Jaw cancer is a very rare type of oral cancer, or cancer in the mouth. It falls under the broader category of head and neck cancers. Experts often refer to cancers of the jaw as oral cavity cancers.
“Jaw cancer typically refers to cancer of the mandible or maxilla, the structural bones that make up the face,” says Brittany Barber, MD, a surgeon who specializes in head and neck cancers at Fred Hutch Cancer Center in Seattle. The maxilla is your upper jaw, and the mandible is your lower jaw.
Fortunately, jaw cancers are often treatable.
“Jaw cancer can be curable, especially when it’s caught early,” says Raymond L. Chai, MD, associate professor of otolaryngology and a specialist in surgery for head and neck cancer at the Icahn School of Medicine at Mount Sinai in New York City.
What Are the Types of Jaw Cancer?
Barber says that about 90% of jaw or oral cavity cancers are squamous cell carcinomas. Squamous cells line areas in and around your mouth, including your:
- Tongue
- Lips
- Salivary glands
- Soft palate and hard palate, which make up the roof of your mouth
- Gums
- Throat
Cancers of the jaw often start in one of these places before spreading to the jaw.
It’s much less common for cancer to start in your jawbone or in the tissue from which your teeth develop, called odontogenic tissue. Cancers that form here can spread to other parts of your body if they’re not treated. These cancers include:
Ameloblastic carcinoma
This rare cancer usually develops in the jawbone. It’s the most common odontogenic cancer. It starts in the cells that eventually become tooth enamel. It typically grows in your lower jaw near your molars. This type of cancer sometimes develops from benign — or noncancerous — tumors.
Clear cell odontogenic carcinoma
This type of cancer also typically develops in the lower jaw, though nearly 1 in 5 start in the upper jaw. Their name comes from the fact that the cells look clear in a microscope.
Ghost cell odontogenic carcinoma
A very rare type of cancer, only about 50 cases have been documented since the disease was identified in 1985. It’s an aggressive cancer that can start on its own or can develop from a benign growth in the lower jaw. Its name comes from the shadowy appearance of the cells.
Osteosarcoma of the jaw
Sarcomas are cancers that develop within connective tissues, such as cartilage, tendons, and ligaments. When it begins in the bones, experts call it osteosarcoma, and it can happen in either the upper or lower jaw.
Primary intraosseous carcinoma
This is an odontogenic tumor that typically grows in the back of your lower jaw. It may start as a benign growth that eventually becomes cancerous, or it can be cancer from the start. It’s very rare, with about 260 total cases ever reported.
Sclerosing odontogenic carcinoma
This is an extremely rare type of jaw cancer, with fewer than 15 cases ever reported in English-language medical journals. It can develop in the upper or lower jaw. Experts don’t know whether it starts on its own or begins as a benign cyst or whether both scenarios are possible.
What Are the Signs and Symptoms of Jaw Cancer?
“Jaw cancer can cause a range of symptoms, and they often depend on where exactly the cancer is located and how far it’s progressed,” Chai says.
Typically, you won’t notice any symptoms in the early stages of jaw cancer. That can change as the tumor gets bigger. Chai says the following are among the more common symptoms of jaw cancer:
- Persistent jaw or facial pain
- Swelling or a lump in your jaw that doesn’t go away, which may or may not be painful
- A sore in your mouth that may bleed and does not heal
- Loose teeth not caused by gum disease
- Numbness in part of your face
- Difficulty opening your mouth
- Difficulty chewing or speaking
- Changes in how your teeth fit together
Other symptoms include:
- Changes to your bite
- Fever
- Trouble swallowing
- Red or white patches inside your mouth
- Ear pain
- Ongoing numbness in your jaw
- Dental prostheses — like dentures, crowns, and bridges — that no longer fit properly
- An increase in saliva
“If any of these symptoms last more than two weeks, it’s a good idea to have an examination with either a dentist or a physician,” Chai says.
What Causes Jaw Cancer?
Cancer can develop when something alters the way your cells behave. Normally, cells grow and divide in a controlled fashion. Old or damaged cells get replaced with new cells in an ongoing process. But that process can break down, sometimes causing abnormal or damaged cells to clump together to form tumors. Some of those tumors are malignant, or cancerous.
