Question: What are the treatments for Lip and Oral Cavity Cancer ?
Answer: Key Points - There are different types of treatment for patients with lip and oral cavity cancer. - Patients with lip and oral cavity cancer should have their treatment planned by a team of doctors who are expert in treating head and neck cancer. - Two types of standard treatment are used: - Surgery - Radiation therapy - New types of treatment are being tested in clinical trials. - Chemotherapy - Hyperfractionated radiation therapy - Hyperthermia therapy - Patients may want to think about taking part in a clinical trial. - Patients can enter clinical trials before, during, or after starting their cancer treatment. - Follow-up tests may be needed. There are different types of treatment for patients with lip and oral cavity cancer. Different types of treatment are available for patients with lip and oral cavity cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. Patients with lip and oral cavity cancer should have their treatment planned by a team of doctors who are expert in treating head and neck cancer. Treatment will be overseen by a medical oncologist, a doctor who specializes in treating people with cancer. Because the lips and oral cavity are important for breathing, eating, and talking, patients may need special help adjusting to the side effects of the cancer and its treatment. The medical oncologist may refer the patient to other health professionals with special training in the treatment of patients with head and neck cancer. These include the following: - Head and neck surgeon. - Radiation oncologist. - Dentist. - Speech therapist. - Dietitian. - Psychologist. - Rehabilitation specialist. - Plastic surgeon. Two types of standard treatment are used: Surgery Surgery (removing the cancer in an operation) is a common treatment for all stages of lip and oral cavity cancer. Surgery may include the following: - Wide local excision: Removal of the cancer and some of the healthy tissue around it. If cancer has spread into bone, surgery may include removal of the involved bone tissue. - Neck dissection: Removal of lymph nodes and other tissues in the neck. This is done when cancer may have spread from the lip and oral cavity. - Plastic surgery: An operation that restores or improves the appearance of parts of the body. Dental implants, a skin graft, or other plastic surgery may be needed to repair parts of the mouth, throat, or neck after removal of large tumors. Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy. Radiation therapy Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy: - External radiation therapy uses a machine outside the body to send radiation toward the cancer. - Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated. External and internal radiation therapy are used to treat lip and oral cavity cancer. Radiation therapy may work better in patients who have stopped smoking before beginning treatment. It is also important for patients to have a dental exam before radiation therapy begins, so that existing problems can be treated. New types of treatment are being tested in clinical trials. This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated. Hyperfractionated radiation therapy Hyperfractionated radiation therapy is radiation treatment in which the total dose of radiation is divided into small doses and the treatments are given more than once a day. Hyperthermia therapy Hyperthermia therapy is a treatment in which body tissue is heated above normal temperature to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials. Follow-up tests may be needed. Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups. Treatment Options by Stage Stage I Lip and Oral Cavity Cancer Treatment of stage I lip and oral cavity cancer depends on where cancer is found in the lip and oral cavity. Lip If cancer is in the lip, treatment may include the following: - Surgery (wide local excision). - Internal radiation therapy with or without external radiation therapy. Front of the tongue If cancer is in the front of the tongue, treatment may include the following: - Surgery (wide local excision). - Internal radiation therapy with or without external radiation therapy. - Radiation therapy to lymph nodes in the neck. Buccal mucosa If cancer is in the buccal mucosa (the lining of the inside of the cheeks), treatment may include the following: - Surgery (wide local excision) for tumors smaller than 1 centimeter, with or without internal and/or external radiation therapy. - Surgery (wide local excision with skin graft) or radiation therapy for larger tumors. Floor of the mouth If cancer is in the floor (bottom) of the mouth, treatment may include the following: - Surgery (wide local