Verrucous carcinoma is a rare and slow-growing type of squamous cell carcinoma, known for its wart-like appearance and relatively indolent progression. When it develops in the oral cavity, it is often referred to as oral verrucous carcinoma. Although this type of cancer is less likely to metastasize than other forms of squamous cell carcinoma, it can still cause significant damage if not treated appropriately. Understanding what causes verrucous carcinoma in the mouth is critical to recognizing risk factors and potentially preventing its development.
One of the most well-established causes of verrucous carcinoma in the mouth is the use of tobacco, particularly in the form of chewing tobacco or snuff. Smokeless tobacco products irritate the mucous membranes of the mouth, leading to chronic inflammation. Over time, this constant irritation can cause abnormal changes in the cells of the oral tissues, eventually leading to the development of verrucous carcinoma.
The cancerous cells that form in response to tobacco use tend to grow slowly, but they can invade nearby tissues if left untreated. Smokeless tobacco products contain carcinogenic substances, including nitrosamines, which are believed to play a significant role in the initiation of oral cancers like verrucous carcinoma.
In addition to tobacco use, other forms of chronic irritation and trauma to the mouth can contribute to the development of verrucous carcinoma. This includes ill-fitting dentures, poor dental hygiene, and the habitual biting or chewing of the inside of the cheeks. These actions lead to constant injury and irritation of the mucous membranes, creating an environment where abnormal cell growth can occur.
While the body typically heals from minor injuries to the mouth, repeated trauma can interfere with the normal healing process. Over time, this can result in the development of precancerous lesions, which may eventually progress to verrucous carcinoma if left unchecked.
In some cases, oral verrucous carcinoma has been linked to infection with the human papillomavirus (HPV), particularly high-risk strains like HPV-16. HPV is a sexually transmitted virus that is known to cause various cancers, including cervical cancer and oropharyngeal cancer. While the link between HPV and verrucous carcinoma is not as strong as with other forms of squamous cell carcinoma, some studies suggest that HPV infection may play a role in a subset of cases.
HPV-related verrucous carcinoma tends to occur in individuals who engage in oral sex or other activities that increase their risk of contracting the virus. The virus can cause changes in the DNA of oral cells, leading to abnormal growth and the eventual development of cancer. However, more research is needed to fully understand the connection between HPV and oral verrucous carcinoma.
Oral verrucous carcinoma is most commonly diagnosed in older adults, particularly those over the age of 50. Men are more likely to develop this type of cancer than women, possibly due to higher rates of tobacco use and other risk factors in male populations. However, both men and women can be affected by verrucous carcinoma, especially if they have a history of chronic irritation or HPV infection.
Oral verrucous carcinoma typically presents as a thickened, wart-like lesion in the mouth. The lesion may be white, red, or flesh-colored, and it often has a rough or bumpy surface. Unlike some other oral cancers, verrucous carcinoma tends to grow slowly, and it may not cause significant pain or discomfort in the early stages. However, as the tumor enlarges, it can interfere with normal functions like speaking, chewing, and swallowing.
Common locations for oral verrucous carcinoma include:
If you notice any persistent lesions or unusual growths in your mouth, it is essential to see a healthcare provider for evaluation. Early diagnosis and treatment can help prevent the cancer from progressing and causing further damage.
The best way to prevent oral verrucous carcinoma is to avoid known risk factors, particularly tobacco use. Quitting smokeless tobacco products and smoking can significantly reduce your risk of developing oral cancers, including verrucous carcinoma. Maintaining good oral hygiene, visiting your dentist regularly, and addressing any chronic irritation or trauma in the mouth can also help reduce your risk.
Additionally, if you are at risk for HPV infection, practicing safe sex and considering HPV vaccination may help lower your chances of developing HPV-related oral cancers.