Gum Cancer: Symptoms, Causes, Treatment and Prevention

Key Takeaways

• Gum cancer forms when cells in the gums grow out of control, forming lesions or tumors. I
• The symptoms of gum cancer include but are not limited to, rough or crusty spots on the gums, loose teeth, and bleeding along the gums.
• Gum cancer can often be confused with other common problems like gingivitis, lip sores, or dry patches on the inside of the mouth. 
• If your dentist sees possible symptoms of gum cancer, they will follow up with preliminary tests or refer you to an oral cancer specialist. Treatments may include chemotherapy, radiation therapy, and immunotherapy.

What is Gum Cancer?

Gum cancer is a type of mouth or oral cancer. It forms when cells in the gums grow out of control, forming lesions or tumors.

Oral cancer is in the category of head and neck cancers, and doctors treat them similarly. Lesions, growths, and tumors in the mouth characterize oral cancer. They can occur on the:

• Lips
• Tongue
• Gums
• Cheek lining
• The mouth’s roof or floor

What are the Symptoms of Gum Cancer?

Oral cancer has symptoms similar to other common and less severe problems. Rough or dry patches on the gums or inside of the mouth may be signs of precancerous conditions. Gum cancer is commonly mistaken for gingivitis. 

Other symptoms of gum (and mouth) cancer include:

• Rough spots and crusty areas on the gums
• Loose teeth
• Bleeding along the gums
• Sores and lesions on the gums that don’t heal
• Difficulty chewing and swallowing
• Difficulty moving your jaw or tongue
• Speech problems
• Weight loss
• Earache
• Chronic bad breath
• Erythroleukoplakia (red and white patches)
• Erythroplakia (raised red and white patches that easily bleed)
• Leukoplakia (flat white or gray patches in your mouth)
• Pain, numbness, and tenderness inside your mouth, on your face, or around your neck
• Enlarged lymph nodes
• Chronic hoarse voice

What Does Gum Cancer Look Like?

Gum cancer typically looks like:

• Red or white patches lining the gums
• A growth or lump in the mouth or gums
• Loose teeth
• Mouth sores that easily bleed and don’t heal properly
• Chronic bad breath
• Crusty spots and rough areas on the gums
• Lesions on the tongue, soft palate, or lining of the mouth

The Oral Cancer Foundation (OCF) provides photos of gum cancer on its website.

Risk Factors for Gum Cancer and Other Oral Cancers

The National Cancer Institute (NCI), Cleveland Clinic, and American Cancer Society (ACS) report on the risk factors for oral cancer. 

About three out of four people who develop gum cancer and other mouth cancers practice one or more of the following habits:¹

• Smoke cigarettes, cigars, or pipes
• Use smokeless tobacco products, like chewing tobacco, snuff, dip, or hookah
• Regularly drinking excessive amounts of alcohol
• Spend a lot of time in direct sunlight without lip protection 

People who have human papillomavirus (HPV) and/or a family history of mouth cancer are also more prone to developing gum and other mouth cancers

Who Does Oral Cancer Affect?

Men are at higher risk of developing oral cancer compared to women. Light-skinned people are slightly more likely to develop oral cancer than dark-skinned people.²

According to one study:²

• About 1 in 60 men have a lifetime risk of developing oral cavity and oropharyngeal cancer
• The same is true for 1 in 140 women
• The average age physicians diagnose oral cavity or oropharyngeal cancer is 63

How Does Oral Cancer Affect the Body?

Mouth cancer may affect your oral cavity and your oropharynx. Your oropharynx consists of parts of the tongue, the roof of the mouth, the area behind your wisdom teeth, and the part of the throat that is visible when the mouth is wide open. 

Oropharyngeal cancer (throat cancer) is cancer in your oropharynx and can occur concurrently with mouth cancer. Oral cancer can be confused with other common problems like gingivitis, lip sores, or dry patches on the inside of the mouth. 

