouth for any colour changes that are unusual. Gently press your finger along the floor of your mouth and underside your tongue to feel for any lumps, swellings or ulcers.

8. Roof of mouth

Tilt back your head and open your mouth wide to check the roof of your mouth. Look to see if there are changes in colour or ulcers. Check for changes in texture with your finger.

Make a note of anything unusual. If you have recently had a cold, sore throat, ulcer or swollen glands, bitten or scolded yourself for example, these should heal within three weeks. If you have any concerns visit your dentist or doctor to see if you need specialist advice.

The Mouth Cancer Foundation recommends that everyone over the age of 16 has a professional examination for early signs of mouth cancer, once a year, at their dentist.

* Free support on quitting smoking is available from the Help Me Quit Service here or by calling 0800 085 2219.

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