5. Clinical features and diagnosis of cancer

Oral cancer in the initial clinically detectable stage is usually a red or red and white (erytholeukoplastic) area without symptoms. In more advanced stages, there is a single ulcer or lump with irregular margins, which are rigid to touch (indurated), and pain is the most frequent symptom – especially in tongue and floor of mouth cancers.

The most important task is to establish an early diagnosis in the first stages of the disease, when treatment needed is less severe and the prognosis is best. The different diagnosis for oral cancer includes other malignant diseases (eg lymphomas, sarcomas and metastases), which usually grow more rapidly than a typical oral cancer; and chronic infections (eg syphilis, tuberculosis, or a fungal condition such as histoplasmosis).

The most common locations for mouth cancer are the lower lip (40%), and the tongueand the floor of the mouth (50%). The lip is involved more frequently in some geographic areas with sunny climes. Other oral areas involved include the buccal mucosa, retromolar area, gingiva, soft palate and, less frequently, the posterior tongue and hard palate.