Oral Cavity and Oropharyngeal Cancer

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Causes, Risk Factors, and Prevention TOPICS

Can oral cavity and oropharyngeal cancers be prevented?

Avoid risk factors

Not all cases of oral cavity and oropharyngeal cancer can be prevented, but the risk of developing these cancers can be greatly reduced by avoiding certain risk factors.

Limit smoking and drinking

Tobacco and alcohol are among the most important risk factors for these cancers. Not starting to smoke is the best way to limit the risk of getting these cancers. Quitting tobacco also greatly lowers your risk of developing these cancers, even after many years of use. The same is true of heavy drinking. Limit how much alcohol you drink, if you drink at all.

Limit exposure to ultraviolet (UV) light

Ultraviolet radiation is an important and avoidable risk factor for cancer of the lips, as well as for skin cancer. If possible, limit the time you spend outdoors during the middle of the day, when the sun’s UV rays are strongest. If you are out in the sun, wear a wide-brimmed hat and use sunscreen and lip balm with a sun protection factor (SPF) of at least 15.

Wear properly fitted dentures

Avoiding sources of oral irritation (such as dentures that do not fit properly) may also lower your risk for oral cancer.

Eat a healthy diet

A poor diet has been linked to oral cavity and oropharyngeal cancers, although it’s not exactly clear what substances in healthy foods might be responsible for reducing the risk of these cancers.

In general, eating a healthy diet is much better than adding vitamin supplements to an otherwise unhealthy diet. The American Cancer Society recommends eating a healthy diet that emphasizes plant foods. This includes eating at least 2½ cups of vegetables and fruits every day. Choosing whole-grain breads, pastas, and cereals instead of refined grains, and eating fish, poultry, or beans instead of processed meat and red meat may also help lower your risk of cancer. See the American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention for our full guidelines.

Avoid HPV infection

The risk of HPV infection of the mouth and throat is increased in those who have oral sex and multiple sex partners. These infections are also more common in smokers, which may be because the smoke damages their immune system or the cells that line the oral cavity. These infections are common and rarely cause symptoms. Although HPV infection is linked to oropharyngeal cancer, most people with HPV infections of the mouth and throat do not go on to develop this cancer. In addition, many oral and oropharyngeal cancers are not related to HPV infection.

In recent years, vaccines that reduce the risk of infection with certain types of HPV have become available. These vaccines were originally meant to lower the risk of cervical cancer, but they have been shown to lower the risk of other cancers linked to HPV as well, such as cancers of the anus, vulva, and vagina. HPV vaccination may also lower the risk of mouth and throat cancers, but this has not yet been proven.

Since these vaccines are only effective if given before someone is infected with HPV, they are given when a person is young, before they are likely to become sexually active.

For more information see our document HPV Vaccines.

Treat pre-cancerous growths

Areas of leukoplakia or erythroplakia in the mouth sometimes progress to cancer. Doctors often remove these areas, especially if a biopsy shows they contain areas of dysplasia (abnormal growth) when looked at under a microscope.

But removing areas of leukoplakia or erythroplakia does not always prevent someone from getting oral cavity cancer. Studies have found that even when these areas are completely removed, people with certain types of erythroplakia and leukoplakia still have a higher chance of developing a cancer in some other area of their mouth.

This may be because the whole lining of the mouth has probably been exposed to the same cancer-causing agents that led to these pre-cancers (like tobacco). This means that the entire area may already have early changes that can lead to cancer. This concept is called field cancerization.

It is important for patients who have had these areas removed to continue having checkups to look for cancer, and for new areas of leukoplakia or erythroplakia.

Chemoprevention

In recent years, doctors have been testing medicines to try to help lower the risk of these cancers. This approach, called chemoprevention, is particularly needed for people who have a higher risk of these cancers, such as those with leukoplakia or erythroplakia.

Several kinds of drugs have been studied for oropharyngeal cancer chemoprevention, but most of the research has focused on drugs related to vitamin A (retinoids). Studies so far have shown that retinoids can cause some areas of leukoplakia to shrink or even go away temporarily. But these studies have not found a long-term benefit in preventing cancer or helping patients live longer. At the same time, most of these drugs have bothersome and even serious side effects.

Research into other anti-cancer compounds that may be used as oral rinses is now under way. This is discussed further in the section “What’s new in oral cavity and oropharyngeal cancer research and treatment?


Last Medical Review: 07/16/2014
Last Revised: 08/05/2014