/ Cancer (Oncology) / Oral Cancer Treatment

Oral Cancer Treatment

Oral cancer treatment involves advanced technology treatments that reduce or eliminate the tumors that grow inside the lining of the mouth. Although a rare form of cancer, not only can oral cancer be treated, efforts can also be made to restore the appearance completely.
How it works
Oral cancer involves three phases of treatment: surgery, radiotherapy and chemotherapy. Your doctor may advise you any one of these or a combination of these, depending upon your condition.
This phase of treatment removes the cancerous tumor from the mouth. When detected at an early stage, surgery can be a stand-alone treatment for oral cancer. However, it may also work for patients who are in advanced stages of oral cancer as a combination with radiation and chemotherapy.
There are many surgical techniques when it comes to oral cancer treatment. The doctor may recommend any one or a couple of the procedures mentioned below:
  • Tumor resection: This procedure removes the tumor completely along with some of the surrounding normal tissue. It works for small tumors that can be accessed easily.
  • Mohs micrographic surgery: This procedure is recommended for certain cancers of the lip. Here the tumor is removed in thin slices and each slice is microscopically examined for cancerous cells if any.
  • Full or partial mandible (jawbone) resection: This procedure is for tumors that may have grown into the jawbone. It involves the removal of the jawbone, either partially or completely.
  • Glossectomy: Being a surgery that is aimed at treating the cancers of the tongue, this treatment involves the removal of the tongue, either partially or in whole.
  • Maxillectomy: This surgery involves the removal of the hard palate, which is the front of the roof of the mouth, either completely or partially. A special denture would be created to fill in this hole, after the surgery.
  • Laryngectomy: Apart from the primary tumor, this surgery also removes the voice box. Through the appropriate technique, vocal capabilities can be successfully restored after the surgery.
  • Neck dissection: This surgery is performed when the oral cancer has spread to the neck. The lymph nodes in the neck would be removed here. This dissection could be partial, modified radical or radical. 
Apart from the above, there are a few other types of oral cancer surgeries such as Pedicle or free flap reconstruction, tracheostomy, gastrostomy tube surgery and dental extraction and implants.

Radiation therapy or Radiotherapy:
Highly energized rays are used to destroy cancer cells or slow down their growth. Radiation therapy uses high-energy x-rays or particles to destroy cancer cells or slow their rate of growth. Radiotherapy is generally used as the main treatment to treat small cancers. For larger cancers, this may be used as a combination with surgery, chemotherapy or targeted therapy. As a combination with chemotherapy, it can kill those small deposits of cancer that may have been left behind after surgery (adjuvant radiation therapy). It can be used to shrink the size of the cancer prior to oral cancer surgery (neoadjuvant therapy).
It can also relieve symptoms of advanced stages of cancer such as bleeding, pain, difficulty in swallowing and bone metastases problems. Radiation therapy can be of different types:
  • External beam radiation therapy: A beam of high energized x-rays is emitted from a radiation machine externally. The dosage can be adjusted accurately and the beam aimed precisely at the target so that no damage is caused to the surrounding tissues. The procedure is similar to X-Ray and requires treatment 5 days a week for about six to seven weeks.
  • Hyperfractionation: In this type of radiation, the total dose is divided into larger number of doses. For instance, instead of 1 large dose, you may receive 2 small doses that add up to that dose.
  • Accelerated fractionation: To ensure faster completion of treatment, more number of doses are given per day.
  • Brachytherapy: Also known as internal radiation, this involves the placement of radioactive materials near or directly into the cancer. It may not be recommended for oropharyngeal or oral cavity cancers.
- In one form of this treatment, hollow thin tubes or catheters are placed during the surgery, either within or around the tumor. Then the radioactive materials will be inserted into these tubes for some amount of time every day.

- The other form involves the placement of small radioactive pellets directly into the tumor. 

Radiation maybe combined with techniques such as Intensity Modulated RadiationTherapy and three-dimensional conformal radiation therapy which precisely map the location of the cancer by using the results of imaging tests such as MRI and other special computer programs. They make radiation a whole lot safer.
Also known as systemic therapy, this phase of treatment makes use of anticancer drugs to destroy cancer cells. These drugs are usually given through injections.Technological developments have also introduced a new type of targeted therapy called Cetuimab. This aims at blocking the growth factors of cancer cells, completely. This is used alone or as a combination with radiotherapy.
Side Effects & Risks
The side effects and risks in the case of oral cancer treatment may differ from person to person, depending upon the treatment and location of tumor.
Side effects of surgery
  • Swelling near operated area
  • Difficulty in chewing, swallowing or talking
  • Change in shape of face
Side Effects of Radiation
  • Dry mouth with difficulty in chewing and swallowing
  • Tooth decay
  • Jaw stiffness
  • Loss of sense of smell and taste
  • Fatigue
  • Change in texture of skin at the treated area
Side effects of Chemotherapy
  • Fatigue
  • Vomiting
  • Indigestion
  • Hair loss
  • Change in taste
Nevertheless, most of these side effects are temporary and will disappear with time.
Preparing for the Oral cancer treatment
You will have to be prepared both mentally and physically to endure the treatment you are going to undergo for oral cancer. Make sure you let your doctor know about any kind of allergies you may have to any medications, any ailments or illnesses you may be
suffering from and any medications you may be taking, much before your oral cancer treatment begins.
You may be asked to refrain from consuming tobacco or alcohol. You may be asked to go through a few blood tests and urine tests. You may also have to undergo a few other tests such as:
  • ECG
  • CT scan
  • PET scan
  • MRI Scan
  • X-rays
  • Endoscopy
What to expect after Oral cancer treatment?
Regular checkups may be required to make sure you are recovering as expected and there are no recurrences or secondary cancers. You may have to go to your dentist a couple of times to get your mouth examined. 

Apart from managing the side effects, you may have to focus on improving your abilities to chew, swallow and talk so as to lead a better quality life. In some cases, reconstructive procedures and proper prosthodontics may be required to restore appearance after surgery.
Results of Oral cancer treatment
While oral cancers that are detected early seem to have a 90% chance of being treated completely, there are certain types where you can only control the growth. However, the advancements in technology have started painting a better picture of oral cancer treatment in today’s world. With such treatments you can be assured of adding a few more years to your life span, while leading an almost normal regular lifestyle.