Mouth cancer is fortunately, not that common, although it definitely occurs more frequently amongst heavy drinkers and smokers, and when it does occur it can affect the lip the tongue, floor of the mouth, or the throat.
The head and neck is a complex part of the body with many networks of nerves and blood vessels as well as important organs such as the eyes and brain so treatment of cancers in this region can be difficult and complex. For this reason it is usual for a multi-discipline approach to be taken, with specialists in various types of treatment procedures co-operating in order to get the best result.
Before definitive treatment, it is necessary to carry out a full dental examination and have any necessary reparative work done since radiotherapy is often part of cancer management and leaves the body more susceptible to infection afterwards.
It is imperative for a smoking and/or drinking habit also to be stopped, and for a really good level of daily oral hygiene to be established in order to have the best chance of a successful mouth cancer treatment outcome.
This video from Macmillan (cancer charity in the UK) helps sum up the treatment options:
Types of treatment
If you are unlucky enough to get a cancer in the facial area, the treatment plan will largely depend on whether the cancer is localised or may have already spread. In the former case it is often possible to effect a cure with combination therapy involving surgery, radiotherapy, and chemotherapy.
If the cancer has spread to other parts of the body, then unfortunately a complete cure cannot usually be expected, but treatment can slow the progress of the disease and help relieve symptoms. A comprehensive consultation is always given, along with time to discuss all options.
It is generally agreed that surgery is often the best main thrust of treatment for mouth cancer if a tumor is localised and discrete, and has not as yet spread to other parts of the body. Surgery in the facial area is not easy however because of the complex anatomy and the many important parts of the face needing to be preserved. The aim is to remove a cancer in situ with as little damage to surrounding tissues as possible.
If the cancer is caught early enough it may be possible to remove it with a type of laser surgery known as photodynamic therapy (PDT). This treatment involves administering a drug to make body tissues sensitive to light, and the cancerous tissue is more sensitive than normal tissue and can be destroyed this way.
For more advanced or established tumors it is necessary to have surgery which would involve removal of some oral cavity lining, skin, or even part of the tongue. Grafts are used to make good the affected areas following surgical removal of the cancer.
In some cases the jawbone may be infiltrated by cancer and in that case part of it would have to be removed. There again bone grafts are used to make good the damage. If the upper jaw is involved, however, it’s sometimes necessary to replace lost bone with a plastic prosthesis.
It is fairly common practice for local lymph nodes to also be surgically removed since they may be harbouring small numbers of cancerous cells already escaped from the tumor. There is no way of telling whether this has happened or not so this is a recognised preventative measure.
Radiotherapy involves measured doses of radiation to destroy cancerous cells, since they are more sensitive to irradiation than normal cells. Radiotherapy can be used on its own but is more commonly employed after surgery to prevent recurrence of a tumor. Radiotherapy may involve several treatment sessions spread out over a period of weeks.
Radiotherapy inevitably causes some damage to normal tissues and side effects can include burns, ulcers, soreness, dry mouth, loss of taste, loss of appetite, a stiff jaw, nausea, and general tiredness. Any side effects are alleviated as far as possible by a support medical team.
Cancer of the tongue may be amenable to irradiation from within using radioactive wires inserted under a general anaesthetic. A course of this type of treatment can mean hospitalisation for up to a week. Side effects include temporary swelling and pain which are alleviated as far as possible.
Chemotherapy may be used along with radiotherapy in certain cases, but again there areinevitable side effects such as a sore mouth, nausea, tiredness, and loss of hair. Hair usually grows back within a few months, however.
Newer treatments for mouth cancer may involve biological measures such as monoclonal antibodies which can attack cancer cells and prevent them spreading. An example of this type of treatment is the use of Cetuximab but it may only be used if chemotherapy is not appropriate for health reasons apparently, because of the extraordinary cost involved. Cetuximb is given by infusion into a vein and also carries a risk of side effects but of course it is necessary to weigh the benefits against the risks.
Intravenous infusion of vitamin C has also been claimed by some to provide effective treatment for some cancers but the treatment is a long way from being generally accepted as yet.
Health experts generally agree that over 80% of oral cancers could be prevented by simply avoiding the likely triggering habits of drinking and smoking. Oral cancer can be treated but it is infinitely better to avoid it in the first place!