Oral Cancer Treatment in Delhi, India

Oral cancer refers to the uncontrolled growth of abnormal cells in the tissues of the mouth or throat. It is a subset of head and neck cancers and can affect areas such as the lips, tongue, gums, inner cheeks, floor of the mouth and roof of the mouth (palate)

The majority of oral cancers are squamous cell carcinomas, which originate in the thin, flat cells lining the mouth and throat. These cancers tend to spread quickly if not detected and treated in their early stages. Over time, oral cancer can invade nearby structures and metastasise to distant parts of the body, including the lymph nodes, lungs, and bones.

Often starting as a small, painless sore or lump, oral cancer may go unnoticed in its early stages. However, as it progresses, it can interfere with essential functions like speaking, eating, and breathing. Timely diagnosis and intervention are crucial for improving survival rates and quality of life.

Oral cancer can develop due to a mix of lifestyle habits, infections, environmental exposures, and biological factors. While anyone can be affected, some causes and risk factors significantly increase the likelihood of developing this disease. Understanding these factors helps individuals stay informed and take steps toward prevention.

• Tobacco Use: Using tobacco in any form, smoking cigarettes, cigars, pipes, or chewing smokeless tobacco, is the single biggest cause of oral cancer. Tobacco contains harmful carcinogens such as nitrosamines and benzopyrenes, which damage the DNA in the cells lining the mouth and throat, increasing the risk of cancerous changes.
• Alcohol Consumption: Heavy and regular alcohol intake significantly raises the risk of oral cancer. Alcohol irritates the mucous membranes of the mouth, making them more susceptible to damage from carcinogens. When combined with tobacco use, the risk multiplies, as alcohol helps harmful chemicals penetrate oral tissues more easily.
• Areca Nut Consumption: Areca nut or betel nut or supari usage can lead to oral cancers.
• Excessive Sun Exposure: Prolonged exposure to ultraviolet (UV) radiation from the sun can damage the lips and surrounding skin, increasing the risk of lip cancer. Individuals who spend extended time outdoors without adequate lip protection are more vulnerable to this type of oral cancer.
• Poor Oral Hygiene and Chronic Irritation: Neglecting oral health or experiencing chronic irritation from rough teeth, ill-fitting dentures, or dental infections can increase oral cancer risk. Maintaining good dental hygiene and regular dental check-ups help reduce this risk by preventing persistent inflammation.
• Age: The risk of developing oral cancer increases with age, with most cases occurring in individuals over 40. However, younger people can also be affected, particularly due to factors like HPV infection.
• Gender: Men are statistically more likely to develop oral cancer than women. This difference is largely attributed to higher rates of tobacco and alcohol use among men, although this gap is narrowing in some regions.
• Diet and Nutrition: A diet low in fresh fruits and vegetables may increase the risk of oral cancer. Nutrients and antioxidants found in a balanced diet help protect cells from damage and support the immune system’s ability to prevent cancerous changes.
• Weakened Immune System: Individuals with weakened immune systems, whether due to medical conditions, medications, or infections, are at a higher risk of developing oral cancer. A strong immune system plays a critical role in identifying and eliminating abnormal cells before they become cancerous.
• Genetic Predisposition: A family history of cancer can increase one’s susceptibility to oral cancer. Genetic factors may affect how an individual’s body responds to environmental risks and repairs damaged cells.

While oral cancer can affect anyone, certain lifestyle choices, infections, environmental exposures, and biological factors significantly raise the risk. Awareness of these causes and risk factors is key to early detection and prevention. Regular dental visits, avoiding tobacco and excessive alcohol, protecting lips from the sun, maintaining good oral hygiene, and a balanced diet all contribute to lowering your risk of oral cancer.

Early detection of oral cancer significantly improves treatment outcomes and overall prognosis. Many symptoms of oral cancer can mimic common, non-serious conditions, making it easy to overlook the warning signs. However, recognizing persistent or unusual changes in the mouth, throat, or neck is key to catching the disease at an early and more treatable stage.

Mouth Sores That Don’t Heal

A sore, ulcer, or lesion in the mouth or on the lips that doesn’t heal within 2–3 weeks may be a sign of oral cancer. Unlike canker sores, cancer-related sores may be initially painless and persist or grow over time.

Lumps or Thickening in the Mouth or Neck

Another common sign of oral cancer is a lump, bump, or area of thickening in the cheek, gums, or neck that feels firm and does not go away. Cancerous lumps usually grow over time and can be painless or painful.

Red or White Patches

Caused by chronic irritation, red or white patches indicate cell changes that can lead to oral squamous cell carcinoma, the most common type of oral cancer. Both red and white patches forming together can mean that the individual is at a higher risk for oral cancer.

Difficulty Swallowing

Dysphagia or difficulty swallowing can be caused by:

• A cancerous tumour in the mouth, throat (oropharynx), or surrounding areas that obstructs or narrows the passageway involved in swallowing
• Cancerous sores, inflammation, or ulcerations in the mouth or throat
• Poor coordination between nerves and muscles (affected by oral cancer) involved in swallowing

Chronic Mouth or Throat Pain

As oral cancer develops, tumours may form on the tongue, gums, inner cheeks, throat, or other parts of the oral cavity. These tumors can press on nerves or damage surrounding tissues, leading to chronic pain.

