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Types of mouth and oropharyngeal cancer

Most mouth and oropharyngeal cancers are squamous cell cancers. But there are other less common types.

Squamous cell cancers of the mouth and oropharynx

More than 9 out of 10 mouth and oropharyngeal cancers (90%) are squamous cell carcinomas. Squamous cells are the flat, skin like cells that cover the inside of the mouth, nose, larynx and throat. Carcinoma just means cancer. So squamous cell carcinoma is cancer that starts in these cells.

There is an unusual type of squamous cell carcinoma called verrucous carcinoma. Verrucous carcinoma rarely spreads to other parts of the body but can grow very deeply into surrounding tissues.

Other types of mouth and oropharyngeal cancer

About 1 in 10 mouth and oropharyngeal cancers (10%) are salivary gland cancers, lymphomas or melanomas. We have separate sections about these cancers. 

Non cancerous growths of the mouth and oropharynx

A growth or tumour may not always be cancer. Some mouth and oropharynx tumours are non cancerous (benign). The main difference is that a cancer can spread, while a benign tumour will not. 

Precancerous conditions

There are two medical conditions that cause abnormal areas in the mouth or throat. They are harmless to begin with but if left untreated can turn into a cancer in a small number of people. One condition is leukoplakia, which is white patches in the mouth. The other is erythroplakia, which is a red area in the mouth that bleeds easily.

 

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Mouth and oropharyngeal cells

Several types of tissue make up the mouth and oropharynx. Each tissue contains several types of cells. Cancer can develop from any of these cell types. It is important that your doctor finds out exactly which type of cancer you have so you get the right treatment.

 

Squamous cell cancers of the mouth and oropharynx

More than 9 out of 10 mouth and oropharyngeal cancers (90%) are squamous cell carcinoma. Squamous cells are the flat, skin like cells that cover the inside of the mouth, nose, larynx and throat. Carcinoma just means cancer. So squamous cell carcinoma is cancer that starts in these cells.

There is an unusual type of squamous cell carcinoma called verrucous carcinoma. Verrucous carcinoma rarely spreads to other parts of the body but can grow very deeply into surrounding tissues.

 

Other types of mouth and oropharyngeal cancer

Squamous cell cancer is not the only type of cancer that can develop in the mouth and oropharynx. 1 in 10 mouth and oropharyngeal cancers (10%) are one of the following types

Salivary gland cancer

There are minor salivary glands throughout the lining of the mouth and oropharynx. It is more common for a lump in this area to be non cancerous (benign). But cancers can develop in these glands and are mostly adenocarcinomas.

Adenoid cystic cancer

Adenoid cystic cancer is a rare type of cancer that develops from glandular tissue and occurs mostly in the salivary glands but can also occur in the mouth. The parotid gland is the most common place to find a cancerous tumour. About 1 out of every 4 tumours (25%) found in the parotid gland are cancerous. We have a section about salivary gland cancer.

Lymphoma

Lymphomas are cancers that develop from cells in the lymph nodes. The base of the tongue and tonsils are made up of lymph tissue that can develop into cancer. There are also many lymph nodes in the neck. Painless swelling of a lymph node is the most common symptom of lymphoma. If you are looking for information about lymphoma, you need to go to the lymphoma section. Your treatment will be very different to treatment for mouth and oropharyngeal cancer.

Melanoma

Melanomas develop from the pigment producing cells that give the skin its colour. Melanomas of the head and neck can occur anywhere on the skin or inside the nose or mouth (oral cavity). If you have a melanoma of the mouth or lip, some of the information in this section will be helpful, for example in the radiotherapy or surgery sections. But there is also a section about melanoma that you may like to look at.

 

Non cancerous growths in the mouth and oropharynx

A growth or tumour is not always a cancer. Non cancerous growths are called benign. The main difference is that a cancer can spread, while a benign tumour doesn't. Some mouth and oropharynx tumours are not cancerous (benign) and so don't spread to other parts of the body. There is information about the differences between cancer cells and normal cells in our section about cancer.

 

Precancerous conditions

Two different medical conditions can cause abnormal areas in the mouth or throat. They are harmless to begin with but if left untreated can turn into a cancer in a small number of people. Doctors call these conditions precancerous. They are

  • Leukoplakia and
  • Erythroplakia

Leukoplakia is a white patch in the mouth. Erythroplakia is a red area in the mouth that bleeds easily. These white or red patches may be harmless. But they can be precancerous and contain abnormal cells. If not treated, these cells could go on to develop into a cancer. Doctors call these abnormal cells dysplasia (pronounced dis-play-zee-a).

Your doctor will need to take a sample of these cells. This is the only way to find out exactly what the patches are. The tissue sample is called a biopsy. Your doctor will send the biopsy to a lab, where a specialist checks for abnormal cells by examining the sample under a microscope.

If left untreated, precancerous changes may go on to develop into a cancer years later. Only about 5 out of every 100 people (5%) diagnosed with leukoplakia have either cancerous or precancerous changes. But about half (50%) of the red erythroplakia lesions can become cancerous.

If you have dysplasia, there is a risk that you may go on to develop mouth cancer. But if your doctor removes the dysplasia, your risk of mouth cancer usually disappears. The most common causes of erythroplakia and leukoplakia are smoking or chewing tobacco. Or you may develop it because you have badly fitting dentures that are always rubbing on your gums, the inside of your cheeks or your tongue. So it is important that you get regular dental check ups if you have dentures.

The treatment for leukoplakia can vary. Giving up alcohol or stopping smoking may help reduce the white patches. If that doesn’t work, or if the lesions show early signs of cancer, your doctor may choose to remove the patches using a laser or scalpel.

Researchers are trying a group of drugs called retinoids on leukoplakia. Retinoids are made from vitamin A. They are used to treat severe acne and other skin conditions. Although retinoids seem to help to treat leukoplakia, they can cause serious side effects.

Beta carotene is an antioxidant that is converted to vitamin A in your body. It may also completely or partially reduce leukoplakia patches. This type of treatment is still experimental and it is not generally prescribed on the NHS.

If you develop either of these conditions and you smoke, there is a greater risk that they will come back. Your doctor will strongly advise you to give up smoking.

 

Grade of mouth and oropharyngeal cancers

When you have a cancer removed, or if you have a biopsy, the specialist examining the cells under a microscope will usually grade them. This means that they look at how different they are from normal cells. Cells that are very like normal cells are called low grade (well differentiated). Cells that look quite abnormal are called moderate grade. Cells that look very abnormal are called high grade (poorly differentiated).

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Updated: 2 October 2014