Gum and other types of oral cancer can spread to other parts of the body, including the:

• Lips
• Cheek lining
• Tongue
• Head
• Neck

Oral cancer causes the cells of the affected area to grow and multiply. It can cause:

• Lesions
• Rough patches
• Discomfort
• Pain

It is best to diagnose and treat oral cancer early. This is essential to stop cancerous cells from growing. It also allows doctors to perform any other necessary treatments before the problem worsens.

How is Gum Cancer Diagnosed?

Dentists usually identify gum cancer through an oral cancer exam. If they spot a potential symptom or early sign of oral cavity cancer, they will follow up with preliminary tests or refer you to an oral cancer specialist. 

Oral cancer specialists include: 

• Oral surgeons
• Maxillofacial surgeons
• Head and neck surgeons

These specialists are commonly known as ear, nose, and throat (ENT) surgeons. The next step after the oral cancer exam is conducting tests to determine if it is mouth cancer. 

These tests include:

Physical Examination

Your doctor will examine the entirety of your oral cavity and may feel around your mouth. They will also examine your head, face, and neck for any warning signs of oral cancer.

Brush Biopsy

A brush biopsy is also known as a scrape biopsy or exfoliative cytology. Doctors use a tool to scrape mouth areas to test cells for cancer.

Incisional Biopsy

Like a brush biopsy, the doctor removes pieces of cells to test for cancer. However, they use an incision tool rather than a scraping tool.

Indirect Laryngoscopy and Pharyngoscopy

The doctor uses a tool with a small mirror on one end to visibly examine the throat, the base of the tongue, and the larynx.

Direct (Flexible) Pharyngoscopy and Laryngoscopy

The doctor uses an endoscope to look at other areas of the mouth and throat that aren’t visible with a mirror. An endoscope has a small lens with a light attached to a thin pole. This can detect oral cancer. 

How is Gum Cancer Treated? 

Physicians advise early oral cavity cancer treatment for best outcomes. Gum cancer and other mouth cancers have three main treatment options:

• Surgery
• Radiation therapy
• Chemotherapy

The best treatment for oral cancer depends on your health, age, preference, risk factors, stage and type of cancer, and whether or not it has spread to other parts of the body. Therefore, treatment options vary.

Some treatments for oral cancer include:

• Primary tumor surgery — removal of the tumor through your oral cavity or an incision in the neck via neck surgery.
• Glossectomy — partial or total removal of the tongue.
• Mandibulectomy — surgery for oral cancer in your jaw.
• Neck dissection — removal of lymph nodes from the neck.
• Maxillectomy — removal of all or part of the bony roof of the mouth, also known as the hard palate.
• Reconstruction — surgeons perform reconstruction after removing large pieces of tissue. Reconstruction surgery fills in the spaces left by other surgeries.

Chemotherapy

This treatment involves anti-cancer drugs that target and kill cancer cells.

Radiation Therapy

Beams of radiation energy target cancer cells to kill them or halt any additional oral cancer growth. Physicians may combine radiation therapy with other cancer treatment options.

Targeted Therapy

Drugs and other substances can precisely identify and kill specific types of cancer cells without harming normal cells.

Monoclonal antibodies are an example of targeted cancer treatment therapy. These antibodies are immune system proteins that help treat oral cancers.

Immunotherapy

Also called biological therapy, immunotherapy supports your immune system to fight oral cancer.

Gum Cancer Prevention Tips

To help prevent oral cancer:

• Use sunscreen, especially on your lips
• Stop smoking tobacco or using smokeless tobacco products; if you cannot stop, try to cut back or speak to your doctor about ways to quit
• Drink alcohol in moderation; talk to your doctor about ways to cut back if you experience difficulty in doing so
• Get the human papillomavirus (HPV) vaccine
• Eat a well-balanced diet
• Schedule routine dental exams; regular exams will help you and your doctor detect oral cancer early

What Causes Gum Cancer?

Gum cancer and other mouth cancers begin in the squamous cells of the oral cavity. Squamous cells are flat cells that look like fish scales under a microscope.

Like other cancers, squamous cells become cancerous when their DNA alters. These squamous cells begin to grow and multiply out of control. 

As oral cancer progresses, the cancerous squamous cells may spread to other areas of the mouth, head, neck, or other body parts.