These abnormal cell growths result from changes to the genes that control the way your cells grow and divide. Sometimes, these genetic changes result from damage to your DNA, which can be caused by environmental factors like smoking and excessive sun exposure.
The specific DNA changes that trigger jaw cancer remain a mystery. But experts have identified some risk factors that increase your chances of developing jaw cancer.
Who’s most at risk for jaw cancer?
The risk factors for jaw cancer can be divided into two groups: those you can’t change and those you can. The first group includes:
- Your age. People who are 55 and older have a higher risk of jaw cancer.
- Your sex. Males have a somewhat higher risk of jaw cancer.
- Your genes/family history. You may have inherited a gene mutation that ups your risk of jaw cancer. If a first-degree relative — parent, sibling, or child — has or had an oral cancer, your risk is higher.
The risk factors that you can change include:
- Tobacco use. This is the biggest risk factor. It includes smoking, chewing tobacco, and exposure to secondhand smoke.
- Alcohol. Drinking large amounts of alcohol significantly boosts your risk of jaw cancer.
Barber says tobacco and alcohol use are both well-established risk factors. Together, Barber says, they’re a dangerous combination, boosting your risk at least 15 times above normal.
“Tobacco and alcohol use have a synergistic effect on development of this cancer,” she says, adding that other modifiable risk factors are less well studied. These include:
- Poor nutrition. A diet that contains only a small amount of fruits and vegetables may increase your risk of jaw cancer.
- Inadequate oral hygiene. Taking poor care of your teeth, as well as any dental prostheses you have, may up your chances of jaw cancer.
How Is Jaw Cancer Diagnosed?
Before it’s diagnosed, your doctor must suspect there’s something wrong. Often, if you don’t have bothersome symptoms, the first person to notice a problem is your dentist, as a growth may show up during an exam of your teeth or on a dental X-ray.
For that reason, both Barber and Chai emphasize the importance of regular trips to the dentist.
“Dentists often spot early signs during routine exams,” Chai says.
Once a potential problem has been identified, your doctor can investigate the cause. This will include a physical exam and a discussion of any symptoms you may be having. After that, you’ll undergo a variety of tests.
Which tests help diagnose jaw cancer?
- Blood tests, which can pick up signs of of cancer.
- Imaging tests, such as X-rays, magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET), or imaging tests that combine two of these, such as PET-CT and PET-MRI.
- Biopsy, in which your doctor removes a tissue sample from your tumor and examines it in a lab for cancer cells. Biopsies also can show how fast-growing the cancer is and help guide treatment.
What Are the Treatment Options for Jaw Cancer?
First, it's important to know that jaw cancer often can be treated successfully, especially when you catch it early.
“Most jaw or oral cancers are very curable, but this does depend on the type and stage at diagnosis,” Barber says.
And most of the time, jaw cancer requires surgery.
“For these rare cancers, surgery is typically the mainstay of treatment,” says Laila Gharzai, MD, assistant professor of radiation oncology at Northwestern University Feinberg School of Medicine in Chicago.
Types of jaw cancer surgery
The surgery your doctor recommends will depend on the location of your cancer and whether it has spread beyond your jaw.
Mandibulectomy. This procedure removes part of your lower jaw. Depending on your cancer, this may be a small or large part of your jaw.
Maxillectomy. During this procedure, your surgeon will remove all or part of your upper jaw.
Neck dissection. If your cancer has spread, it often goes to the lymph nodes in your neck. In this procedure, your surgeon will remove the nodes that may have cancer. This can help prevent your cancer from spreading.
Reconstructive surgery. To rebuild your jaw, you will undergo reconstructive surgery as part of your initial procedure. Bone, blood vessels, and tissue may be taken from another part of your body — usually a leg or arm — and used to reconstruct your jaw. You also likely will need dental implants and prosthetic teeth.
Gharzai says your doctor will evaluate your overall health to be sure you can tolerate surgery. Heart conditions, she says, may make anesthesia risky, while lung conditions can complicate intubation, or the use of a breathing tube during the procedure. Blood circulation problems, such as peripheral vascular disease (PVD), can cause problems as well. They can make your blood vessels too narrow to use, for example.
Radiation, chemotherapy, targeted therapy, and immunotherapy also may be part of your treatment plan. This depends on the type of jaw cancer you have and how much it has progressed. For example, radiation can be an effective add-on to treatment if your cancer has begun to spread to nearby areas.
