Buccal mucosa cancer happens when cells divide uncontrollably in the buccal mucosa, which is the inner lining of the cheek. This is a rare but aggressive cancer, and surgery is often necessary to treat it.

Buccal mucosa cancer can cause a sore or ulcer inside the cheek. While there are numerous possible causes of sores in the mouth or cheek, it is important to contact a doctor for an accurate diagnosis. The doctor can order various tests to determine whether oral cancer is present.

Read on to learn more about the symptoms and causes of buccal mucosa cancer. This article also looks at diagnosis, treatment options, and more.

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According to a 2017 case report, the first symptoms of buccal mucosa cancer usually involve a sore or ulcer on the inside of the cheek that does not heal.

Doctors may be able to identify this type of cancer early on, as it might cause noticeable symptoms that interfere with daily life. For example, a person may experience pain while eating or speaking.

The exact cause of buccal mucosa cancer is unclear. However, researchers know that it is a result of DNA changes that affect cell division and affect the body’s ability to repair genes.

Certain risk factors increase the likelihood of oral mucosa cancer, including:

Tobacco use

Smoking tobacco or consuming it in the form of chewing tobacco, betel quid, snuff, or snus can increase the risk of oral mucosa cancer. Tobacco contains many chemicals that damage DNA and have links to cancer development.

Alcohol use

The chemicals in alcohol may not have any properties that directly lead to cancer development. However, they make the mucosa — the moist lining of the mouth and other areas — easier for chemicals to move through.

Human papillomavirus (HPV)

HPV is a sexually transmitted infection that might have a link to oral cancer development, though it is more likely to relate to cancer in the cervix or the middle part of the throat.

People with oral cancer are four times as likely to have HPV as those without oral cancer, according to a 2017 review.

Stem cell transplant

Receiving a stem cell transplant may increase a person’s risk of oral cancer by 4 to 7 times when compared to the larger population. This often follows graft-versus-host disease, in which an implant of foreign cells or tissues attacks a person’s own tissue.

Doctors test for buccal mucosa cancer similarly to other oral cancers. If a person has a mouth lesion that is not healing, the doctor may carry out the following tests:

  • Biopsy: This involves removing tissue from the cheek lining to examine the cells under a microscope. Because buccal mucosa lesions may develop at the back of the mouth, general anesthesia might be necessary during this procedure.
  • Endoscopy: A doctor may insert a lighted tube called an endoscope through the nose or mouth and into the vocal cords or windpipe to check whether the cancer has spread.
  • Imaging tests: CT scans and MRI scans can help a doctor assess the tumor and whether it has spread to the nerves or soft tissue.

Several treatments are available depending on the size of a buccal mucosa tumor and whether it has spread to nearby tissues or distant organs.

Some research estimates that receiving a single treatment, such as surgery or radiation therapy, can successfully treat about 80% of head and neck squamous cell carcinomas that have not spread beyond the original tissue.

Surgery

The most common treatment for most oral cavity cancers is wide local excision surgery, during which a surgeon removes the tumor and the surrounding tissue.

If the cancer has spread to nearby lymph nodes in the neck, a surgeon may need to remove the lymph nodes or part of the neck.

People may need follow-up surgery to reconstruct the jaw and neck to restore function and appearance as best as possible.

Additionally, the airway may swell during the initial operation, so a tracheostomy might be necessary. During a tracheostomy, a surgeon creates a new opening to the windpipe in the neck to allow a person to breathe safely.

Learn more about oral cancer surgery.

Other treatments

After surgery, a person may undergo chemotherapy, radiation therapy, or both. These treatments help kill the remaining cancer cells and improve the chances of successful removal.

Chemotherapy involves medications that kill the cancer cells. During radiation therapy, the treatment team targets the area with radioactive materials or beams.

If the cancer has spread beyond its original site, the doctor may administer a medication called cetuximab along with radiation therapy. Cetuximab is an epidermal growth factor receptor inhibitor, a type of drug that prevents cancer cells from binding to certain proteins that help them grow.

Complications of buccal mucosa cancer may result from the spread of the cancer or the effects of treatment. Possible complications include:

  • difficulty swallowing
  • breathing difficulties or airway obstruction
  • mucositis (inflammation of the mucosa)
  • trismus (jaw muscle spasms)
  • bleeding
  • pain
  • infection
  • speech problems
  • psychological impacts of a cancer diagnosis and the effects of treatment

It is important that a person report any complications to their doctor or cancer care team. The healthcare professionals can advise on steps to take to manage complications and reduce the likelihood of further complications.

There is no certain way to prevent any cancer. However, a person may be able to reduce their likelihood of developing a new oral cancer or experiencing a recurrence of a previously treated oral cancer.

Avoiding or stopping the use of tobacco products and reducing alcohol intake may help a person reduce their risk of buccal mucosa cancer.

In some cases, a doctor may also recommend the HPV vaccination.

A person’s doctor can provide more advice on ways to help reduce the likelihood of oral cancer.

Many factors may affect a person’s outlook with buccal mucosa cancer, including:

  • the stage of the cancer
  • whether the cancer has spread to nearby tissues or distant organs
  • a person’s overall health
  • the type of treatment the person received
  • any complications of surgery or radiation therapy

Few studies have looked specifically at the survival rate for buccal mucosal cancer. However, in a 2018 study that assessed 409 cases of buccal mucosa cancer treated at the same hospital from 2006 through 2008, the 5-year survival rate was 54.1%.

The American Cancer Society does not have enough data on cancer of the cheek lining specifically, but the overall 5-year relative survival rates for cancers in different parts of the mouth range from 52% to 91%, depending on the part of the mouth the cancer affects.

Survival rate:

The survival rate represents the proportion of people who are still alive for a length of time after receiving a particular diagnosis. For example, a 5-year survival rate of 50% means that 50%, or half, of the people with a certain condition are still alive 5 years after receiving the diagnosis.

Relative survival rate:

A relative survival rate helps give an idea of how long a person with a particular condition will live after receiving a diagnosis as compared with people without the condition.

For example, if the 5-year relative survival rate is 70%, it means that a person with the condition is 70% as likely to live for 5 years as someone without the condition.

It is important to remember that these figures are estimates and are based on the results of previous studies or treatments. A person can consult a healthcare professional about how their condition is going to affect them.

Buccal mucosa cancer is a rare, aggressive oral cavity cancer that develops in the inner lining of the cheek. People often identify its symptoms, including ulcers or lesions that do not heal, at an early stage.

A doctor will usually diagnose the cancer using a biopsy. They may follow this up by performing an endoscopy or ordering imaging tests to check whether the cancer has spread.

Treatment for buccal mucosa cancer usually involves surgery to remove the affected part of the mouth and any lymph nodes in the neck to which the cancer may have spread.

A surgeon may need to reconstruct the jaw and cheek after surgery. This may cause complications with swallowing and speech.

It is important that a person contact a doctor as soon as they have concerns about mouth lesions or buccal mucosa cancer. The doctor can order tests to determine the cause of symptoms and can advise on a suitable treatment plan.