Cancer is a frightening word for anyone to hear. When most people think of cancer, they think of tumors and chemotherapy. Cancer can occur in any part of the body, including the jaw bone. If you are experiencing any of the signs and symptoms of jaw bone cancer, it is important to see a doctor right away. This type of cancer can be very serious if not treated early on. This blog post will discuss the signs, symptoms, and treatment options for jaw bone cancer. We will also provide some helpful resources for those diagnosed with this disease.
- Jaw tumors and cysts
- Types of new growths in the Jaw and surrounding tissue
- Jaw cancer types
- Jaw cancer symptoms
- Causes of jaw cancer
Jaw tumors and cysts
Cancer rarely starts in the jaw. Sometimes, cysts or growths form in the jaw area, called odontogenic tumors, but these tumors are often benign (noncancerous). If not initially detected on x-ray, jaw tumors are diagnosed clinically because their growth causes swelling of the face, palate, or alveolar ridge (the part of the jaw supporting the teeth). They can also cause bone tenderness and severe pain.
Bony outgrowths (torus palatinus, torus mandibularis) may develop on the palate or mandible. These are common growths and may prompt concerns about cancer, although they are benign and of concern only if they interfere with dental care or function of the submandibular gland. They are in the midline on the palate and have intact smooth mucosa.
Types of new growths in the Jaw and surrounding tissue
A tumor is an abnormal growth or mass of tissue. A cyst is a lesion that contains liquid or semisolid material. Examples of jaw tumors and cysts include:
- Ameloblastoma. The cells that create the tooth’s protective enamel lining, known as dental pulp cells, are the origin of this uncommon (benign) tumor. It tends to appear in the jaw near the molars. The most common form is aggressive, which grows into the jawbone and forms large tumors. Although this disease may come back after treatment, surgical intervention generally lowers the chance of recurrence.
- Central giant cell granuloma. Giant cell granulomas are benign bone-cell tumors that form in the front of the lower jaw. They most often appear in the front of the lower jaw, known as frontal giant cell granulomas. Benign tumors of the ear are frequently slow-growing (benign), painless, and benign. They may develop rapidly, cause agony and bone destruction, and recur after surgical cure. The second type is less aggressive and seldom causes any symptoms. A tumor rarely may shrink or resolve independently, but typically these tumors require surgical treatment.
- Dentigerous cyst. A cyst forms from tissue surrounding a tooth before erupting into the mouth. The most prevalent kind of jaw cyst is this one. These cysts are most often found around wisdom teeth that have not fully erupted, but they can also affect other teeth.
- Odontogenic keratocyst. A keratocystic odontogenic cyst is a name given to this cyst since it has the characteristics of a tumor. Even though this cyst is generally slow-growing, it can be harmful to the jaw and teeth if left neglected for a long time. The cyst often develops in the lower jaw near the third molars. These cysts may also be found in people with an inherited condition called nevoid basal cell carcinoma syndrome.
- Odontogenic myxoma. The lower jaw is the most frequent site of this uncommon, slow-growing, noncancerous tumor. The tumor can grow quite large and aggressively invade the jaw and surrounding tissue, displacing teeth. Myxomatosis is a chronic, progressive disease that affects the odontogenic region of the jaw. Myxomatosis may be treated surgically by removing portions or all of the infected tissue; however, more-aggressive surgical therapies often reduce recurrence rates.
- Odontoma. This benign tumor is the most common odontogenic tumor. Odontomas often have no symptoms, but they may interfere with tooth development or eruption. Odontomas are abnormal-shaped tumors that develop on a tooth in the jaw and are composed of dental tissue. They may be tiny or huge calcified growths, and they might look like oddly-shaped teeth. These tumors might be part of some genetic disorders.
- Other types of cysts and tumors. These include:
a. adenomatoid odontogenic tumor
b.calcifying epithelial odontogenic tumor
c. glandular, squamous, or calcifying odontogenic cyst
d. glandular, squamous, or calcifying odontogenic cyst
f. aneurysmal bone cyst
g. ossifying fibroma
i. central odontogenic fibroma
Jaw cancer types
Squamous cell carcinoma (SCC) is the most common malignant tumor in the oral cavity (mouth), and it accounts for approximately 90% of all oral cancers.1 But SCC of the jaw is rare, accounting for only 6% of cancers in the head and neck.2
Other types of oral cancer may also affect the jaw:
- Osteosarcoma (a rare type of bone cancer that typically affects long bones in the arms and legs)
- Multiple myeloma (a rare, incurable cancer of the blood)
- Metastatic tumors (cancer that has spread from another part of the body)
Jaw Cancer Symptoms
The most typical symptoms of this cancer include jaw pain, discomfort, trouble chewing and swallowing. In the early phases, you may only experience pain or no signs.