excision) for tumors smaller than centimeter. - Surgery (wide local excision) or radiation therapy for larger tumors. Lower gingiva If cancer is in the lower gingiva (gums), treatment may include the following: - Surgery (wide local excision, which may include removing part of the jawbone, and skin graft). - Radiation therapy with or without surgery. Retromolar trigone If cancer is in the retromolar trigone (the small area behind the wisdom teeth), treatment may include the following: - Surgery (wide local excision, which may include removing part of the jawbone.) - Radiation therapy with or without surgery. Upper gingiva or hard palate If cancer is in the upper gingiva (gums) or the hard palate (the roof of the mouth), treatment is usually surgery (wide local excision) with or without radiation therapy. Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage I lip and oral cavity cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Stage II Lip and Oral Cavity Cancer Treatment of stage II lip and oral cavity cancer depends on where cancer is found in the lip and oral cavity. Lip If cancer is in the lip, treatment may include the following: - Surgery (wide local excision). - External radiation therapy and/or internal radiation therapy. Front of the tongue If cancer is in the front of the tongue, treatment may include the following: - Radiation therapy and/or surgery (wide local excision). - Internal radiation therapy with surgery (neck dissection). Buccal mucosa If cancer is in the buccal mucosa (the lining of the inside of the cheeks), treatment may include the following: - Radiation therapy for tumors that are 3 centimeters or smaller. - Surgery (wide local excision) and/or radiation therapy for larger tumors. Floor of the mouth If cancer is in the floor (bottom) of the mouth, treatment may include the following: - Surgery (wide local excision). - Radiation therapy. - Surgery (wide local excision) followed by external radiation therapy, with or without internal radiation therapy, for large tumors. Lower gingiva If cancer is in the lower gingiva (gums), treatment may include the following: - Surgery (wide local excision, which may include removing part of the jawbone, and a skin graft). - Radiation therapy alone or after surgery. Retromolar trigone If cancer is in the retromolar trigone (the small area behind the wisdom teeth), treatment may include the following: - Surgery (wide local excision, which includes removing part of the jawbone). - Radiation therapy with or without surgery. Upper gingiva or hard palate If cancer is in the upper gingiva (gums) or the hard palate (the roof of the mouth), treatment may include the following: - Surgery (wide local excision) with or without radiation therapy. - Radiation therapy alone. Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage II lip and oral cavity cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Stage III Lip and Oral Cavity Cancer Treatment of stage III lip and oral cavity cancer depends on where cancer is found in the lip and oral cavity. Lip If cancer is in the lip, treatment may include the following: - Surgery and external radiation therapy with or without internal radiation therapy. - A clinical trial of chemotherapy before or after surgery. - A clinical trial of chemotherapy and radiation therapy. - A clinical trial of hyperfractionated radiation therapy. Front of the tongue If cancer is in the front of the tongue, treatment may include the following: - External radiation therapy with or without internal radiation therapy. - Surgery (wide local excision) followed by radiation therapy. - A clinical trial of chemotherapy and radiation therapy. - A clinical trial of hyperfractionated radiation therapy. Buccal mucosa If cancer is in the buccal mucosa (the lining of the inside of the cheeks), treatment may include the following: - Surgery (wide local excision) with or without radiation therapy. - Radiation therapy. - A clinical trial of chemotherapy before or after surgery. - A clinical trial of chemotherapy and radiation therapy. - A clinical trial of hyperfractionated radiation therapy. Floor of the mouth If cancer is in the floor (bottom) of the mouth, treatment may include the following: - Surgery (wide local excision, which may include removing part of the jawbone, with or without neck dissection). - External radiation therapy with or without internal radiation therapy. - A clinical trial of chemotherapy before or after surgery. - A clinical trial of chemotherapy and radiation therapy. - A clinical trial of hyperfractionated radiation therapy. Lower gingiva If cancer is in the lower gingiva (gums), treatment may include the following: - Surgery (wide local excision) with or without radiation