The treatment for oral cancer is determined by the stage of the disease at the time of diagnosis. Surgery and radiation are the primary therapy options. Chemotherapy is usually provided as adjuvant or neoadjuvant chemoradiotherapy, rather than as a standalone treatment (CRT). If recurring or metastatic oral cancer is not responsive to surgery or radiation, doctors recommend systemic chemotherapy.
Early-stage oral cancer treatment
The first and second stages are the most basic. For early-stage oral cancer, both primary surgery and definitive radiation are viable therapeutic choices. Oncologists prefer surgery to radiation because it produces better results.
In the treatment of early-stage oral cavity malignancies, both external beam radiation therapy (EBRT) and brachytherapy are critical. Small tumours are frequently treated with an intra-oral cone or interstitial brachytherapy by oncologists.
Oncologists advocate treatment for both the primary tumour and the lymph nodal groups in early-stage mouth cancer. Oral cancer surgery can involve a wide local excision or a partial excision of the affected areas with some repair (if required depending on the size of the tumour). Elective neck dissection is routinely performed after this sort of surgery.
After surgery, a final biopsy is conducted, and patients with positive margins of residual tumours, numerous lymph node involvements, or other high-risk features are advised to get adjuvant radiation. To reduce the treatment's potential negative effects, conformal radiation therapy procedures are chosen over traditional radiotherapy.
Locally advanced oral cancer treatment
Oral cancer stages 3 and 4 are locally advanced stages. If these individuals are just treated with surgery or radiation therapy, they are at a high risk of local recurrence. As a result, oncologists recommend a multimodal strategy.
Surgery is recommended when the tumour may be operated on, followed by postoperative radiation therapy or chemoradiotherapy. When a tumour is inoperable, definitive radiation therapy, also known as chemoradiotherapy, may be used.
Treatment of metastatic oral cancer
Oral cancer that has progressed to nearby or distant organs such as the lungs, liver, bones, or brain is known as metastatic oral cancer.
Recurrent oral cancer is a condition in which a patient's cancer returns after the first line of treatment has been completed. This could happen at any point after therapy, such as days, weeks, months, or years afterwards.
Doctors recommend combining chemotherapy with platinum combination regimens for individuals who did not receive systemic therapy during their initial treatment and are in generally good health. Patients with this type of cancer should be treated with a single-agent chemotherapy medication, according to oncologists.
Oncologists recommend chemotherapy or immunotherapy for patients who received systemic chemotherapy as part of their initial treatment. Patients should enrol in a relevant clinical study that is recruiting near them whenever possible. Palliative radiotherapy or palliative surgery are two further treatment choices for relieving a patient's symptoms.
Patients with metastatic or recurring oral cancer have a poor prognosis, with an average survival rate of 6 to 12 months.