Floor of the Mouth Cancer: Symptoms, Causes, Treatments, and More

The human mouth is susceptible to cancer, like any other part of the body. Mouth cancers typically begin in the inner cheek, gums, hard palate, lips, tongue, and floor of the mouth. The latter is the main focus of this post. The floor of the mouth cancer deserves more attention, and this post aims to shed more light on its symptoms, causes, and treatment options. Read on to learn more.

What is Floor of the Mouth Cancer?

Floor of mouth cancer is a type of oral cancer that forms in the tissues of the mouth, primarily the area underneath the tongue. As a subset of oral cavity cancers, this disease can affect the functionality of the mouth and impair speaking or swallowing abilities.

This specific cancer typically forms in the squamous cells, thin and flat cells located in the lining of the mouth. The term for cancers that involve these cells is squamous cell carcinoma.

Although a serious disease, floor of the mouth cancer is treatable, sometimes people mistake this cancer for canker sore, which is why it’s important to see a doctor if you believe you have a sore that simply won’t heal.

Symptoms of Floor of the Mouth Cancer

Early stages of this cancer are usually asymptomatic i.e., there may be no symptoms. As the cancer spreads, a wide range of symptoms may appear. The most common signs and symptoms of the floor of the mouth cancer include:

• Persistent sores in the mouth
• Sores continue to grow larger
• Painless ulcers or lumps in the mouth
• Pain or swelling in the mouth or jaw
• Difficulty moving the tongue and jaw
• Difficulty and pain when swallowing
• Loose teeth or pain around teeth
• Dentures no longer fit
• Ear pain
• Weight loss
• Painful swelling in the neck
• Persistent white, dark, or red patches in the mouth

Causes of Floor of the Mouth Cancer

The main cause of floor of mouth cancer is the development of mutations in the DNA of cells located under the tongue. DNA contains instructions necessary for the development, survival, and reproduction of a specific organism. In cells, the role of DNA is to provide instructions for their growth. DNA also instructs cells on how to multiply. Healthy cells grow and multiply at a fixed rate.

Mutations in DNA interrupt this process. When that happens, cells start multiplying and growing uncontrollably. Instead of dying at a specific time, these cells continue to live. As a result, there are more and more abnormal cells that pave the way to the formation of tumors.

Although the floor of the mouth cancer results from mutations in DNA of the cells the exact reason behind it is unclear. At this point, it’s unknown why DNA mutations happen or why cells start dividing uncontrollably. One potential reason is genetics. Oral cancers have a genetic component meaning parents can pass on specific gene mutations to their children. However, genetics is not the only factor in the development of floor of mouth cancer.

Risk Factors for Floor of the Mouth Cancer

While everyone can develop floor of mouth cancer, some people are more susceptible to this disease. Common risk factors for this type of cancer include:

• Being male
• All forms of tobacco use (smoking cigarettes, cigars, pipes, snuff, and chewing tobacco)
• Frequent and heavy alcohol consumption
• Exposure to human papillomavirus (HPV), particularly strains 16 and 18
• Weakened immune system due to medicines and illnesses such as HIV
• Being an organ transplant recipient
• Overweight or obesity

How is Floor of the Mouth Cancer Diagnosed?

Diagnosing floor of the mouth cancer may include the following:

• Physical exam of mouth and neck: a doctor may use a tongue depressor tool to look at the floor of the mouth. They proceed to check the inside of the mouth and cheeks for the presence of lumps or sores. During a physical exam, the doctor checks your neck to determine whether the lymph nodes are swollen. As the cancer spreads and progresses, it tends to affect lymph nodes first, which is why swelling may be present.
• Biopsy: the procedure where a doctor takes a sample of tissue or cells from the mouth. Laboratory analysis of the sample shows whether the cells are cancerous or not.
• Imaging tests: doctors order imaging tests because they display the size and location of a tumor. Common imaging tests for floor-of-the-mouth cancer diagnosis are X-ray, CT, MRI, and PET scan.

Stages of the floor of the mouth cancer

Once a doctor diagnoses the floor of the mouth cancer, they determine the stage or severity of the disease. Staging is necessary because it provides more information about the cancer and shapes the treatment process.

The stages of oral cancers are:

• Stage 0: abnormal cells with the potential to become cancerous are present in the lining of the tissues.
• Stage 1: the tumor is not longer than 2 centimeters (cm) and the cancer didn’t reach lymph nodes or other tissues.
• Stage 2: tumor is larger than 2cm, but shorter than 4cm and it didn’t spread to lymph nodes or other tissues and organs.
• Stage 3: the tumor is larger than 4cm and has spread to a lymph node located in the neck.
• Stage 4: advanced cancer, regardless of the size of the tumor, which spreads to nearby tissue, one large lymph node, and distant parts of the body.

How is Floor of the Mouth Cancer Treated?

Treatment of floor of the mouth cancer depends on the stage of the disease. The most common treatment for this cancer is surgery, especially in the early stages. Advanced stages of cancer require a combination of surgery and other treatment approaches, such as chemotherapy.

The oncologist recommends the most suitable surgical approach based on the stage of the disease. One surgical option is to remove the cancer and a part of healthy tissue around it to be certain the whole cancer is removed. In cases when the cancer spreads to the tongue or jaw, the doctor may recommend surgery to remove a part of these tissues.

Since removing a part of the tongue or jaw may cause difficulties swallowing or speaking, physical therapy can help manage these challenges.

Besides removing cancer, treatment for this disease may involve surgery to remove lymph nodes in the neck and reconstructive surgery. Removal of lymph nodes in the neck is only recommended when it’s clear the cancer has affected these tissues, but sometimes an oncologist may recommend this operation as a precautionary measure.

Reconstructive surgery is performed after removal of parts of the jaw, face, or neck. It is usually done by taking tissue or bone from other parts of the body. Then, bone or tissue is implanted to fill the gaps in the parts of the jaw, face, or neck that were removed.

In addition to surgery, treatment for this cancer may include:

• Chemotherapy: uses medications to destroy cancer cells. Doctors may recommend chemotherapy after the surgery to destroy cancer cells that may have been left behind.
• Radiation therapy: uses a powerful source such as X-ray to kill cancer cells. Like chemotherapy, it may be used after the surgery to destroy remaining cancer cells. Sometimes radiation therapy is used together with chemotherapy to kill cancer cells more effectively. Additionally, radiation therapy is recommended when surgery isn’t an option.
• Targeted therapy: relies on medications to target specific characteristics or abnormalities in cancer cells. By targeting these abnormalities, target therapy destroys those cells.
• Photodynamic therapy: involves medicine that makes cancer cells sensitive to light, after which they die.
• Immunotherapy: uses medications to strengthen the immune system’s defenses and thereby destroy cancer cells.

How do you lower the risk of floor of mouth cancer?

You can minimize your risk of developing floor of the mouth cancer by:

• Quitting smoking or avoiding any form of tobacco use
• Reducing or avoiding alcohol consumption
• Receiving a vaccine to prevent HPV
• Getting dental exams and attending checkups regularly
• Eating a healthy diet rich in fruits and vegetables

Treatment of Floor of the Mouth Cancer at King’s College Hospital London in Dubai

Floor of the mouth cancer is a curable disease when diagnosed early and treated properly. A well-structured treatment approach is crucial for recovery and improved quality of life, which is why it’s necessary to make sure world-class specialists are taking care of you.

King’s College Hospital London in Dubai has a multidisciplinary team of surgeons and oncologists who rely on the latest techniques and the most advanced treatment methods to help you overcome this disease.

Schedule an appointment to learn more about treating floor of the mouth cancer at King’s College Hospital London in Dubai.