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Mouth cancer Q&As

Published by Bupa's health information team, March 2009.

Answers to questions about mouth cancer

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

 

Will I have trouble eating and drinking after my treatment?

Yes, you might do. All of the treatments for mouth cancer can affect your ability to eat and drink and have an impact on your enjoyment of food. Your doctor and nurse can advise you on ways to help ease the symptoms and get the food and fluids you need.

Explanation

The treatments for mouth cancer can affect how you eat and drink. You might find that you have problems chewing your food or swallowing it. Your treatment might affect your sense of taste and smell, which are important for your enjoyment of food and drink. These things can also cause you to lose weight.

Things that can make swallowing difficult include:

  • any operation on your jaw, mouth, throat or tongue as this will cause swelling and pain
  • radiotherapy to your mouth or neck which can make your throat and mouth very sore

You may be prescribed painkillers to relieve any pain and reduce redness and swelling. This may be in the form of a liquid, or there are also painkillers available that you wash around your mouth and which form a protective coating. Keeping your mouth and teeth clean can ease your symptoms and also help to prevent infection. Don't eat spicy foods, smoke or drink alcohol as this can make your mouth more painful.

You may not be swallowing properly and this can lead to aspiration - this means small amounts of liquid or food may be leaking into your windpipe (trachea) rather than going into your oesophagus (the pipe that goes from your mouth to your stomach) as it should. Your doctor will arrange for you to have a test called a videoflouroscopy to see how well you can swallow. If this shows that food and drink aren't going into your stomach when you swallow, you may need to have a thin, plastic tube inserted through the skin of your abdomen and into your stomach so that you get all the food you need.

Most people find that as the swelling goes down their swallowing improves and the tube can be removed. This can take a while and your ability to swallow may take some time to recover. It may not recover to the same state as before surgery. Your speech and language therapist will give you exercises and advice on how to make eating and swallowing easier.

Sources

  • Eating after mouth cancer. Cancer Research UK. www.cancerhelp.org.uk, accessed 3 June 2008
  • Changes to eating after treatment for head and neck cancer. Macmillan Cancer Support. www.macmillan.org.uk, accessed 3 June 2008
  • Scully C, Porter S. ABC of oral health - oral cancer. BMJ 2000; 321(7253): 97-100
  • Cancer treatment and oral mucositis. Macmillan Cancer Support. www.macmillan.org.uk, accessed 3 June 2008
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Since having treatment for mouth cancer, I've had a really dry mouth. Is there anything I can do to make this better?

Dry mouth can often be caused by radiotherapy. There are things you can do to ease your symptoms.

Explanation

Dry mouth can make it difficult for you to swallow or speak and can put you at risk of infection and tooth decay. Some tips that may make you feel more comfortable include:

  • chewing sugar-free chewing gum
  • taking small sips of water often, especially when you're eating
  • eating moist foods with sauces or gravy
  • sucking ice chips
  • using artificial saliva and mouth moisteners
  • having regular check-ups at the dentist to check for infection and keep your mouth healthy - it's important to prevent tooth decay
  • not smoking or drinking alcohol as this can make your mouth even drier
  • using acupuncture to ease the symptoms

Sources

  • Eating after mouth cancer. Cancer Research UK. www.cancerhelp.org.uk, accessed 3 June 2008
  • Scully C, Porter S. ABC of oral health - oral cancer. BMJ 2000; 321(7253): 97-100
  • Daily mouth care. Cancer Research UK. www.cancerhelp.org.uk, accessed 3 June 2008
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Lots of the foods that I used to enjoy eating taste odd or have no flavour to me now. What can I do to improve this?

If you have had treatment for mouth cancer, it's quite common for your sense of taste to be affected. This can put you off eating and cause you to lose weight.

Explanation

Radiotherapy and some types of chemotherapy can affect your sense of taste and make your food taste peculiar. This can have a big impact on your enjoyment of food. You might find that all foods seem to taste the same or have a metallic, salty or bitter taste. Losing either your sense of taste or smell can affect your appetite so you don't feel like eating, but it's important to try to eat a healthy balanced diet so that you don't lose weight. Some tips to help are listed below.

  • If a food tastes strange to you, don't eat it but keep trying it every few weeks to see if your sense of taste gets better.
  • Eat foods that have a strong flavour. This might mean choosing stronger versions of the foods you like such as cheese. Cook foods using marinades and strong flavours like garlic, herbs or lemon juice. Take care with spicy foods though as these can sometimes irritate a dry or sore mouth.
  • Try eating different foods with new textures and be creative with the foods you eat.
  • You might want to stop eating your favourite foods while you're having chemotherapy so that it doesn't put you off them for good.
  • If you're losing weight, try eating little and often rather than having big meals. You could also try drinks that contain lots of calories to replace your meals, for example Complan or Fresubin. If you're losing a lot of weight, choose foods that are high in fat and have lots of calories, such as full-fat milk and yogurt.
  • Get advice from your dietitian if you're worried about your weight or the foods you're able to eat.

Further information

Sources

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Will I still be able to talk after treatment?

Cancer of the mouth and the treatments for it can both cause speech problems. These include changes to the way your voice sounds as well as how you talk and how fluent you are. If the whole of your voice box (larynx) is removed, you won't be able to speak in the usual way.