therapy. Radiation may be given before or after surgery. - A clinical trial of chemotherapy and radiation therapy. - A clinical trial of hyperfractionated radiation therapy. Retromolar trigone If cancer is in the retromolar trigone (the small area behind the wisdom teeth), treatment may include the following: - Surgery to remove the tumor, lymph nodes, and part of the jawbone, with or without radiation therapy. - A clinical trial of chemotherapy before or after surgery. - A clinical trial of chemotherapy and radiation therapy. - A clinical trial of hyperfractionated radiation therapy. Upper gingiva If cancer is in the upper gingiva (gums), treatment may include the following: - Radiation therapy. - Surgery (wide local excision) and radiation therapy. - A clinical trial of chemotherapy and radiation therapy. - A clinical trial of hyperfractionated radiation therapy. Hard palate If cancer is in the hard palate (the roof of the mouth), treatment may include the following: - Radiation therapy. - Surgery (wide local excision) with or without radiation therapy. - A clinical trial of chemotherapy and radiation therapy. - A clinical trial of hyperfractionated radiation therapy. Lymph nodes For cancer that may have spread to lymph nodes, treatment may include the following: - Radiation therapy and/or surgery (neck dissection). - A clinical trial of chemotherapy and radiation therapy. - A clinical trial of hyperfractionated radiation therapy. Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage III lip and oral cavity cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Stage IV Lip and Oral Cavity Cancer Treatment of stage IV lip and oral cavity cancer depends on where cancer is found in the lip and oral cavity. Lip If cancer is in the lip, treatment may include the following: - Surgery and external radiation therapy with or without internal radiation therapy. - A clinical trial of chemotherapy and radiation therapy. - A clinical trial of chemotherapy before or after surgery. - A clinical trial of hyperfractionated radiation therapy. Front of the tongue If cancer is in the front of the tongue, treatment may include the following: - Surgery to remove the tongue and sometimes the larynx (voice box) with or without radiation therapy. - Radiation therapy as palliative therapy to relieve symptoms and improve quality of life. - A clinical trial of chemotherapy and radiation therapy. - A clinical trial of chemotherapy before or after surgery. - A clinical trial of hyperfractionated radiation therapy. Buccal mucosa If cancer is in the buccal mucosa (the lining of the inside of the cheeks), treatment may include the following: - Surgery (wide local excision) and/or radiation therapy. - A clinical trial of chemotherapy and radiation therapy. - A clinical trial of chemotherapy before or after surgery. - A clinical trial of hyperfractionated radiation therapy. Floor of the mouth If cancer is in the floor (bottom) of the mouth, treatment may include the following: - Surgery before or after radiation therapy. - A clinical trial of chemotherapy and radiation therapy. - A clinical trial of chemotherapy before or after surgery. - A clinical trial of hyperfractionated radiation therapy. Lower gingiva If cancer is in the lower gingiva (gums), treatment may include the following: - Surgery and/or radiation therapy. - A clinical trial of chemotherapy and radiation therapy. - A clinical trial of chemotherapy before or after surgery. - A clinical trial of hyperfractionated radiation therapy. Retromolar trigone If cancer is in the retromolar trigone (the small area behind the wisdom teeth), treatment may include the following: - Surgery to remove the tumor, lymph nodes, and part of the jawbone, followed by radiation therapy. - A clinical trial of chemotherapy and radiation therapy. - A clinical trial of chemotherapy before or after surgery. - A clinical trial of hyperfractionated radiation therapy. Upper gingiva or hard palate If cancer is in the upper gingiva (gums) or hard palate (the roof of the mouth), treatment may include the following: - Surgery with radiation therapy. - A clinical trial of chemotherapy and radiation therapy. - A clinical trial of chemotherapy before or after surgery. - A clinical trial of hyperfractionated radiation therapy. Lymph nodes For cancer that may have spread to lymph nodes, treatment may include the following: - Radiation therapy and/or surgery (neck dissection). - A clinical trial of chemotherapy and radiation therapy. - A clinical trial of chemotherapy before or after surgery. - A clinical trial of hyperfractionated radiation therapy. Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage IV lip and oral cavity cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.