Your treatment will depend on the nature of the oral lesion. Your dental or medical
professional can tell you about types of treatment, which may include:
- Surgery
- Radiation therapy
-
Combination therapy(Both surgery and radiation therapy may be used
to treat advanced cases of oral cancer.)
- Chemotherapy
It takes time to heal after surgery and the time needed to recover is different
for each person. You may be uncomfortable for the first few days after surgery.
However, medicine can usually control the pain. Before surgery, you should discuss
the plan for pain relief with your doctor. After surgery, your doctor can adjust
the plan if you need more pain relief.
It is common to feel tired or weak for a while. Surgery may cause tissues in your
face to swell. This swelling usually goes away within a few weeks. However, removing
lymph nodes can result in swelling that lasts a long time.
Surgery to remove a small tumour in the mouth may not cause any problems. For a
larger tumour, however, the surgeon may remove part of the palate, tongue or jaw.
This surgery may change your ability to chew, swallow or talk. Also, your face may
look different after surgery. Reconstructive or plastic surgery may be done to rebuild
the bones or tissues of the mouth.
Surgery is performed to remove the tumour in the mouth or throat. Sometimes the
surgeon also removes lymph nodes in the neck. Other tissues in the mouth and neck
may be removed as well. Patients may have surgery alone or in combination with radiation
therapy. Questions to ask before surgery:
- What operation do you recommend for me?
- Do I need any lymph nodes to be removed? Why?
- How will I feel after the operation? How long will I be in the hospital?
- What are the risks of surgery?
- Will I have trouble speaking, swallowing or eating?
- Where will the scars be? What will they look like?
- Will I look different?
- Will I need reconstructive or plastic surgery? When can that be done?
- Will I lose my teeth? Can they be replaced? How soon?
- Will I need to see a specialist for help with my speech?
- When can I get back to my normal activities?
- How often will I need checkups?
- Would a clinical trial be appropriate for me?
Surgery is considered as a safer option when it comes to cancer. If all the cancerous
tissue is removed in the surgery, there are all the chances that it would never
recur.
Radiation therapy (also called radiotherapy) is a type of local therapy. It affects
cells only in the treated area. Radiation therapy is used for small tumours or for
patients who cannot have surgery. It may be used before surgery to kill cancer cells
and shrink the tumour. It also may be used after surgery to destroy cancer cells
that may remain in the area.
Radiation therapy uses high-energy rays to kill cancer cells. Doctors use two types
of radiation therapy to treat oral cancer:
-
External radiation : The radiation comes from a machine. Patients
go to the hospital or clinic once or twice a day, generally 5 days a week for several
weeks.
-
Internal radiation (implant radiation) : The radiation comes from
radioactive material placed in seeds, needles, or thin plastic tubes put directly
in the tissue. The patient stays in the hospital. The implants remain in place for
several days. Usually they are removed before the patient goes home. Some people
with oral cancer have both kinds of radiation therapy.
Treatment often damages healthy cells and tissues, unwanted side effects are common.
These side effects depend mainly on the location of the tumour, type and extent
of the treatment. Side effects may not be the same for each person, and they may
even change from one treatment session to the next. Almost all patients who have
radiation therapy to the head and neck area develop oral side effects. This is why
it is important for the mouth to be in good condition before cancer treatment begins.
Although the side effects of radiation therapy can be distressing, your doctor can
usually treat or control them. It helps to report any problems that you are having
so that your doctor relieve them. Seeing a dentist two weeks before cancer treatment
is necessary. The side effects of radiation therapy depend mainly on the amount
of radiation given. Some side effects in the mouth go away after radiation treatment
ends, while others last a long time. A few side effects (such as dry mouth) may
never go away. Radiation therapy may cause some or all of these side effects:
-
Dry mouth : Dry mouth can make it hard for you to eat, talk, and
swallow. It can also lead to tooth decay. You may find it helpful to drink lots
of water, suck ice chips or sugar-free hard candy, and use a saliva substitute to
moisten your mouth.
-
Tooth decay : Radiation can cause major tooth decay. Doctors suggest
that people gently brush their teeth, gums, and tongue with an extra-soft toothbrush
and fluoride toothpaste after every meal and before bed. If brushing hurts, you
can soften the bristles in warm water. Your dentist may suggest that you use fluoride
gel before, during, and after radiation treatment. Rinsing your mouth several times
a day with a solution made from 1/4 teaspoon baking soda and 1/8 teaspoon salt in
one cup of warm water also helps. After this rinse with plain water.
-
Sore throat or mouth : Radiation therapy can cause painful ulcers
and inflammation. Your doctor can suggest medicines to help control the pain, special
rinses to numb the throat and mouth to help relieve the soreness. If your pain persists,
you can ask your doctor about stronger medicines.
-
Sore or bleeding gums : It is important to brush and floss teeth
gently. Avoid areas that are sore or bleeding. To protect your gums from damage,
it is a good idea to avoid the use of toothpicks.
-
Infection : Dry mouth and damage to the lining of the mouth from
radiation therapy can develop infection. Check your mouth every day for sores or
other changes and to tell your doctor or nurse.
-
Delayed healing after dental care : Radiation treatment makes it
difficult for tissues in the mouth to heal. Plan a thorough dental exam and dental
treatment well before radiation therapy begins.
