Oral cancer may recur where it initially started or elsewhere in the body. The recurrence rates differ for people with early and advanced stages of oral cancer.

Oral cancer can occur anywhere in the mouth, including the gums, tongue, inner cheeks, and lips. Doctors typically group oropharyngeal cancers, which affect the part of the throat behind the oral cavity, with oral cancers.

Oncology teams can successfully treat oral cancer in some people, although it may be more challenging or impossible if a person’s cancer is advanced. However, oral cancer can recur even after successful treatment.

This article looks at how common oral cancer recurrence is and the signs of recurrence. It also discusses the diagnosis, treatment, prevention, and outlook for oral cancer recurrence.

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Rates of oral cancer recurrence differ according to different sources.

After a person has received curative treatment for primary oral cancer, doctors may detect recurrence in about 20% of people, usually within the first 2 years.

Rates of recurrence may vary depending on the stage of oral cancer. According to one 2022 review, oral cancer recurrence may occur in 50–60% of people with advanced oral cancer and 25–30% of people with early stage oral cancer.

If oral cancer recurs, a person may experience symptoms they had during the primary cancer, including:

Many other less severe conditions may be responsible for these symptoms, and having them does not mean a person’s oral cancer is recurring. However, someone with these or any other unexplained symptoms should check with their oncology team.

Learn more about what oral cancer looks like.

People typically receive follow-up visits with an oncologist for many years after their initial treatments for oral cancer. The risk of oral cancer recurrence is higher within the first 2 years of curative treatment. Various researchers have reported that 86–94% of oral cancer recurrence occurs during this time.

A person may attend follow-ups every few months during the first 2 years after treatment and then every 4–6 months in the following years.

During follow-ups, an oncologist will ask about the symptoms of possible recurrence and perform physical examinations. They may also:

If an oncologist suspects cancer recurrence, they may take a tissue sample, called a biopsy, for laboratory technicians to test for cancer cells. They may also order further testing.

Treatment for recurrent oral cancer depends on the size and location of the cancer and how oncologists treated the initial cancer.

Local recurrence

If oral cancer recurs in the same place as before, there are different treatment options. The treatments depend on how oncology teams treated the previous cancer.

If doctors previously treated oral cancer with radiation therapy, they typically treat the recurring cancer with surgery, if possible. Doctors usually do not repeat external beam radiation therapy in the same area but may use brachytherapy or internal radiation to help manage the cancer.

If doctors treated the previous cancer with surgery, they may use the following treatment types or a combination:

Regional recurrence

If oral cancer recurs in the lymph nodes of the neck, oncology teams will usually surgically remove the lymph nodes. Treatment may also include radiation or chemoradiation, which involves chemotherapy and radiation therapy at the same time.

Distant recurrence

It is often difficult to treat and cure distant cancer recurrence. This is cancer that returns to another area of the body, distant from where it first occurred.

Oncology teams may use treatment options, such as chemotherapy, immunotherapy, and cetuximab to try and shrink or slow the growth of the cancer and relieve symptoms.

Read about nonsurgical mouth cancer treatment.

A person cannot prevent recurrence or predict whether their cancer will return.

If someone is a smoker, quitting smoking can reduce the risk of oral cancer recurrence. Other lifestyle changes to improve overall health, such as a nutritious diet and regular physical activity, may also help lower the risk.

A person should attend all of their follow-up appointments to increase the chances of early detection should the cancer return.

Read more about oral cancer prevention.

Cancer resources

To discover more evidence-based information and resources for cancer, visit our dedicated hub.

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Overall, the 5-year relative survival rate for oral cancer is 68.5%. This means that people with oral cancer are 68.5% as likely as people without it to be alive 5 years after diagnosis.

The 5-year relative survival rate can differ depending on whether oral cancer is localized, regional, or distant:

  • Localized: 86.6%
  • Regional: 69.1%
  • Distant: 39.3%

People with localized oral cancer who receive an early diagnosis generally have a more favorable outlook.

Advanced and distant oral cancer may be difficult or impossible for oncology teams to treat successfully.

Read more about oral cancer survival rates by age.

Oral cancer is more likely to recur in people who previously had advanced stage oral cancer than those whose cancer was early stage.

Signs of recurrence include sores on the mouth, mouth pain, numbness, and swelling.

Oncologists use various tests to diagnose oral cancer and will base treatment on its location and stage. They also consider a person’s previous treatment when treating recurrent oral cancer.

Detecting and treating oral cancer before it spreads is likely to lead to more favorable outcomes.