Mouth Cancer – Symptoms, Causes & PET CT Scan

Mouth or oral cavity cancer develops in the tissues of the mouth and is a form of head and neck cancer. It may involve the lips, gums, tongue, lining of the inside of the cheeks, floor of the mouth, hard palate, and the space behind the wisdom teeth. Oral cancer usually starts on the thin tissues of the mouth in thin cells called squamous cells.

Oral cancer can occur anywhere in the oral cavity and may start as a small sore or a change, patch, or lump in the mouth. Several of these changes may sometimes happen due to non-cancerous conditions, so be sure to seek medical or dental attention if symptoms persist. If diagnosed early, the doctor may be able to identify the severity of the disease and plan the treatment. Depending on the condition of the patient, imaging examinations such as CT, MRI, and PET-CT may be ordered in addition to a physical exam and biopsy.

What Is Mouth Cancer?

The development of cancer in the mouth is directly caused by the abnormal growth of cells in the mouth when they multiply at a faster rate than usual. It may occur on the lips, tongue, gums, inner cheeks, floor of the mouth or roof of the mouth. Squamous cell carcinoma is the most common type of oral cancer. When the cancer progresses, it can penetrate into surrounding tissue and, in a small number of cases, be found in other lymph nodes in the neck area or elsewhere in the body. Cancer staging is a way to describe how far the cancer has spread to help doctors decide the best treatment.

Common Symptoms of Mouth Cancer

Sometimes symptoms of mouth cancer are not readily apparent in the early stages. Sometimes the symptoms are similar to common mouth injuries. Therefore, continuous or unusual changes should be investigated by a health care worker. One of the important signs to be not ignored is a sore or ulcer in the mouth that will not heal. Another area of abnormality on the body is a lump or local thickening on the lips, gums, tongue, or the inside of the mouth that needs to be evaluated.

Other symptoms may be numbness or pain in the mouth, a white or red area on the tongue, bleeding without reason, sore chewing or swallowing, ability to move tongue or jaw movement is affected, having a jaw swollen or loose teeth, or dentures. One may also experience a nagging sore throat or a "lump in the throat. The above-mentioned symptoms do not indicate that someone has cancer. If changes including mouth ulcers, patches, lumps, pain, or anything unusual continue, however, then it is worth looking into for medical advice.

What Causes Mouth Cancer?

Cancer occurs when cells change and affect their growth and division. Oral cavity cancer can be caused by several risk factors. One of the major risk factors is tobacco. Cigarettes, smokeless tobacco, and other exposures from tobacco use may lead to an increased risk of oral and head and neck cancer.

Another top risk factor is drinking excess alcohol. Smoking along with alcohol can be a bigger risk than smoking or drinking alcohol alone. There are other causes of risk, too; for cancers of the lips, long exposure to sunlight may be a factor, as may be some genetic conditions, and age. There is no guarantee that individuals with risk factors will necessarily have mouth cancer, and individuals without risk factors can develop mouth cancer. 

How Is Mouth Cancer Diagnosed?

The first step in the diagnosis is a mouth, tongue, gum, lip, and surrounding area. The dentist or doctor may also take the patient's history, check the tobacco and alcohol consumption, inspect the neck for swollen lymph glands, and inquire about any other medical or dental problems.

If any area appears abnormal, other tests might be suggested. Imaging may be useful if the doctor suspects a tumour and can help give them ideas about where the tumour is and how large it might be; a biopsy usually is necessary to diagnose whether or not there is cancerous tissue. Detailed anatomical information of the tumour and surrounding structures can be provided by CT and MRI. The imaging modalities used are dependent upon the site of suspected cancer and the clinical conditions.

What Is a PET-CT Scan?

PET-CT is a combination of two imaging technologies – Positron Emission Tomography (PET) and Computed Tomography (CT) – in one scan. A single dose of a radioactive tracer, which is usually a glucose-based tracer, is injected. PET images can show increased activity in areas of the body where the tracer is being concentrated in the body more than is anticipated. The “CT” component offers in-depth anatomical detail of the location and structure of these areas. A scientific method called PET-CT, which combines metabolic information from PET with anatomical information from CT, can offer the physician a "whole body" view of the location and extent of disease activity. 

Why Is PET-CT Used in Mouth Cancer?

PET-CT may be recommended in selected patients with mouth or head and neck cancer, particularly when doctors need to assess the extent of disease. One important role of PET-CT is helping evaluate whether cancer may have spread beyond the original tumour. It can help identify areas of increased metabolic activity in lymph nodes or other parts of the body that may require further assessment.

PET-CT can therefore contribute to cancer staging. Knowing whether the disease is limited to the primary site, has involved nearby lymph nodes, or has spread to distant parts of the body can help doctors plan treatment. However, PET-CT is not used alone to diagnose every case of mouth cancer. The findings need to be interpreted together with clinical examination, biopsy results, and other imaging studies.

Conclusion

Mouth cancer can occur across various regions of the mouth, and symptoms may include an ulcer in the mouth that does not heal, a lump or sore in the mouth and lips, a white or red area in the mouth, bleeding without any obvious cause, pain, asymmetry or numbness, trouble swallowing, changes in the tongue or jaw. While use of tobacco and excessive alcohol consumption are significant risk factors, some people develop mouth cancer who do not have these factors. Symptoms that do not go away should always be assessed by a suitable health professional.

Diagnosis includes examination, imaging studies and biopsy. PET-CT may be a valuable tool in select patients when the diagnosis of mouth cancer has been made or is strongly suspected, moving beyond the information provided by detailed anatomical imaging; it also provides data regarding the cancer's metabolic properties. It may be helpful for doctors to review the lymph nodes, check for the presence of the disease in other parts of the body, and aid staging and treatment planning. Molecular Diagnostics and Therapy has advanced diagnostic imaging services that can help doctors and patients determine and treat cancer. The best scan and/or diagnosis should always be chosen based on the individual's medical status and guidance from the treating healthcare provider.