Buccal Mucosa Cancer

What is the buccal mucosa?

The buccal mucosa is the lining of the cheeks and the back of the lips, inside the mouth where they touch the teeth.

What are the causes and risk factors of buccal mucosa cancer?

  • Tobacco (cigarettes or smokeless) and alcohol use greatly increases the risk of contracting buccal mucosa cancer
  • More common in men
  • Occurs in women who use snuff
  • More likely to occur at 50 to 80 years of age but can develop at any time

What are the symptoms of buccal mucosa cancer?

There are no symptoms in the early stage. Later symptoms include:

  • White or red lump in the mouth that does not go away after two weeks
  • A red, raised patch in the mouth that bleeds easily
  • A lump or thickening in the mouth
  • Pain increases when eating or drinking
  • Soreness or a feeling that something is caught in the throat
  • Difficulty chewing or swallowing
  • Severe ear pain
  • Difficulty moving the jaw or tongue
  • Hoarseness
  • Numbness of the tongue or other areas of the mouth
  • Dentures fit poorly or become uncomfortable because the jaw is swollen

How is buccal mucosa cancer diagnosed?

A doctor will examine the inside of the mouth and back of the throat to check the location and size of the tumor. Examination of the ears, nose and neck are needed to help determine if the tumor has spread.

The doctor may also order tests, including:

  • Blood tests
  • X-rays to determine if the tumor has spread to the lung
  • Fine needle aspiration biopsy (FNA). A thin needle is placed in the mouth. The cells are aspirated (suctioned) and then examined under a microscope to determine if the lump is cancerous
  • Imaging studies to determine if the tumor has invaded nearby tissues or other organs of the body. These may include:
    • Computerized tomography scan. A computer is linked to an X-ray machine which creates a series of detailed pictures of areas inside the mouth and neck. A dye may be injected into a vein or a pill swallowed to help highlight the organs or tissue on the X-ray.
    • Magnetic resonance imaging. This machine uses a magnet, radio waves and a computer to create detailed pictures of the inside of the mouth and neck. This procedure may also be referred to as nuclear magnetic resonance imaging.
    • Positron emission tomography (PET) scan. During a PET scan, a small amount of radioactive glucose (sugar) is injected into a vein. The scanner creates computerized pictures of the areas inside the body. Cancer cells absorb more radioactive glucose than normal cells, so the tumor is highlighted on the pictures.

How is buccal mucosa cancer treated?

Early-stage cancer of the buccal mucosa is often treated with surgery. Advanced cancer cases may require a combination of surgery and chemotherapy.

Surgery

Small buccal mucosa tumors are removed from the inside of the cheek with a scalpel. The size of the tumor determines the size of the incision. The surgeon will make an incision on the inside of the cheek. If the tumor is small, the surgeon will not need to incise through the cheek. This technique preserves the skin.

Reconstruction of the cheek might be needed if the tumor is large. A flap of skin, usually from the forearm, is used to reconstruct the cheek.

If the lymph nodes in the neck are affected, the nodes may need to be removed.

Chemotherapy

Medical oncologists administer chemotherapy if cancer has spread to lymph nodes or other organs. The medicine circulates in the blood and disrupts the growth of the cancer cells. Chemotherapy medications are taken by mouth or given through a vein for several months.

Chemotherapy is not curative for this type of tumor, but when combined with surgery it is helpful in controlling the tumor. Chemotherapy is prescribed for different reasons:

  • After surgery to decrease the risk of the cancer returning
  • To slow the growth of a tumor and control symptoms when the cancer cannot be cured (palliative treatment)

Key points

  • The use of tobacco and alcohol makes cancer in the buccal mucosa — the lining of the cheeks and lips — far more likely.
  • The disease is treated with surgery, chemotherapy or both.
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