Explanation

Some people do have problems speaking after treatment for mouth cancer. Whereabouts in your mouth the cancer is and the kind of treatment you need are the main factors that will affect whether or not you have problems. You're more likely to have difficulties if you have cancer that affects your tongue, lips or soft palate (part of the roof of your mouth towards the back). If you have teeth removed as part of your surgery or have all or part of your voice box (larynx) taken out, this will affect your ability to speak.

Mouth cancer and its treatments may cause you to slur or have problems saying certain words or sounds. Your voice may also sound different - you might sound quieter, husky or as if you have a cold.

You may also need to have a tracheostomy if your windpipe is blocked or you can't use it, for example if your voice box is swollen after radiotherapy. This is when a breathing tube is inserted through the front of your neck. A tracheostomy may be temporary if it's to relieve swelling or permanent if you have had your voice box removed or there is more serious damage to your airway.

If your voice box is still working, to speak with a tracheostomy you will need to block the hole in your neck with your finger. This allows the air to pass through your voice box so you can speak.

If you have had your voice box removed, you will need to have a tracheostomy with a speech valve inserted or learn to speak from your oesophagus (the pipe that goes from your mouth to your stomach). Your surgeon can give you more information about the options available to you.

A speech and language therapist will be involved in your care from the start and can help you learn to cope with changes to your voice or the way you have to speak. Speech therapy can help you to communicate effectively and clearly. You might be given exercises to do which improve the way your tongue and mouth move or which help you develop new ways to make sounds and speech.

Therapy will continue for as long as you need it and are improving. This can mean months of therapy both while you're in hospital and when you go home. It takes time to adjust to any changes in your speech and your ability to communicate with other people. You might find it useful to carry a notebook and pen with you and to tell people straight away that you have had an operation that means you have problems speaking. The important thing is to give yourself time to adjust and get help if you need it.

Further information

Sources

  • Head and neck cancer. Association of Speech and Language Therapists in Independent Practice. www.helpwithtalking.com, accessed 9 June 2008
  • Changes to your speech due to mouth cancer. Cancer Research UK. www.cancerhelp.org.uk, accessed 9 June 2008
  • Changes to speech after treatment for head and neck cancer. Macmillan Cancer Support. www.macmillan.org.uk, accessed 9 June 2008
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I've got an ulcer in my mouth - how can I tell if it's cancer or not?

Mouth cancer is relatively uncommon compared to other types of cancer. The two main symptoms are an ulcer that doesn't heal and a lump in your mouth or neck that doesn't go away. Mouth cancer usually isn't painful. See your dentist and check your mouth regularly so that any symptoms of cancer are spotted early. The sooner any cancer is found and treated the better your chances of a full recovery will be.

Explanation

Compared with many other types of cancer, cancer of the mouth is uncommon. In every 300 people who have cancer only one will have mouth cancer. Most mouth cancers develop in the lining (mucosa) of the mouth.

One of the main symptoms of mouth cancer is an ulcer that doesn't heal - eight out of 10 people with mouth cancer have this symptom. It's important that you're aware that mouth cancer usually isn't painful so if you have any symptoms you're worried about, see your GP or dentist.

There are other symptoms of mouth cancer. The following symptoms aren't always due to cancer but if you have them, you should visit your GP.

  • Red or white patches on the lining of your mouth that have been there for more than three weeks can be a sign of cancer or pre-cancer. If you have pre-cancer, being treated can help to prevent the development of cancer.
  • You may have problems chewing or swallowing, difficulty moving your jaw or a feeling that something is caught in your throat.
  • A lump in your neck or swelling in your mouth or on your lip that has been there for longer than three weeks could be a swollen lymph node - this is a common symptom of some types of mouth cancer that have spread.
  • You may have loose teeth for no specific reason.
  • It's possible you will have unusual bleeding in your mouth or a feeling of numbness.
  • Bad breath can be a problem - most people have bad breath from time to time but if you have mouth cancer it may be worse or happen more often.
  • Mouth cancer can make your voice sound different - husky or quieter. You may sound as though you're slurring your words.
  • A common symptom of many types of cancer is weight loss. You might be eating less because of pain or problems with swallowing.

It's important to check the inside of your mouth and visit your dentist regularly. Dentists and dental hygienists are specially trained to examine your mouth for signs of cancer. Your dentist should examine you every time you go for a routine appointment. He or she can refer you to a doctor or surgeon if they see something unusual or concerning. If you do have cancer, the sooner it's found and treated the better your chances of a full recovery will be.

Further information

Sources

  • What are the symptoms of cancer of the mouth? Macmillan Cancer Support. www.macmillan.org.uk, accessed 9 June 2008
  • Symptoms of mouth cancer. Cancer Research UK. www.cancerhelp.org.uk, accessed 10 June 2008
  • Symptoms and screening. Mouth cancer awareness week. British Dental Health Foundation. www.mouthcancer.org, accessed 10 June 2008
  • Mouth cancer referral guidelines for dentists. Cancer Research UK. http://info.cancerresearchuk.org, accessed 10 June 2008
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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: March 2009

 

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