Oral Cancer: Treatment Choices
Oral cancer is often curable, especially if it is found early. Treatment can also help control oral cancer, meaning it may help control symptoms or reduce its spread. Once you know the type and stage of oral cancer you have, you and your doctor will decide on a treatment plan. Talking about your treatment choices will be one of the most important discussions that you will have with your doctor.
There are various treatment choices for oral cancer. Which may work best for you? It depends on a number of factors. These include:
Type of oral cancer you have
Size and location of the main tumor
If the cancer cells have spread to other parts of your body
Your overall health
Your personal preferences
Understanding the goals of treatment
Treatment may control or cure the oral cancer. It can also improve your quality of life by helping to control the symptoms of the disease. Treatment for oral cancer may have one or more of these goals:
Remove or kill the cancer cells as quickly as possible, while doing as little damage as possible to nearby areas
Kill any cells that may have spread
Control further spread of cancer cells
Relieve symptoms caused by the cancer
Types of treatment for oral cancer
Oral cancer can be treated with any of these:
Surgery. Most people with oral cancer have surgery first. There are several types of surgery. The kind you have depends on the location of the tumor. The goal is to take out the tumor. In some cases, this may cure the cancer. Depending on the location of the tumor, you may also need reconstructive surgery after the tumor is removed.
Radiation treatment. This is the use of high-energy rays to kill cancer cells. You may have external radiation. The radiation is directed to your skin above the site of the tumor from a machine. In some cases, you may have radiation alone or along with chemotherapy as your only treatment. For more advanced cancer, radiation may be used to help control symptoms.
Chemotherapy. This treatment uses medicines to kill cancer cells. You may take one or more medicines. Chemotherapy is often used for more advanced cancer, sometimes along with radiation therapy.
Cetuximab. This is a type of targeted therapy called a monoclonal antibody. It mimics part of your immune system. It targets the part of cancer cells that allows them to grow and divide. It may be used for all stages of oral cancer.
Supportive care. These are treatments that help ease your symptoms, but don’t treat the cancer. Your healthcare provider may advise supportive care if other treatments are more likely to do you more harm than good.
Your doctor may suggest that you get more than 1 type of treatment. Getting 2 or more treatment types is called combination treatment or combination modality treatment.
For instance, you may have surgery and chemotherapy. Or you may have surgery and radiation, or radiation and chemotherapy. You may even have all 3 types of treatment.
The order that you get treatments has a specific name. For instance, when you have a treatment before having surgery, it is called neoadjuvant treatment. You may have chemotherapy and/or radiation before surgery. These help shrink the tumor. A smaller tumor is easier to take out. They also help keep the cancer from spreading.
Or, you may have more treatment after surgery. This is called adjuvant treatment. You may have chemotherapy or radiation soon after surgery. The goal is to kill any cancer cells that are left. Even if there is no sign of cancer, your doctor may still suggest adjuvant treatment. Having it reduces the risk that cancer may come back or spread.
Clinical trials for new treatments
Research is ongoing to find more ways to treat oral cancer. These new methods are tested in clinical trials. Talk with your healthcare provider to find out if there are any clinical trials you should consider.
Making a decision
It may take some time to choose the best plan. Talk with your doctor about how much time you can take to explore your options before you must make a decision. You may want to talk with your family and friends, and you may want to consider getting a second opinion. It's rare that the time it will take to get a second opinion will have a negative impact on your treatment. The peace of mind a second opinion provides may be well worth the effort.
March 15, 2019
Cunningham, Louise, RN,Gersten, Todd, MD