Treating Oral Cancer
The first step in oral cancer treatment is identifying the abnormal cells. Once an area of possible tumor activity has been identified through a dental health screening, a biopsy is performed. Sometimes, this is done using a brush. This procedure simply scrapes a sample of cells off the affected area. It’s a painless technique and may be used as a preliminary biopsy. If the results come back showing abnormal cells, a scalpel biopsy is done to extract a sample that is larger or that goes deeper into the tissue. This can be done with a local anesthetic to numb the biopsy site. The tissue is sent to a pathologist who scrutinizes it under a microscope to check for cancerous cells. If the lesion is small, the entire oral tumor may be removed by this kind of incisional biopsy. In this case, the biopsy itself may be the only oral cancer treatment required (besides close monitoring for recurrence).
Additional Oral Cancer Biopsy Methods
If the oral cancer has potentially spread to the lymph nodes, a needle biopsy may be performed to suction a few cells from the suspected nodes. For a larger mass, the doctor may take needle samples from several different areas of the enlarged lymph node to ensure that any cancer is located. Some doctors use a punch biopsy that snips out and extracts a perfectly cylindrical sample of the tissue instead of performing either a traditional incisional or needle biopsy. The purpose of each type of biopsy is the same — identifying whether oral cancer cells are present. It may also be possible to evaluate how advanced the cancer is by the degree of differentiation between healthy and abnormal cells in the biopsy sample.
Other Tests Used In Oral Cancer Treatment
Most oral tumors can be seen or felt in the mouth or neck. However, there are cases when x-ray, CT, PET scans, endoscopy or MRI can check for oral cancer that has developed in internal regions such as the throat, jaw bones, lungs or other internal organs. These scans may be helpful for staging the cancer (determining how much it has spread). They aren’t used for primary diagnosis. A biopsy is still needed to confirm whether there is actually a malignancy present or if the growth is benign.
Assessing Test Results
The goal of the various tests and evaluations is to determine:
- If cancer is currently present
- The size of the oral tumor(s)
- Where it has spread (if applicable)
- How fast it is spreading (how “aggressive” it is)
This information will determine the appropriate oral cancer treatment strategy. Cancer is staged in different ways by different medical practitioners. You should always ask your doctor to explain your stage of oral cancer in plain language you can understand. Stage 1 or 2 cancers are usually localized, smaller tumors. Stage 3 and 4 are larger tumors. Stage 4 is more likely to have spread into the lymph nodes and possibly other areas of the body as well.
Oral Cancer Treatment Procedures
The most common treatment for oral cancer is surgical removal. The tools used (scalpel, laser, etc.) will vary depending on the size and location of the tumor. The surgeon’s two goals will be to ensure that the tumor is completely removed and that the procedure is as minimally invasive as possible. Surgery is the most certain way to eliminate oral cancer that is localized in a small area. Reconstructive surgery may be needed to rebuild tissues and restore function in areas where a larger tumor is removed.
Radiation may also be used to kill cancer cells in a specific area such as the oral tumor itself or affected lymph nodes. Radiation may be employed in combination with surgery (or even during surgery) to target and destroy malignancies. This can be helpful in cases where removing the entire tumor surgically would remove too much of the structure of the patient’s mouth or face. A thorough tooth/gum cleaning is done before oral cancer treatment with radiotherapy begins. This preparatory phase may include addressing any periodontal disease and extracting teeth are too decayed or loose to be saved. The goal is to avoid the need for periodontal or dental surgery after the cancer treatment since radiation therapy can cause problems with tissue healing.
Chemotherapy is not used to actually destroy oral cancer, but it can be useful for preventing or limiting the spread or recurrence of the cancer once it has been treated with surgery and/or radiotherapy. It may also be used to prepare cancerous tissue and make it more susceptible to radiation. Newer treatments for advanced oral cancer include various biological therapies such as vaccines, gene therapy, interleukins, and monoclonal antibodies. Many of these therapies are experimental and only available in clinical trials.
After Oral Cancer Treatment
The side effects and aftereffects of oral cancer therapy depend on the extent and type of treatment. Removal of a small tumor may leave little or no mark. Removal of larger tumors may mean disfigurement that must be corrected with prosthetics or reconstructive surgery. The salivary glands may be damaged by the cancer itself or by radiation, leading to permanent dry mouth. Some patients need therapy to help them eat or speak properly again. When oral cancer is detected and treated early, there are typically fewer and less severe complications.