Mouth cancer can appear on the lips or anywhere in the mouth, including the tissues inside the cheeks, the tongue, and the gums. Mouth cancer may look like red, gray, or white patches of skin, thick growths, or sores that do not heal with time.

Mouth cancer is a type of head and neck cancer, and it often comes under the category of oral and oropharyngeal cancer. Oral cancer accounts for roughly 3% of all cancer diagnoses in the United States, meaning that about 54,000 people in the U.S. receive a diagnosis each year.

Some signs of precancerous conditions may be indicators to see a doctor. In many cases, a person may have no noticeable symptoms at first.

In this article, we discuss the appearance of mouth cancer, its symptoms, and how to differentiate it from other conditions.

Oral cancer is cancer that starts in the mouth, or oral cavity, which includes the:

  • lips
  • tongue
  • tongue lining
  • gums
  • inside of the cheeks
  • hard palate (the bony roof of the mouth)
  • floor of the mouth below the tongue

Cancer occurs when cancerous cells begin to reproduce and grow out of control. Cells virtually anywhere in the body may become cancerous, and the growth of cancerous cells may spread to other areas of the body.

According to the American Cancer Society, oral cancer occurs most often in the following sites:

  • tongue
  • tonsils
  • gums
  • floor of the mouth
  • oropharynx (back of the mouth and soft palate)

Oral cancer may appear differently based on its stage, location in the mouth, and other factors. Oral cancer may present as:

  • patches of rough, white, or red tissue
  • a hard, painless lump near the back teeth or in the cheek
  • a bumpy spot near the front teeth
  • growths of tissue on the roof of the mouth
  • open, oozing sores in the mouth that do not go away with time
  • bright red patches on the tongue
  • tissue turning gray or white
  • numbness in the tongue

In the earliest stages of oral cancer, many people experience no symptoms or mistake them for those of another condition. Regular checkups with the dentist may help identify any early warning signs.

Research suggests that more than 90% of cancers in the mouth are squamous cell carcinomas. Squamous cells are flat cells that cover the surface of the mouth, tongue, and lips. Noticing a patch or thick tissue in these areas may be an early warning sign to see a doctor for a diagnosis.

As cancer develops and progresses, a person may notice symptoms such as:

  • bleeding and pain in the mouth
  • numbness in one or more areas of the mouth
  • a lump or buildup of tissue in the gums
  • sore throat
  • loose teeth
  • red and white patches on the mouth or tongue
  • difficulty moving the tongue or chewing
  • discomfort or difficulty while chewing or swallowing

Precancerous growths

Dysplasia is a term that refers to the abnormal development of cells in tissues or organs. In adults, an increase in abnormal cell growth may suggest precancer.

Possible precancerous conditions for oral cancer may include:

  • Leukoplakia: These are white or gray patches in the mouth that do not go away when a person rubs them.
  • Erythroplakia: These are flat or slightly raised areas of tissue that are often red and may bleed easily on scraping.
  • Erythroleukoplakia: A combination of the two, this is a patch of tissue with both red and white areas.

Smoking and chewing tobacco are the most common causes of these conditions. Dysplasia will often go away if a person removes the causes, but there is not always a clear cause.

A biopsy is the only way to know whether the tissue contains precancerous or cancerous cells.

Most cases of leukoplakia do not develop into cancer. Erythroplakia and erythroleukoplakia are less common but usually more serious. Most of these lesions progress into cancer.

However, it is important to note that most oral cancers do not develop from preexisting lesions.

There are several types of oral lesions that can be concerning but are not signs of cancer.

Canker sores

Canker sores are a common condition, with research suggesting that they may affect up to 20% of the general population. They are painful white lesions that occur in various areas inside the mouth.

Canker sores typically heal naturally within 2 weeks, whereas cancerous lesions do not go away with time.

Working with a doctor may help a person identify their triggers of canker sores so that they can avoid them where possible.

Lichen planus

Oral lichen planus is chronic inflammation in the mucous membranes in the mouth. It causes white, lacy markings in the mouth, which are not similar to the patchy white marks of leukoplakia.

There is still debate regarding the association between lichen planus and cancer. However, some research suggests that people with lichen planus may have an increased risk of developing cancer of the lip, tongue, oral cavity, esophagus, and larynx.

Anyone with lichen planus should check in with their doctor often for checkups and treatment.

Benign tumors

Some benign or noncancerous tumor-like growths may also occur in the mouth, including:

  • fibroma
  • granular cell tumor
  • lipoma
  • eosinophilic granuloma
  • neurofibroma
  • papilloma
  • odontogenic tumors

These noncancerous tumors and growths occur due to variations in different cells, and they have a variety of causes. While some may cause problems, they are unlikely to be life threatening. Typically, treatment for these growths involves surgery to remove them.

Anyone who is uncertain about their symptoms should see a doctor, if only to provide peace of mind. Doctors may perform a physical exam to check for noticeable features of cancer. If necessary, they will order diagnostic tests.

Anyone with concerning symptoms, such as trouble chewing, swallowing, or breathing, should see a doctor immediately. Although cancer is not the only cause of these symptoms, they are concerning signs of an underlying issue.

Additionally, anyone noticing patches of tissue or growths in the mouth that do not go away with time should see a doctor.

Learn more about mouth cancer, including the outlook and treatment options.

Here are some answers to questions people often ask about mouth cancer:

What are the signs of cancer in the mouth?

Signs of cancer in the mouth include:

  • rough patches
  • tissue turning white, red, or gray
  • painless bumps, lumps, or other tissue growths
  • open, oozing sores that do not seem to heal

How long can you survive untreated mouth cancer?

Whether or not a person has treatment for mouth cancer, various factors will affect the outlook. They include the stage at diagnosis, where the cancer starts, and other factors.

Overall, there is a 91% chance of surviving at least another 5 years after a diagnosis of mouth cancer that starts on the lip. Cancer of the lip has a better prognosis than other types of oral cancer.

If cancer that starts on the lip spreads to other parts of the body, however, the chance of surviving falls to 33%. If cancer starts on the floor of the mouth, the overall chance of survival for 5 years or longer is 52%, according to the American Cancer Society.

Is mouth cancer curable?

Treatment includes surgery, radiation therapy, and chemotherapy. The choice will depend on the individual and the stage of cancer. It is often effective. For people with early-stage mouth cancer that starts on the lip, there is a 93% chance of surviving at least another 5 years, if they have treatment.

Mouth cancer usually presents with distinctive symptoms and features, such as red or white patches in the mouth, changes in oral tissue, or difficulty chewing or swallowing.

While these symptoms are not unique to oral cancer, if they are persistent and do not heal over time, they may indicate cancer.

If people notice these or other concerning symptoms, they should see a doctor. Early diagnosis provides a higher chance of successful treatment.