This form of cancer may originate in the part of the throat at the back of the mouth, or in the oral cavity . The oropharynx includes the back one-third of the tongue, the soft palate, the tonsils, and the back of the throat.  Salivary glands throughout the oral cavity make saliva, which keeps the mouth moist and helps digest food.

When the cancer spreads, it travels through the lymphatic system.  The cancerous cells that enter the lymphatic system are carried along by lymph, an almost colorless fluid containing cells that help fight infection and disease.  Along the lymphatic channels are groups of small organs called lymph nodes.  Oral cancer that spreads usually travels to the lymph nodes in the neck.

It is important to diagnose oral cancer as early as possible because the treatment will  work best if the disease is caught in its infancy.  The National Cancer Institute encourages people to perform a monthly self-examination

Regular dental checkups that include an examination for the mouth are also very important in the early detection of  precancerous conditions.


Oral cancer usually occurs in people over the age of 40 but can develop at any age.  These are some warning signs to watch for:

  • A sore in the mouth that doesn't heal
  • A lump in the cheek
  • Sores on the tongue
  • A red  patch on the gums, or lining of the mouth
  • A feeling that something is stuck in your throat
  • Difficulty chewing
  • Numbness of the mouth
  • Problems swallowing
  • Difficulty moving the jaw
  • Numbness of the tongue
  • Swelling of the jaw that causes dentures to fit poorly or become uncomfortable


If an abnormal area has been found in the mouth, your doctor should have you get a biopsy on the abnormality, since a biopsy is the only way to know if it is cancerous.  Usually, the patient is referred to an oral surgeon or an ear, nose, and throat surgeon, who removes part or all of the lump or abnormal-looking area.  A pathologist examines the tissue under a microscope to check for cancer cells.

Almost all oral cancers are scaly cell tumors.  Scaly cells line the oral cavity.  If the pathologist finds oral cancer, the patient's doctor needs to know the stage that the cancer is in, so they know which plan would be the best treatment.  These tests help the doctor find out whether the cancer has spread and what parts of the body have been affected.

These tests generally will include dental x-rays and x-rays of the head and chest.  The doctor may also want the patient to have a CT Scan.  A CT scan is a series of x-rays put together by a computer to form detailed pictures of areas inside the body.  Ultrasonography is another way to produce pictures of areas in the body.  High frequency sound waves (ultrasound), which cannot be heard by humans, are bounced off organs and tissue.  The pattern of echoes produced by these waves creates a picture called a sonogram.  Sometimes the doctor asks for MRI, a procedure in which pictures are created using a magnet linked to a  computer.  The doctor also feels the lymph nodes in the neck to check for swelling or other changes.  In most cases, the patient will have a complete physical examination before treatment begins.


Before starting treatment, the patient might want a specialist who treats lymphomas to review the diagnosis and treatment plan.  Treatment planning takes into account the type of lymphoma, the stage of disease, whether it is likely to grow slowly or rapidly, and the general health and age of the patient. 

For low-grade lymphomas that usually grow very slowly and cause few symptoms, the doctor may decide to wait until the disease shows signs of spreading before starting treatment.

Treatment for intermediate or high-grade lymphomas usually involves chemotherapy, with or without radiation therapy.  In addition, surgery may be needed to remove a large tumor.  Often, patients are referred to medical centers that specialize in treating lymphomas.

Chemotherapy is the use of drugs to kill cancer cells.  Chemotherapy for non-Hodgkin's lymphomas usually is a combination of several drugs.  Some drugs are given by mouth; others are injected into a blood vessel or muscle.  The drugs travel through the bloodstream to almost every part of the body.  Chemotherapy is usually given in cycles, a treatment period followed by a rest period, then another treatment period, and so on.

Radiation therapy (also called x-ray therapy, radiotherapy, or irradiation), uses high-energy rays to damage cancer cells and stop their growth.  Radiation therapy is generally given in the outpatient department of a hospital or clinic.  Most often, patients receive radiation therapy five days a week for five to six weeks.

Side Effects of Treatment

The methods used to treat lymphomas are very powerful.  That's why treatment often causes side effects.  Fortunately, most side effects are temporary.

The side effects of chemotherapy depend on the drugs given and the individual response of the patient.  Chemotherapy commonly affects rapidly growing cells, such as blood-forming cells and cells that line the digestive tract.  As a result, patients may have side effects, such as lowered resistance to infection, loss of appetite, nausea and vomiting, and mouth sores.  They may also lose their hair.  These side effects usually end after chemotherapy is finished.

During radiation therapy, patients may notice a number of side effects.  They may become unusually tired as the treatment continues.  Resting as much as possible is important.  Skin reaction (redness or dryness) in the area being treated are also common.  Patients should be gentle with the treated area of skin.  Lotions and creams should not be used without the doctor's advice.  When the chest and neck area is treated, patients may have a dry, sore throat, and may have some trouble swallowing.  Sometimes, they have shortness of breath or a dry cough.  Radiation therapy to the abdomen may cause nausea, vomiting, or diarrhea.  Some patients may have tingling or numbness in their arms, legs, and lower back.  These side effects gradually disappear when treatment is over.  To help withstand the side effects of treatment, it is important that patients maintain good nutrition practices.

Source:  Margolis, Simeon, The Johns Hopkins Medical Book, 2000

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