Unexplained Bleeding in the Mouth

As cancerous tumours grow, they can erode blood vessels and tissues, making them more likely to bleed without any apparent cause. Chronic inflammation and secondary infections caused by oral cancer can also lead to bleeding. 

Decreased Mouth Opening

Trismus may happen because of oral sub-mucous fibrosis. This can happen because of areca/betel nut usage.

Decreased tongue mobility

With advanced cancer tongue protrusion and movement may get restricted

Early and accurate diagnosis of oral cancer is crucial for effective treatment, which improves patient outcomes. Here are some oral cancer diagnostic techniques that healthcare professionals use to diagnose cancer at its earliest stages, when it is most treatable.

Clinical Examination

A thorough examination of the oral cavity is the first step. The doctor visually inspects the mouth, tongue, gums, cheeks, and throat for any abnormalities such as non-healing ulcers, red or white patches, or lumps. Palpation (touch-based examination) may also be used to detect any masses or tissue changes.

Adjunctive Screening Techniques

These are used to enhance the accuracy of visual inspections and help identify areas that may need further evaluation:

• Toluidine Blue Staining: A blue dye is applied to the mouth’s lining. Areas that retain the dye (typically turning dark blue) may indicate abnormal or cancerous tissue.
• Brush Biopsy (OralCDx): A non-invasive method where a brush is used to collect cells from suspicious lesions. These cells are then analyzed for precancerous or cancerous changes.
• Chemiluminescence (e.g., ViziLite, Microlux DL): The patient rinses with a vinegar-like solution before a special light is used to highlight abnormal tissues, which often appear white under the light.

Biopsy

A biopsy is the definitive diagnostic tool for oral cancer. A small sample of tissue is collected from the suspicious area and examined under a microscope. Types of biopsy may include:

• Incisional Biopsy: A portion of the abnormal tissue is removed.
• Excisional Biopsy: The entire lesion is removed, typically used for smaller growths.

Histopathological Examination

The tissue sample from the biopsy is stained and studied under a microscope to confirm the presence of cancer cells. This examination also helps determine the type and grade of cancer—important factors in planning treatment.

Imaging Tests

If cancer is confirmed, imaging may be used to assess the extent of spread (staging):

• X-rays (including dental or panoramic X-rays)
• CT Scan (Computed Tomography)
• MRI (Magnetic Resonance Imaging)
• PET Scan (Positron Emission Tomography)

These scans help evaluate the size of the tumour, involvement of surrounding tissues, and whether cancer has metastasized to lymph nodes or other organs.

Timely oral cancer treatment can help prevent cancer from spreading to other parts of the body, improving patient outcomes. Here are some oral cancer treatment options:

Surgery

Usually, surgery is the first-line treatment for oral cancer. The main goal of surgery is to remove the cancerous tumour from the mouth with a cuff of normal tissue around for margins.

After a part of the mouth or face is removed, reconstructive surgery may be needed to restore appearance and function (such as speaking, chewing, and swallowing).

If cancer has spread to the lymph nodes in the neck, a procedure called neck dissection may be performed to remove affected lymph nodes and prevent cancer from further spreading.

Radiation Therapy

Also known as radiotherapy, radiation therapy uses high-energy rays (for example X-rays, gamma rays, and particle beams) to damage the DNA of abnormal cells. Because cancer cells grow and divide more quickly than normal cells, they are less able to repair this damage and die as a result.

Chemotherapy

In chemotherapy, chemotherapy drugs such as Carboplatin, Cisplatin, and 5-FU are introduced directly into the bloodstream or administered orally. Once absorbed into the bloodstream, chemotherapy drugs:

• Identify and attack rapidly dividing cells, including cancer cells
• Interfere with the cell cycle (depending on the drug type), leading to the destruction of cancer cells

Immunotherapy

Used when cancer has metastasized and other treatments have failed, immunotherapy utilizes substances, either made by the body or in a lab, to stimulate or restore the immune system’s ability to fight cancer.

Targeted Therapy

This is combined with other oral cancer treatment options, targeted therapy uses drugs or other substances that specifically target the molecular changes or abnormal proteins that help cancer cells survive and grow. It can: 

• Block cell signals that instruct cancer cells to grow and spread
• Prevent new blood vessels that tumours need to grow from forming
• Affect specific signalling pathways to trigger cancer cell death

Here are some oral cancer complications that can affect a patient’s health, quality of life, and treatment outcomes.

