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- Asymptomatic coronary artery disease
- Bone problems
- Cancer-related fatigue
- Central precocious puberty – CPP
- Chronic pain
- Craniofacial growth problems
- Dental and oral problems
- Dyslipidemia
- Eye problems
- Gastro-intestinal problems
- Hair loss
- Health promotion
- Hearing problems
- Heart problems
- Higher risk groups
- HP axis problems
- Hypertension
- Impaired glucose metabolism and diabetes
- Kidney problems
- Liver problems
- Lower urinary tract problems
- Lung problems
- Male fertility problems, testosterone deficiency and sexual dysfunction
- Mental health problems
- Neurocognitive problems
- Obstetric problems
- Overweight and obesity
- Peripheral neuropathy
- Premature ovarian insufficiency
- Psychosocial problems
- Spine scoliosis and kyphosis
- Spleen problems
- Stroke
- Subsequent neoplasms:
- Thyroid problems
SUBSEQUENT NEOPLASMS: ORAL CANCER
This page is part of the PanCare PLAIN summaries about late effects and recommendations for long-term follow-up care for survivors of childhood, adolescent, and young adult cancer. Click here, for more information on the PLAIN summaries.
On this page you can find:
This brochure is a sequel to the brochure Subsequent neoplasms: general. Please read that brochure first before you continue.
This PLAIN summary is based on the PanCareFollowUp guideline about “Subsequent neoplasms” [1], which is based on the consensus of different national guidelines.
PLAIN version 2.1: 27/05/2024
Subsequent cancer: oral cancer
The mouth consists of many different parts, such as the lips, tongue, cheeks, floor and roof of the mouth, salivary glands and throat.
Sometimes, the cells that make up part of the mouth can become malignant. This means that they do not work properly anymore and multiply uncontrollably, causing a tumour to grow. When this happens, this is called mouth cancer, or oral cancer.
Only a very few people who have had cancer before develop oral cancer.
Due to treatment of the first cancer, survivors sometimes have a higher risk of oral cancer. There are a number of things anyone can do to lower the risk of having oral cancer, such as avoiding smoking.
Survivors
The mouth
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Hover over the numbers in the figure for more information.
Am I at higher risk of oral cancer?
Anyone, including people who have never had cancer treatment, may develop oral cancer. However, there are some cancer treatments that may increase the risk of having oral cancer as a subsequent cancer later in life.
The following treatment can increase the risk of oral cancer:
- Radiotherapy to the mouth or an area including the mouth
- Graft versus host disease (GvHD) in the mouth after stem cell transplantation
You can find out if you had radiotherapy to the mouth or GvHD in the mouth by looking at your treatment summary. If you do not have a treatment summary or if you have any questions, do contact your treating hospital.
If you develop oral cancer, it does not always mean that this is caused by treatment for your first cancer. Oral cancer may have other causes, such as smoking tobacco, drinking (too much) alcohol and using recreational drugs. Oral cancer can also be caused by human papillomavirus (HPV).
Graft versus host disease
Stem cell transplantation is a type of cancer treatment that involves taking stem cells from the blood of a donor (‘graft’) and putting them in your body (‘host’). Sometimes these stem cells can attack your own cells because they falsely recognize them as foreign and attack them. This is called GvHD.
GvHD can have serious health implications when you are experiencing it but it can also put you at higher risk of some late effects.
Stem cell transplantation
Stem cell transplantation means that blood stem cells are taken out of the body of a person and transplanted back into the same person (autologous) or to another person (allogeneic).
This procedure is often used to treat diseases such as leukaemia and lymphoma, and some solid tumours (such as neuroblastoma) as well as certain immune system and genetic disorders.
There are different types of stem cell transplants, including:
- Autologous Transplant: Uses the patient’s own stem cells, which are harvested before treatments like chemotherapy or radiation and then returned to the body to help recover.
- Allogeneic Transplant: Uses stem cells from a donor. The donor can be a relative (often a sibling) or someone unrelated with a matching tissue type.
The blood stem cells can be harvested in different ways. They can either be taken out of the blood stream (peripheral blood stem cell transplantation) or out of the bone marrow (bone marrow transplantation).
During the transplantation process, the patient often undergoes a treatment to kill the diseased bone marrow cells before receiving the new stem cells through an intravenous line, similar to a blood transfusion. After the transplant, it takes time for the new stem cells to grow and start producing healthy blood cells, during which the patient needs close medical care to prevent and manage potential complications, such as infections or graft-versus-host disease (in case of allogeneic transplants).
Radiotherapy
Your treatment summary can tell you which areas of your body were irradiated. If you do not have a treatment summary or if you don’t understand what is written about the radiotherapy you received, do contact your treating hospital.
Radiotherapy is a treatment for cancer which uses high-energy radiation to destroy cancer cells and to shrink tumours. The radiation comes from a machine outside the body (external beam radiotherapy) or occasionally from radioactive material that is placed in the body near cancer cells (intracavitary or interstitial radiotherapy). The aim of radiotherapy is to treat only one area of the body, around and near the cancer or where the cancer was before it was removed by surgery and as far as possible to protect unaffected areas. For example, if you have cancer in your lung, you will have radiation only to your chest, not to your whole body.
External beam radiotherapy is painless and takes only a few minutes. It is given once or occasionally twice a day often for several weeks. A radiation beam is like an invisible light beam. The machines which produce the radiation beam can be moved so that the beam enters the body from different directions, ‘spotlighting’ on the area to be treated. This means that the tumour is given a high dose whilst normal areas get either a lower or no dose at all.
