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It is hard to limit the effects of therapy so that only cancer cells are removed or destroyed. Because healthy cells and tissues can also be damaged, treatment often causes unpleasant side effects.
The side effects of cancer treatment vary. They depend mainly on the type and extent of the treatment and the specific area being treated. Also, each person reacts differently. Some side effects are temporary; others are permanent. Attempts are made to plan the patient’s therapy to keep side effects to a minimum. Patients are also very carefully monitored so that any problems which occur can be addressed.

Surgery to remove a small tumor in the mouth usually does not cause any lasting problems. For a larger tumor, however, the surgeon may need to remove part of the palate, tongue, or jaw. Such surgery is likely to change the patient’s ability to chew, swallow, or talk. The patient may also look different.

After surgery, the patient’s face may be swollen. This swelling usually goes away within a few weeks. However, removing lymph nodes can slow the flow of lymph, which may collect in the tissues. This swelling may last for a long time.

Before starting radiation therapy, a patient should see a dentist who is familiar with changes this therapy can cause in the mouth. Radiation therapy can make the mouth sore. It can also cause changes in the saliva and may reduce the amount of saliva, making it hard to chew and swallow. Because saliva normally protects the teeth, mouth dryness can promote tooth decay. Good mouth care can help keep the teeth and gums healthy and can make the patient feel more comfortable. The health care team may suggest the use of a special kind of toothbrush or mouthwash. The dentist usually suggests a special fluoride program to keep the teeth healthy. To help relieve mouth dryness, the health care team may suggest the use of artificial saliva and other methods to keep the mouth moist. Mouth dryness from radiation therapy goes away in some patients, but it can be permanent.

Weight loss can be a serious problem for patients being treated for oral cancer because a sore mouth can make eating difficult. In many cases, it helps to have food and beverages in very small amounts. Many patients find that eating several small meals and snacks during the day works better than trying to have three large meals. Often, it is easier to eat soft, bland foods that have been moistened with sauces or gravies. Thick soups, puddings, and high-protein milkshakes are nourishing and easy to swallow. It may be helpful to prepare other foods in a blender. Special liquid dietary supplements for patients who have trouble chewing can also be suggested. Drinking lots of fluids helps keep the mouth moist and makes it easier to eat.

Some patients are able to wear their dentures during radiation therapy. Many, however, will not be able to wear dentures for up to a year after treatment. Because the tissues in the mouth that support the denture may change during or after treatment, dentures may no longer fit properly. After treatment is over, a patient may need to have dentures refitted or replaced.

Radiation therapy can also cause sores in the mouth and cracked and peeling lips. These usually heal in the weeks after treatment is completed. Often, good mouth care can help prevent these sores. Dentures should not be worn until the sores have healed.

During radiation therapy, patients may become very tired, especially in the later weeks of treatment. Resting is important, but doctors usually advise their patients to try to stay reasonably active. Patients should match their activities to their energy level. It is common for radiation to cause the skin in the treated area to become red and dry, tender, and itchy. Toward the end of treatment, the skin may become moist and “weepy.” There may be permanent darkening or “bronzing” of the skin in the treated area. This area should be exposed to the air as much as possible but should also be protected from the sun. Good skin care is important at this time, but patients should not use any lotions or creams without checking with the doctor. Men may lose all or part of their beard, but facial hair generally grows back after treatment is done. Usually, men shave with an electric razor during treatment to prevent cuts that may lead to infection. Most effects of radiation therapy on the skin are temporary. The area will heal when the treatment is over.

The side effects of chemotherapy depend on which drugs that are given. In general, anticancer drugs affect rapidly dividing cells, such as blood cells that fight infection, cells that line the mouth and the digestive tract, and cells in hair follicles. As a result, patients may have side effects such as a lower resistance to infection, loss of appetite, nausea, vomiting, or mouth sores. They also may have less energy and lose their hair.

The side effects of cancer treatment are different for each person, and they may even be different from one treatment to the next in the same person. Doctors, nurses, and dietitians can explain the side effects of cancer treatment and can suggest ways to deal with them.

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