“Once it spreads to lymph nodes or other areas, treatment becomes more complex,” Chai says.
Some types of jaw cancer are tougher to treat than others.
“I think of osteosarcoma as being the most challenging to treat — these tumors tend to be very poorly responsive to radiotherapy,” Gharzai says. “For this subtype, we usually think of surgery followed by chemotherapy.”
Complications of Jaw Cancer
Jaw cancer can be fatal. Caught early, however, 85% of people live at least five years with jaw cancer. After it has spread, the five-year survival rate drops to 60%. Barber says the disease can also make you prone to jaw fractures, infections, and difficulties swallowing and speaking.
Treatment of jaw cancer can lead to similar complications as well as the following:
- Infections at the surgery site
- Infections around the hardware, implanted during reconstructive surgery, such as plates, screws, and prostheses
- Radiation burns
Can You Prevent Jaw Cancer?
There’s no certain way to prevent jaw cancer, but you can reduce your risk of getting it.
Chai says that tobacco use and heavy alcohol use are the major risk factors for jaw cancer. “And the two combined are even more dangerous,” he says. Quit smoking and chewing tobacco, and limit how much alcohol you drink to reduce your chances of jaw cancer.
Chai also recommends practicing good oral hygiene and addressing any irritation caused by ill-fitting dentures or other dental prostheses. Such irritation as well as poor oral hygiene, he says, play a role in jaw cancer.
Good oral hygiene — which includes routine trips to the dentist — also can help catch jaw cancer early, when it’s most treatable.
“Regular dental checkups are key,” Chai says.
Living With Jaw Cancer
“A cancer diagnosis is overwhelming, but support and preparation go a long way,” Chai says.
He points out that life with cancer and the aftermath of treatment can feel both isolating and stressful. But you can make it less so.
“Connect with support groups, mental health professionals, or even just talk openly with loved ones,” Chai says.
Barber says where you seek treatment is a critical choice.
“We advise that patients are treated at a center that has extensive experience in treating these types of cancers,” she says.
Your care team, she continues, should be multidisciplinary, ideally including medical oncologists and radiation oncologists, as well as speech and language pathologists and physical therapists. These specialists can help if you have trouble with speech or swallowing, particularly after surgery and radiation.
Prosthodontists, who specialize in dental prosthetics, will help with reconstructing your jaw. You also will benefit from talking to a dietitian.
“I emphasize the importance of good nutrition,” Chai says. “Even when eating is challenging, a dietitian can help patients stay nourished and strong.”
Chai says that staying active also can aid your recovery. Ask your doctor to recommend a safe exercise program for you. Chai often advises walking, stretching, and other light activity.
“Finally, I remind patients that healing doesn’t happen overnight,” Chai says. “Follow-up care is key, not only for monitoring recovery but also for addressing long-term effects and ensuring the best possible quality of life moving forward.”
Takeaways
Jaw cancers are rare and often treatable. As with many cancers, early diagnosis and treatment offer the best chance of a cure. If you develop any symptoms, talk with your doctor right away. Also, make sure you see a dentist regularly, as dentists often are the first to notice that something is wrong.
Jaw Cancer FAQs
What is the first stage of jaw cancer?
In stage I jaw cancer, the cancer is only in the bone and has not spread to nearby tissue, lymph nodes, or other parts of the body.
Can you live 20 years with oral cancer?
Yes. If your cancer is successfully treated, you can live at least that long.
Does jaw cancer spread quickly?
Some types of jaw cancer are more aggressive than others, meaning they progress quickly. That makes them more challenging to treat. Ameloblastic carcinomas, for example, often grow and spread quickly.
Can a dentist see jaw cancer?
Yes. Dentists often spot jaw cancer before other health care providers, as tumors can be visible during a dental exam or show up on a dental X-ray. Seeing a dentist routinely is one way to boost your chances of catching jaw cancer early, when it’s most treatable.
Is jaw cancer curable?
It can be. It depends on the type of cancer and how early it was diagnosed. Caught before it has spread to other parts of the body, jaw cancer often can be effectively treated with surgery, sometimes combined with radiation. Once it has spread, though, treatment becomes more challenging.
What age is jaw cancer most common?
Most jaw cancers develop after age 55.