Since the early 1980’s computers and other technical advances have improved radiotherapy. Before this there were not many ways to protect normal tissues which were in the path of a radiation beam. Even now, whilst modern techniques allow doctors to target the cancer cells more precisely than older techniques, healthy cells may still get damaged. This can result in some of the late effects covered in the PLAIN summaries. It will help you and your follow up specialist to know what long term effects there might be after your radiotherapy if you and they have your treatment summary.
Your treatment summary can tell you which areas of your body were irradiated. If you do not have a treatment summary or if you don’t understand what is written about the radiotherapy you received, please contact your treating hospital.
What are the symptoms and signs of oral cancer?
There are symptoms and signs that can tell you if you might have oral cancer. You might not have these symptoms and signs at the moment, but it is important to be aware of them in case they may develop in the future.
These symptoms and signs may suggest that you have oral cancer:
- Wounds anywhere in the mouth that do not heal and that may be painful
- Lumps anywhere in the mouth and/or neck that do not go away
- Discolouration of the mouth
- Numbness, pain or bleeding in the mouth
- Difficulty swallowing, eating or talking
- Loose teeth or molars
- Bad mouth odour
These symptoms and signs are often caused by something else. However, early diagnosis and treatment of oral cancer is very important. If you experience any of these symptoms or signs, please contact your dentist, general practitioner or follow-up care specialist soon.
Symptoms and signs
Soon
Pain
From a physical point of view, pain is a life-sustaining biological reaction to damaging influences – even if tissue damage has not yet occurred. Due to its function as a damage indicator or warning, pain is usually associated with negative feelings so that we pay sufficient attention to it and learn as quickly as possible when it is dangerous for us. How intensely we feel a pain stimulus, whether it causes us to feel fear and panic, depends not only on the pure nerve signal, but is an interplay of biological, psychological and social factors.
All pain whose duration exceeds the extent of an acute (recent) cause and lasts for an incomprehensibly long time is called chronic pain. Strong and prolonged pain stimuli can make the transmitting nerve cells of the spinal cord and brain more sensitive to subsequent pain stimuli. This means that even mild stimuli can be perceived as severe pain. Under certain circumstances, these nerve cells, which have become hypersensitive
I am at higher risk of oral cancer. What tests should I have and when?
If you are at higher risk of oral cancer, we do not recommend regular testing at this point. However, it is important that you are aware of the symptoms and signs of oral cancer. If you have any of these symptoms or signs, your general practitioner or follow-up care specialist may:
- Do a physical exam.
What happens if I (might) have lung cancer?
If you (might) have oral cancer, your general practitioner or follow-up care specialist will refer you to an oncology team. This team may include, but is not limited to:
- Ear, Nose and Throat (ENT) specialist
- Maxillofacial surgeon (surgeon specialised in the area of the mouth)
- Radiation oncologist (physician specialised in treating cancer with radiotherapy)
The specialist may discuss different treatment options with you.
What else can I do?
Knowing that you may be at increased risk of subsequent cancer can be difficult. Talking to friends and family can be helpful as well as specialist counselling and/or contact with support groups, such as patient organisations. For more information on taking care of your mental health, please read: Mental health problems.
To lower your risk of oral cancer, adopting or maintaining a healthy lifestyle is extremely important. In particular, it is important to avoid/quit smoking, drink less or no alcohol, and maintain regular oral hygiene. Taking care of your mental health may be beneficial; even small changes to your lifestyle can have a positive impact on both your physical and mental health. For more information on taking up a healthier lifestyle, please read: Health promotion.
In both boys and girls, vaccination against the human papillomavirus (HPV) may reduce the risk of developing oral cancer.
It is important that you are aware of the possibility of developing oral cancer and that you know the symptoms and signs. If you have any further questions or if the information in this brochure concerns you, please contact your general practitioner or follow-up care specialist.
Healthy lifestyle
- Having a healthy diet
- Drinking less (or no) alcohol
- Exercising regularly
- Quitting smoking (if you smoke)
Your follow-up care specialist or general practitioner may give you additional advice tailored to your individual situation for maintaining a healthy lifestyle. For more information on taking up a healthier lifestyle, please read: Health promotion.
Where can I find more information?
You may find more information about oral cancer online. However, it is important to be aware that this information is not always up to date or accurate.
On this website, you can also find more information related to this topic:
Please note
This PLAIN summary is based on the PanCareFollowUp guideline about “Subsequent neoplasms” [1], which is based on the consensus of different national guidelines.
While the PanCare PLAIN information group strives to provide accurate and complete information that is up-to-date as of the date of publication, you can check with your general practitioner or follow-up care specialist if this summary reflects the most up-to-date information available and whether it is relevant for you.
Please do not rely solely on this information. It is best to also seek the advice of a qualified medical practitioner if you have questions regarding a specific medical condition, disease, diagnosis or symptom.
No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information. PanCare has produced the English version and PanCare is not responsible for the translated versions of this summary.
The PanCare materials are free to use for anyone aiming to inform about late effects and long-term survivorship care. However, no financial advantage may be achieved. All communication should reference PanCare and link to the PanCare website.
[1] van Kalsbeek, R. et al. (2021) European PANCAREFOLLOWUP recommendations for surveillance of late effects of childhood, adolescent, and Young Adult Cancer, European journal of cancer. Available at: https://www.ejcancer.com/article/S0959-8049(21)00368-3/fulltext.