After diagnosis and staging, the doctor develops a treatment plan to fit each patient's needs. Treatment for oral cancer depends on a number of factors. Among these are the location, size, type, and extent of the tumor and the stage of the disease. The doctor also considers the patient's age and general health. Oral cancer treatment involves surgery, radiation therapy, or, in many cases, a combination of the two. Some patients receive chemotherapy, treatment with anticancer drugs.
For most patients, it is important to have a complete dental exam before cancer treatment begins. Because oral cancer treatment may make the mouth sensitive and more easily infected, doctors often advise patients to have any needed dental work done before treatment begins.
Methods of Oral Cancer Treatment
Patients with oral cancer may be treated by a team of specialists. The medical team may include an oral surgeon; an ear, nose, and throat surgeon; a medical oncologist; a radiation oncologist; a prosthodontist; a general dentist; a plastic surgeon; a dietitian; a social worker; a nurse; and a speech therapist.
Surgery to remove the tumor in the mouth is the usual treatment for patients with oral cancer. If there is evidence that the cancer has spread, the surgeon may also remove lymph nodes in the neck. If the disease has spread to muscles and other tissues in the neck, the operation may be more extensive.
Radiation therapy (also called radiotherapy) is the use of high-energy rays to damage oral cancer cells and stop them from growing. Like surgery, radiation therapy is local therapy; it affects only the cells in the treated area. The energy may come from a large machine (external radiation). It can also come from radioactive materials placed directly into or near the tumor (internal radiation). Radiation therapy is sometimes used instead of surgery for small tumors in the mouth. Patients with large tumors may need both surgery and radiation therapy.
Radiation therapy may be given before or after surgery. Before surgery, radiation can shrink the tumor so that it can be removed. Radiation after surgery is used to destroy oral cancer cells that may remain.
For external radiation therapy, the patient goes to the hospital or clinic each day for treatments. Usually, oral cancer treatment is given 5 days a week for 5 to 6 weeks. This schedule helps protect healthy tissues by dividing the total amount of radiation into small doses.
Implant radiation therapy puts tiny "seeds" containing radioactive material directly into the tumor or in tissue near it. Generally, an implant is left in place for several days, and the patient will stay in the hospital in a private room. The length of time nurses and other caregivers, as well as visitors, can spend with the patient will be limited. The implant is removed before the patient goes home.
Chemotherapy is the use of drugs to kill cancer cells. Researchers are looking for effective drugs or drug combinations for oral cancer therapy. They are also exploring ways to combine chemotherapy with other forms of oral cancer treatment to help destroy the tumor and prevent the disease from spreading.