Tissue Destruction

When abnormal cells in the oral cavity divide uncontrollably, they can:

• Group together to form a tumour, which can erode tissues in the tongue, cheeks, gums, or jawbone
• Cause necrosis (tissue death). Necrotic tissue can become ulcerated or infected, and may lead to further destruction of healthy tissue

Breathing Problems

Here are some ways in which oral cancer can cause breathing problems:

• If a tumour in the oral cavity grows large enough, it can partially or completely block the airway or respiratory tract
• Cancer can spread to nearby structures such as the pharynx (throat), larynx (voice box), or trachea (windpipe), impeding airflow
• Mouth infections can occur after oral cancer surgery. An infection can lead to the formation of abscesses, which can interfere with breathing
• If oral cancer affects nerves controlling the muscles of the tongue, throat, or voice box, it can affect the airway causing breathing difficulties

Dysphagia or Difficulty Swallowing

Tumours in the oropharynx, soft palate, or tongue base may make swallowing difficult or painful. As a result, many patients avoid eating, and may even reduce their fluid intake. Such individuals are at a high risk of malnutrition and dehydration.

While like other types of cancers, oral cancer isn’t 100% preventable, individuals can follow these tips to significantly reduce their risk of this type of cancer:

Steer Clear of Tobacco Products 

Tobacco use is the leading cause of oral cancer. Studies show that quitting tobacco can reduce the risk of oral cancer by 35-50%. In addition to quitting tobacco, individuals should avoid secondhand tobacco smoke to rescue their exposure to carcinogens.

Limit Alcohol Consumption

Alcohol can irritate and damage the cells lining the mouth and throat, increasing the risk of mutations that can lead to oral cancer. To reduce oral cancer risk, one should avoid binge drinking. Those who can’t stop drinking should limit their alcohol intake to 1 drink/day (for women) or 2 drinks/day (for men).

Avoid Betel Quid and Areca Nut

Betel quid usually contains areca nuts and sometimes tobacco. Both areca nut and tobacco use is a major risk factor for oral cancer. Avoiding betel quid and areca nut is a great way to reduce one’s risk of oral cancer.

Get Vaccinated Against HPV

HPV-16, a strain of the human papillomavirus, a sexually transmitted virus, is linked to most HPV-related oral cancer cases. To reduce the risk of HPV transmission, one should get vaccinated, use protection during oral sex, and limit the number of sexual partners.

Practice Good Oral Hygiene

Poor oral hygiene can lead to chronic irritation and infections that can increase oral cancer risk. To prevent oral health problems, one should:

• Brush twice a day and floss once every day
• Use mouthwash as recommended
• Visit their dentist regularly (every 6 months or as advised)

Can oral cancer be hereditary?

While most cases of oral cancer are linked to lifestyle and environmental factors, a family history of cancer may increase susceptibility. Individuals with genetic mutations that affect cell repair and immunity may be at higher risk, even without common risk factors like smoking or alcohol use.

Is oral cancer contagious?

Oral cancer itself is not contagious.

How long does oral cancer take to develop?

Oral cancer often develops gradually over several months to years. Precancerous lesions, such as leukoplakia or erythroplakia, may precede cancer. Early-stage lesions are often asymptomatic, which is why routine dental exams and oral screenings are essential.

What does a cancerous lesion in the mouth look like?

Cancerous lesions may appear as persistent ulcers, red or white patches, thickened tissue, or lumps. These often do not heal on their own and may bleed, harden, or become painful over time. However, only a biopsy can confirm whether a lesion is cancerous.

Who should get screened for oral cancer?

Routine oral cancer screenings are especially important for individuals over 40 and those with risk factors such as tobacco/alcohol use, HPV infection, or poor oral hygiene. However, anyone noticing unusual symptoms (e.g., non-healing sores or difficulty swallowing) should consult a healthcare provider.

Can oral cancer relapse after treatment?

Yes, oral cancer can recur, especially within the first 2 to 3 years after treatment. Regular follow-ups, lifestyle modifications, and adherence to medical advice are essential to reduce the risk of recurrence and detect any signs early.

What are the long-term side effects of oral cancer treatment?

Long-term effects vary depending on the treatment used but may include dry mouth (xerostomia), changes in taste, speech difficulties, difficulty chewing/swallowing, jaw stiffness (trismus), and cosmetic or functional impairments after surgery.

Can oral cancer affect your voice?

Yes, if cancer affects areas like the base of the tongue, throat, or voice box—or if radiation or surgery involves those areas—it may result in hoarseness, changes in voice quality, or reduced vocal strength.

Is oral cancer more aggressive than other cancers?

Oral cancer can be aggressive if not detected early. It tends to spread quickly to nearby lymph nodes and tissues. However, with early diagnosis and comprehensive treatment, survival rates are significantly improved.

Can oral cancer affect eating and nutrition?

Absolutely. Tumours or treatment can cause pain, difficulty chewing, swallowing, or a loss of appetite. Nutritional counseling is often part of cancer care to ensure patients receive adequate calories and nutrients during recovery.

Reviewed by Dr Akshit Malik, Principal Consultant, Surgical Oncology, Cancer Care Oncology, Head & Neck Oncology, Robotic Surgery, on 01 July 2025.

1. What Do You Need to Know About Oral Cancer?
2. Oral Cancer: Symptoms, Causes, and Treatments
3. Tobacco and Oral Cancer