-
Jaw stiffness : Radiation can affect the chewing muscles and make
it difficult for you to open your mouth. You can prevent or reduce jaw stiffness
by exercising your jaw muscles. Dentists often suggest opening and closing the mouth
as far as possible (without causing pain) 20 times in a row, 3 times a day.
-
Denture problems : Radiation therapy can change the tissues in your
mouth so dentures do not fit . Because of soreness and dry mouth, some people may
not be able to wear dentures for as long as one year after radiation therapy. After
the tissues heal completely and your mouth is no longer sore, your dentist may need
to refit or replace your dentures.
-
Changes in the sense of taste and
smell :
During radiation therapy, food may taste or smell different.
-
Changes in voice quality : Your voice may be weak at the end of the
day. Changes in the weather may affect it. Radiation directed at the neck may cause
your larynx to swell, causing voice changes and the feeling of a lump in your throat.
Ask your doctor to suggest medicine to reduce this swelling.
-
Changes in the thyroid : Radiation treatment can affect your thyroid
(an organ in your neck beneath the voice box). If your thyroid does not make enough
thyroid hormone, you may feel tired, gain weight, feel cold and have dry skin and
hair. Your doctor can check your thyroid hormone. If the level is low, you may need
to take medications for the same.
-
Skin changes in the treated area : The skin in the treated area becomes
red or dry. Good skin care is important at this time. It is helpful to expose this
area to the air while protecting it from the sun. Also, avoid clothes that rub the
treated area, and do not shave the treated area. You should not use lotions or creams
in the treated area without your doctor's advice.
-
Fatigue : You may become very tired, especially in the later weeks
of radiation therapy. Resting is important, but doctors usually advise their patients
to stay as active as they can.
You may want to ask the doctor these questions before having radiation therapy:
- Why do I need this treatment?
- Which drug or drugs will I have?
- How do the drugs work?
-
Should I see my dentist before I start chemotherapy? If I need dental treatment,
how much time does my mouth need to heal before the chemotherapy begins?
- What are the expected benefits of the treatment?
- What are the risks and possible side effects of treatment? What can I do about them?
- When will treatment start? When will it end?
- Will I need to stay in the hospital? How long?
- How will treatment affect my normal activities?
- Would a clinical trial be appropriate for me?
Chemotherapy uses anticancer drugs to kill cancer cells. It is called systemic therapy
because it enters the bloodstream and can affect cancer cells throughout the body.
Chemotherapy is usually given by injection. It may be given in an outpatient part
of the hospital, at the doctor's office or at home. Rarely, a hospital stay may
be needed.
Chemotherapy and radiation therapy can cause similar side effects, including painful
mouth and gums, dry mouth, infection, and changes in taste. Some anticancer drugs
can also cause bleeding in the mouth and a deep pain that feels like a toothache.
The problems you have depend on the type and amount of anticancer drugs you receive
and how your body reacts to them. You may have these problems only during treatment
or after treatment.
Generally, anticancer drugs affect cells that divide rapidly. In addition to cancer
cells, these rapidly dividing cells include the following:
You may want to ask the doctor these questions before having chemotherapy:
- Why do I need this treatment?
- Which drug or drugs will I have?
- How do the drugs work?
-
Should I see my dentist before I start chemotherapy? If I need dental treatment,
how much time does my mouth need to heal before the chemotherapy begins?
- What are the expected benefits of the treatment?
- What are the risks and possible side effects of treatment? What can I do about them?
- When will treatment start? When will it end?
- Will I need to stay in the hospital? How long?
- How will treatment affect my normal activities?
- Would a clinical trial be appropriate for me?
Eating well during cancer treatment means getting enough calories and protein to
prevent weight loss, regain strength, and rebuild healthy tissues. But eating well
may be difficult after treatment for oral cancer. Some people with cancer find it
hard to eat because they lose their appetite. They may not feel like eating because
they are uncomfortable or tired. A dry or sore mouth or changes in smell and taste
also may make eating difficult.
If your mouth is dry, you may find that soft foods moistened with sauces or gravies
are easier to eat. Thick soups, puddings, and milkshakes often are easier to swallow.
Nurses and dietician can help you choose the right foods.
After surgery or radiation therapy for oral cancer, some people need a feeding tube.
A feeding tube is a flexible plastic tube that is passed into the stomach through
an incision in the abdomen. In almost all cases, the tube is temporary. Most people
gradually return to a regular diet. To protect your mouth during cancer treatment,
it helps to avoid:
- Sharp, crunchy foods like taco chips
- Foods that are hot, spicy, or high in acid like citrus fruits and juices
- Sugary foods that can cause cavities
- Alcoholic drinks.
The best prevention is regular oral checkups. To help reduce your risk for oral
cancer, follow the tips below.
- Oral checkups : Visit your dentist regularly or at least 2 times a year.
-
Say no to tobacco : Don’t use tobacco in any form, as it increases the risk for oral
cancer.
-
Limit alcohol : You may be at a higher risk for oral cancer, if you are a chronic
alcohol user.
- Eat healthy : A diet rich in fruits and vegetables may lower your risk of oral cancer.
-
Good oral hygiene : Brush and floss your teeth each day. If you wear dentures, keep
them clean. Maintain good oral hygiene practices.
