See your doctor if you:

• Notice sores inside your mouth that don't heal

• Have lumps or white, red or dark patches in your mouth

• Feel persistent pain or have a loss of feeling inside your mouth

• Have repeated bleeding in your mouth

• Notice any change in the way the soft tissues of your mouth look and feel

• Have severe ear pain

Any of the above factors may indicate oral cancer. The earlier you seek medical advice, the better your chances of successful treatment.

Diagnosis initially involves you and your dentist or doctor discussing the history of your signs and symptoms and your doctor performing an examination of your mouth. To determine whether cells within your mouth are cancerous, your doctor will need to take a small tissue sample (biopsy) to be examined in the laboratory.

Almost all oral and throat cancers are of the squamous cell type (squamous cell cancer or carcinoma). Squamous cells are firm and flat, and they form the lining of the oral cavity and upper throat as well as the surface of your skin. Squamous cell cancer begins with abnormal cells located only on the surface. As it progresses, the malignant cells invade deeper layers of the oral cavity and upper throat and may spread to your lymph nodes as well as to other parts of your body.

For your doctor to determine how far oral or throat cancer may have spread, you'll need to undergo imaging procedures, which may include:

• X-ray. Your doctor may want to see dental X-rays as well as X-rays of your head and chest.

• Computerized tomography (CT) or magnetic resonance imaging (MRI) scan. A CT scan allows your doctor to see your organs in two-dimensional slices. Split-second computer processing creates these images as a series of very thin X-ray beams are passed through your body. An MRI scanner uses no X-rays. Instead, a computer creates tissue slice images from data generated by a powerful magnetic field and radio waves. These images can be viewed from any direction or plane. These images help determine the extent of the mass and whether there is lymph node involvement.

• Ultrasound. This imaging technique uses no radiation. Instead, it combines high-frequency sound waves and computer processing. Ultrasound is especially good for providing information about the shape, texture and makeup of tumors and cysts. While you relax on a bed or examining table, a wand-like device (transducer) is placed next to your head. It emits inaudible sound waves that are reflected back to the transducer (similar to sonar). Those reflected sound waves are then translated into a moving image by a computer.

Many oral and throat cancers aren't detected until they're far advanced. When detected early, squamous cell cancer can almost always be successfully treated.

You may not have any major side effects from surgery to remove a small tumor from your mouth. However, extensive surgery may require major adjustments in the way you chew, swallow, breathe and speak. You may need a prosthetic device in your mouth to replace removed portions of your teeth, gums and jaw. In more advanced cases, you may need to use tubes for feeding and breathing and an artificial voice aid for speaking.

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