In carcinoma of the lip, submental and submandibular lymphatics are initially involved. Later on the course of the disease, deep cervical lymph nodes can also be involved. The patient may present with masses under the chin and the neck region. Carcinoma of the anterior two thirds of the tongue can spread to the mid and upper deep cervical lymph nodes of the same side. Carcinoma of the posterior one third of the tongue metastasizes to the lymphatic ring around the oropharynx (ring of Waldeyar), and from there to the upper deep cervical lymph nodes.
Hard Palate carcinoma and gingival carcinoma metastasize to the submandibular and upper jugular nodes. Cancer of the floor of the mouth metastasizes to submandibular lymphatics. However, lymphatic metastasis of oral cancer is usually not seen because the deformation caused by the tumor is very obvious, and the disease is diagnosed very early.
Excisional biopsy is usually required for the definite diagnosis of mouth cancer, and treatment is done by surgical excision of the tumor mass. If there is lymph node metastasis, it is treated by surgical excision of said lymph node, chemotherapy and radiotherapy. Some drugs can help prevent the transformation of premalignant conditions to malignant, and they can be used as chemoprophylaxis.