How is Oral cancer Treated
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 patient’s age and general health are also considered. 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 cancer treatment can make the mouth sensitive and more easily infected, doctors often advise patients to have any needed dental work done before treatment begins.
Most people with cancer want to learn all they can about their disease and their treatment choices so they can take an active part in decisions about their medical and dental care. The doctor is the best person to answer their questions. Also, the patient may want to talk with the doctor about taking part in a research study of new treatment methods. Such studies, called clinical trials, are designed to improve cancer treatment.
Many patients find it useful to make a list of questions before seeing the doctor. Taking notes can make it easier to remember what the doctor says. Some patients also find that it helps to have a family member or friend with them to take part in the discussion, to take notes, or just to listen.
There is a lot to learn about cancer and its treatment. Patients do not need to ask all their questions or understand all the answers at once. They will have many chances to ask the doctor to explain things that are not clear and to ask for more information.
Methods of 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 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 can 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 cancer cells that may remain.
For external radiation therapy, the patient goes to the hospital or clinic each day for treatments. Usually, 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 to treat oral cancer. They are also exploring ways to combine chemotherapy with other forms of cancer treatment to help destroy the tumor and prevent the disease from spreading.
Health Products AdvertisementsClinical Trials
Researchers are developing treatment methods that are more effective against oral cancer, and they are also finding ways to reduce side effects of treatment. When laboratory research shows that a new methods has promise, doctors use it to treat cancer patients in clinical trials. These trials are designed to answer scientific questions about the new approach and to find out whether it is both safe and effective. Patients who take part in clinical trials make an important contribution to medical science and may have the first chance to benefit from improved treatment methods.
Clinical trials to study new treatments for oral cancer are under way in hospitals throughout the country. Some trials involve ways to shrink or destroy the primary tumor. In others, scientists are testing ways to prevent the cancer from coming back in the mouth or spreading to other parts of the body. Still others involve treatments to slow or stop cancer that has already spread.
Researchers are studying the timing of treatments and new ways to combine various types of treatment. For example, they are trying to increase the effectiveness of radiation therapy by giving treatments twice a day instead of once a day. They are also working with hyperthermia (heat) and with drugs called radiosensitizers to try to make cancer cells more sensitive to radiation. Researchers are also using drugs to help protect normal cells from radiation damage. In addition, they are exploring various new anticancer drugs and drug combinations.
People who have had oral cancer have an increased risk of developing a new cancer of the mouth or another part of the head or neck. Doctors are trying to find ways to prevent these new cancers. Some research has shown that a substance related to vitamin A may prevent a new cancer from developing in someone who has already been successfully treated for oral cancer.
Oral cancer patients who are interested in taking part in a trial should talk with their doctor. They may want to read What are Clinical Trials All About?, a booklet that explains what treatment studies are and outlines some of their possible benefits and risks.
One way to learn about clinical trials is through PDQ, a computerized resource developed by the National Cancer Institute. PDQ contains information about cancer treatment and an up-to-date list of trials all over the country. The Cancer Information Service can provide PDQ information to doctors, patients, and the public.