As the cancer advances, you could experience additional symptoms and indicators, including:
- Painful sores, or ulcers, in your mouth
- A red or white patch in your mouth
- Loose teeth or pain around your teeth
- Dentures that no longer fit
- Swelling inside your mouth near your lower or upper jaw or on the side of your face
- Difficulty opening your mouth
- Numbness in the lower teeth or lower lip and chin area
- Difficulty speaking
- A lump in your neck
Many noncancerous dental conditions are more likely than jaw cancer to cause these symptoms. Tell your dentist or primary care provider if you have experienced the above symptoms for more than two weeks.
Causes of jaw cancer
While the exact cause of jaw cancer is unclear, risk factors can contribute to developing the disease.
- Smoking cigarettes, cigars, and pipes increase your cancer risk anywhere in the mouth, jaw, or throat.
- Using oral tobacco products, like snuff, dip, spit, chew, or dissolving tobacco is linked to cancers of the cheek, gums, and the inner surface of the lips (The longer the use, the higher the risk.)
- Drinking alcohol increases your risk of developing oral cavity cancers. Moderate-to-heavy alcohol consumption is associated with higher head and neck cancers risks. They have higher risks of oral cavity and throat cancers than nondrinkers.
- Eating a diet deficient in fruits and vegetables.
- Having a weakened immune system
- Chewing betel quid, a stimulant drug that’s ingested like chewing tobacco and often mixed with tobacco
- Poor dentition
- History of syphilis
Jaw Bone Cancer Diagnosis
If you have jaw cancer symptoms, you should see your primary care physician or dentist. If they think that your symptoms could be caused by cancer, they may refer you to a specialist, such as a head and neck surgeon.
The doctor will perform a thorough exam, looking for abnormal areas or enlarged lymph nodes. On X-rays, dentists frequently find these tumors. They appear to be soap bubbles on film. The following are some of the other ways that may help you identify a malignant tumor or cyst:
- MRI (magnetic resonance imaging): Powerful magnets and radio waves are used to make images of your mouth.
- CT (computerized tomography) scan: Several X-rays are taken from different angles and put together to show more detailed information.
Your doctor may want to take a small tissue sample to look at under a microscope. A tissue sample is removed for further examination in a lab for biopsy if suspicious areas are seen during the exam. They’ll use a needle or make a small cut to take the sample. If cancer cells are found, the stage of the disease (the size and location of cancer and how far it has spread) is then determined.
Depending on the extent and location of the tumor, various therapies may be used alone or in combination. In general, surgery is the first treatment for jaw cancer and may be followed by radiation therapy or a combination of chemotherapy and radiation.
For jaw cancer, surgical removal of the tumor is almost always part of the treatment plan unless a doctor decides that surgery is impossible or that you are too unwell to proceed with surgery.
Most surgeries involve removing the affected area of soft tissue (tongue, floor of the mouth, tonsils, part of the pharynx), and the adjacent bone. Usually, a lymph node is removed on the same side of the neck.
In rare cases, a more intensive maxillofacial surgery may be needed in patients with advanced cancer. These surgeries include:
- Maxillectomy (partial or total): Removal of the bone that forms the roof of the mouth
- Mandibulectomy (partial or total): Removal of a part or all of the jawbone
Most patients undergoing stage 3 and stage 4 cancers will also have a temporary tracheostomy (a tube inserted into the windpipe via a small incision in the neck to facilitate breathing) while they recover.
Radiation therapy (RT) is a treatment that uses high-energy X-rays or other types of radiation to kill cancer cells. RT may be used alone or in combination with surgery and chemotherapy for jaw cancer.
There are two types of radiation therapy:
External beam radiation: This is the most common type of radiation therapy. A large machine is used to direct the radiation to cancer.
Internal radiation (brachytherapy): This type involves placing a small amount of radioactive material in or near the tumor.
The side effects of radiation therapy vary from person to person and depend on many factors, including:
- The type and stage of the cancer being treated
- The type of radiation therapy is used
- The dose of radiation
- How the radiation is given
- The person’s general health
Chemotherapy is a treatment that uses drugs to kill cancer cells. It may be used alone or combined with radiation therapy and surgery.
There are many different types of chemotherapy drugs, and they are given in different ways. The most common way to give chemotherapy is by mouth (orally). However, it can also be given intravenously (by vein), intra-arterially (into an artery), or directly into the tumor (intratumoral).
The side effects of chemotherapy depend on the drugs used and how they are given. They can include:
- Nausea and vomiting
- Hair loss
- Loss of appetite
- Mouth sores
- Increased risk of infection
- Easy bruising or bleeding
Radiation therapy and chemotherapy can be used before surgery to shrink the tumor. This may make it possible to remove the tumor with less extensive surgery. These treatments may also be used after surgery to kill any cancer cells.
The prognosis for jaw cancer varies depending on the stage of the disease when it is diagnosed.
The five-year survival rate for patients with early-stage jaw cancer (stage 1 or 2) is generally very good, with more than 90% of patients surviving. However, for those with more advanced disease (stage 3 or 4), the five-year survival rate drops to about 50%.
It is rare for cancer to start in the jaw. However, if you are experiencing swelling, pain, difficulty opening your mouth, and numbness in your lower jaw, speak to your dentist. The earlier this type of cancer is caught, the more effective treatment will be.