Oral Cancer Treatment Options - OmniMedicalSearch.com

Conditions & Diseases: Cancers

Oral Cancer

Treatment Options

Oral Cancer Treatment

The treatment plan varies from patient to patient and is established according to five main factors: (1) the patient's age, general health and past medical history, (2) the cancer type, size, and location, (3) the treatment tolerance, (4) the risk for hidden disease, and (5) the need to save certain functions.

A better treatment outcome is achieved in patients diagnosed with oral cancer in early stages.

The main treatment approach in patients with oral cancer are: surgery and radiotherapy. Chemotherapy is also used to treat oral cancer, but it is usually used in patients with metastasis and it does not represent a primary treatment approach for oral cancer.

Surgery

Surgery is a medical procedure aimed to completely remove the tumor tissue together with surrounding healthy tissue in order to prevent a future cancer relapse.

There are six surgery techniques performed in patients with oral cancer. These are:

Primary tumor resection: This is a type of surgery where the entire tumor together with surrounding tissue is removed.
Mandible resection: This is a type of surgery where the tumor is removed together with part or the entire jaw bone.
Maxillectomy: This is a type of surgery where the tumor is removed together with part or the entire hard palate (the mouth’s roof). This surgery is usually performed when the cancer has spread to the mouth roof bone.
Mohs' micrographic surgery: This is an advanced surgically procedure that relies on the microscope accuracy to trace and assure a complete removal of the cancer down to its roots, leaving healthy tissue unharmed. Moh‘s micrographic surgery removes the tumor in thin layers. Each layer of tumor removed is checked under a microscope for cancer cells and the procedure will continue until there are no more cancer cells in the removed layer. This type of surgery can be performed when the tumor is on the lip.
Laryngectomy: This type of surgery is performed in patients with large tumors on the tongue or oropharynx. In some cases, the surgeon has to remove the larynx (the voice box).
Neck dissection: This type of procedure is performed when the cancer has spread to the lymph nodes within the neck. During this procedure, the tumor is removed together with the lymph nodes affected by cancer.

When performed in early stages, the surgery is small with less post-surgery scars or disfiguration. When performed in advanced stages, the surgery is complex, it removes a substantial amount of tissue, and in most cases requires future reconstruction work.

The side effects are also influenced by the complexity of the surgery and the tumor size. The most common post-surgery side effects include:

Swelling (the tissue around the operated area can swell for couple of weeks).
Pain
Feeling tired
Weakness

When the removed tumor is too big and the procedure involves removing surrounding tissues or organs (such as palate, tongue, or jaw), - the patient can experience the following side effects:

Disfiguration.
Chewing, swallowing, or talking difficulties.

Radiation therapy or radiotherapy

This is a local type therapy that uses high-energy rays or particles to destroy cancerous cells. The purpose of this treatment is to destroy cancerous tissues preserving the healthy tissue. The radiation therapy is used (1) as a curative treatment in patients that cannot be operated on with small tumors, (2) as an adjuvant treatment - in addition to surgery (to enhance the results of the surgery by destroying possible cancerous cells that could have been left behind, and reducing the risk of cancer relapse), 3) as a neoadjuvant treatment - before surgery (to reduce the size of the tumor).

There are two type of radiation therapy performed in patients with oral cancer:

1. External beam radiation: This form of radiation therapy uses a device called a linear accelerator that generates an external beam that is concentrated on the tumor area and breaks it up into smaller pieces. Sessions last a few minutes and are administered every day for several weeks.

2. Internal radiation: The radiation is administrated from radioactive materials (such as seeds, needles, thin tubes) inserted into the tumor. When this time of treatment is administrated, the patient has to stay in the hospital.

In some cases, a patient can receive both types of radiation therapy for a better treatment outcome.

Radiation therapy side effects depend mainly on the radiation dosage and the targeted area. The most common side effects displayed by oral cancer patients that undergo radiation therapy are:

Dry mouth.
Eating, swallowing, and talking difficulties.
Mild to major tooth decay (this side effect can be diminished with a correct and good mouth care, keeping the teeth and gums healthy).
Sore throat or mouth (painful sores and inflammations).
Sore or bleeding gums.
Mouth infections (radiation therapy can damage the mouth lining causing infection).
Delayed healing (radiation therapy can slow down the healing process for the mouth tissue).
Jaw stiffness (radiation therapy can affect the chewing muscle which leads to difficulties in opening the mouth).
Denture problems (radiation therapy might cause the denture to not fit anymore).
Taste and smell changes (during radiation therapy the food might taste and smell different).
Voice quality changes (the voice might become weak especially at the end of the day).
Larynx swelling (this also cause the voice to change and the patient can feel a lump in their neck).
Thyroid changes (radiation therapy might affect the normal function of the thyroid, decreasing the amount of hormones normally produce by this gland. These can cause the patient to gain weight, to feel tired, to have cold sensations, and dry skin and hair.
Dry, red and extremely sensitive skin in the area exposed to radiation.
Fatigue.

Most of these side effects can be controlled and diminished with medication.

Chemotherapy

This is a systemic type of treatment (affects cells throughout the entire body) that uses drugs either to stop the abnormal growth and dividing process of the cancerous cells, or to kill them. This treatment also has the ability to interfere with the cancerous cells’ replication.

Chemotherapy can be administrated in combination with surgery and radiation therapy for a better treatment outcome. The chemotherapy drugs can be given intravenous or as pills.

Chemotherapy side effects include:

Mouth bleeding and deep pain (that is felt like a toothache).
Dry mouth
Gums pain
Taste changes
Mouth infections
Temporary hair loss
Nausea with or without vomiting
Diarrhea
Loss of appetite
Fatigue
Weakness
General vulnerability to infection
Easy bleeding and brushing

These side effects vary from patient to patient according to the drugs and the body reaction to these drugs. Some side effects can be controlled with medication to increase the patient’s comfort during the treatment.

Article by Alina Morrow, MS
Medical Writer
OmniMedicalSearch.com