Concerned About a Mouth Ulcer or Change That Is Not Going Away?

When Should You See a Doctor for Changes in Your Mouth?

Consider seeing a doctor or dentist if you have:

• A mouth ulcer that does not heal after 2 to 3 weeks
• A lump or thickened area in the mouth
• A persistent red or white patch
• Unexplained bleeding in the mouth
• Persistent pain or numbness
• Difficulty chewing or swallowing
• Difficulty moving the tongue or jaw
• An unexplained loose tooth
• A persistent lump in the neck

These symptoms do not necessarily mean cancer, but persistent changes should be checked.

How Can I Check if I Have Oral Cancer?

Your assessment usually begins with a review of your symptoms and an examination of the mouth and neck. In some cases, the examination may extend to the neck and may involve additional procedures, such as nasoendoscopy or a bedside ultrasound of the neck to assess the lymph nodes.

Further tests may include:

Biopsy

A small tissue sample may be taken to check for cancer cells.

Imaging

CT scans, MRI scans, or PET scans may be recommended to assess the affected area and nearby structures.

Further Assessment

If cancer is confirmed, additional tests may be recommended to:

• Determine the extent of the cancer (staging) and whether nearby lymph nodes or other parts of the body are involved. Fine needle aspiration cytology (FNAC) may be used to assess a suspicious lymph node or lump for cancer cells.
• Identify the exact tumour type and characteristics. Where appropriate, further tumour testing may help determine whether certain treatments, such as chemotherapy, immunotherapy or targeted therapy, may be suitable.

Not every mouth lesion requires a biopsy or scan. Dr Natascha will advise what is appropriate based on the examination.

How Is Oral Cancer Treated?

Treatment depends on the location and stage of the cancer, as well as your overall health.

For many oral cancers, surgery is an important part of treatment.

Depending on the condition, treatment may involve:

• Removal of the tumour in the mouth
• Neck dissection to remove affected lymph nodes
• Reconstruction where required
• Radiotherapy
• Chemotherapy and other systemic treatments

Oral and head and neck cancers are a diverse group of diseases, and their treatment can be complex.

For some patients, treatment may involve consultations with different specialists, including medical oncologists for chemotherapy, immunotherapy or targeted therapy, and radiation oncologists for radiotherapy or proton therapy. Allied healthcare professionals, such as speech and swallowing therapists, may also be involved in rehabilitation after treatment.

When surgery is required, treatment planning also considers important functions such as speech, eating, swallowing, and appearance, with the aim of achieving cancer control while preserving quality of life where possible.

Consult With Dr Natascha Putri

Dr Natascha Putri is a General Surgeon with subspecialty expertise in Head and Neck Surgery.

Her clinical interests include:

• Oral cancer
• Head and neck cancers
• Thyroid conditions and cancers
• Salivary gland conditions
• Neck lumps
• Skin tumours of the head and neck

She completed advanced fellowship training at Memorial Sloan Kettering Cancer Center in New York and is involved in ongoing medical education and head and neck oncology research.

Her approach focuses on clear communication, individualised treatment plans, preserving functions, and quality of life.