mouth cancer treatment

Treatment of mouth cancer

From Dr. Ananya Mandal, MD

Who treats mouth cancer?
Mouth cancer is treated by a team of specialists ranging from:

oncologists (cancer specialists)

radiotherapists

oncosurgeons

cosmetic surgeons and plastic surgeons for reconstruction after surgery

oncology nurses

pathologists

dental surgeons

dieticians

social workers

psychologists

councilors

behavioral, language therapists etc.

The treatment plan is decided considering the phase of the tumor as well as the patient's preferences and choices.

How likely is long-term survival with mouth cancer?
If the tumor is localized in the mouth and throat (pharynx) there is a high possibility of long term survival and recovery using a combination of surgery, radiotherapy and chemotherapy.

The cure is less likely if the tumor is of a high grade or if it is spreading rapidly to other organs and tissues through the blood and lymphatic system. This type of cancer can also be slowed down in its progress using surgery, radiation therapy and chemotherapy.

Before treatment
First treatment begins a complete dental and oral examination is performed to delineate the cancer. Dental work is essential since radiation therapy can damage your teeth and make it prone to infections and rupture.

Quitting smoking tobacco and alcohol is important before any treatment began as these, if continued; reduce the possibility of treating cancer.

Types of treatment of mouth cancer
Mouth cancer treatment may include surgery, photodynamic therapy (PDT) and so on. 1-4

Surgery for mouth cancer
The primary goal of surgical therapy in mouth cancer is to remove any affected tissue. Usually this is an important operation performed under general anesthesia depending on the site and the extent of cancer involvement.

Some patients may have a large part of their tongue, cheek or removed due to cancer. These patients require reconstructive or plastic surgery to recreate the cheeks and lips. This extra tissue and skin is usually taken from other parts of the body such as the chest, forearms, abdomen or thighs.

If the language is affected it is sectioned out. This is called glossectomy. The tongue can be recreated using grafted or prosthetic tissues.

Some patients may require their jaws or cheekbones to be removed due to cancer. The bone can be reconstructed using bone from another part of the body and grafting into place. Cheekbones can be replaced with dentures that are molded plastic pieces in the shape of bone that is removed.

Surgery also involves the removal of the lymph nodes for biopsy or for the removal of cancer that has spread to the lymph nodes. This is called the neck dissection.Photodynamic therapy (PDT)
Photodynamic therapy (PDT) is preformed in the early stages of cancer. This is a type of laser therapy that involves taking a drug that makes the tissue more sensitive to light therapy. A laser is then used to remove or kill the tumor.

Radiation therapy for mouth cancer
Radiation therapy uses high energy beams to kill cancer cells. The tumor is removed by radiotherapy alone or radiotherapy is performed after the surgical removal of the cancer.

Treatment is normally given every day over three to seven weeks. The regime depends on the extent of the spread of cancer.

Radiation therapy has side effects like:

irritated skin

ulcers in the mouth

fatigue

dry mouth

loss or changes, taste

loss of appetite

nausea

bad breath etc.

Radiation can be provided by x-rays as machines that require the patient to visit the hospital for sessions. This is called external radiotherapy.

Radiation can also be given internally. It involves the insertion of radioactive wires or needles into the tumor and this releases a constant amount of radiation that kills the tumor inside.

Chemotherapy for mouth cancer
Chemotherapy is the use of anticancer drugs such as cisplatin for the treatment of tumors. This is useful when the tumor is of a high degree and has spread to other organs.

These drugs damage the DNA of cancerous cells or kill to prevent them from multiplying. Common side effects include:

ulcers of the mouth

hair loss

loss of appetite

nausea

He retched

fatigue

greater tendency to acquire infections

increased bleeding tendencies

The side effects should stop once you have finished the treatment.

New drugs for the treatment of mouth cancer
New drugs are used against mouth cancer. Among these is Cetuximab used in advanced cases of mouth cancer. It is usually used in combination with chemotherapy or radiotherapy.

This type of therapy targets cancer cells selectively and thus has less chemotherapy related side effects.