Canker Sores and Cancer

Mis-diagnosis of Canker Sores

A canker sore (aphthous ulcer) is a painful, open sore in the mouth. Canker sores can be white or yellow and and are often surrounded by a red area. They are not cancerous, but can be mis-diagnosed as non-cancerous. Oral cancers also look like red sores or white patches. However, unlike canker sores, they do not improve or disappear over time and may be accompanied by a lump or thickening in the mouth or throat. A biopsy is the only way to determine if tissue is cancerous.

Canker sores are a common form of mouth ulcer that may occur with viral infections, but may also be linked to problems with the body’s immune (defense) system. The sores can also be a result of mouth injury due to dental work, aggressive brushing, or biting the tongue or cheek.Canker sores can also be triggered by stress, vitamin or mineral deficiencies, hormonal changes, or food allergies. Anyone can develop canker sores. Women get them more often than men and the is some evidence that canker sores may run in families.

Canker Sore Symptoms

Canker sores occur on the inner surface of the cheeks and lips, tongue, soft palate, and the base of the gums. Symptoms include a red spot or bump that develops into an open ulcer, middle of the sore is white or yellow, may turn gray just before starting to heal. Pain usually goes away in 7 to 10 days. It can take 1 to 3 weeks for a canker sore to completely heal. Large ulcers can take longer to heal. Sometimes, a severe outbreak of canker sores may be accompanied by nonspecific symptoms of illness, such as fever.

Exams and Tests

If canker sores persist or continue to return, your doctor should look for other causes, such as erythema multiforme, drug allergies, herpes infection, bullous lichen planus, and mouth cancer. A biopsy may be needed to distinguish a canker sore from other causes of mouth ulcers. Unfortunately, if cancer is diagnosed, radical surgery to remove large areas is often required in order to save a patient’s life. This type of surgery can be disfiguring and debilitating to the patient, who will often have difficulty with chewing and swallowing, and may require speech rehabilitation. As with all forms of cancer, early detection is crucial. It is extremely critical to get a second or third opinion for persistent mouth ulcers.

Canker Sore Treatment

Canker sores usually heal on their own. The pain usually decreases in a few days. Other symptoms disappear in 10 to 14 days. However there are a few steps that can make healing more comfortable. Avoid hot or spicy foods, which can cause pain. Non alcoholic mouth washes or salt water may help. One home remedy is a mixture of half hydrogen peroxide and half water. Use a cotton swab to apply the mixture directly to the canker sore. Then, dab a small amount of Milk of Magnesia on the canker sore, three to four times a day.

Prescriptions may be required for severe cases. This may include fluocinonide gel (Lidex) or chlorhexidine gluconate mouthwash. Powerful anti-inflammatory medicines called corticosteroids are sometimes used. To prevent bacterial infection, brush and floss your teeth regularly and get routine dental check-ups.

Possible Complications

Antibiotic treatment for canker sores may lead to oral thrush (a type of mouth infection) or other Candida infections. Rarely, bacterial infections such as cellulitis and Ludwig’s angina may occur.

Canker sores are not cancer and don’t lead to cancer. But if you have a mouth ulcer lasts more that 2 weeks, you should see your doctor to rule out possible cancer.

Other resources

Mayo Clinic

Yahoo Voices

Oral Cancer Foundation


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