What are the treatment options for oral cancer

Treatment will depend on various factors, such as where the cancer is, its stage, as well as the patient's general health and personal preferences. Some people may have to undergo a combination of treatments

Surgery - this may include:
* Surgical removal of the tumor - the tumor is surgically taken out, as well as a margin of healthy tissue around it. If the tumor is small surgery will be minor. Larger tumors will require more extensive surgery, such as the removal of some of the jawbone or some of the tongue.
* Surgical removal of cancer that spread to the neck - mouth cancer tends to spread to the lymph nodes in the neck. The surgeon may perform a neck dissection - cancerous lymph nodes and related tissue in the neck are surgically removed. A radical neck dissection involves the removal of a tumor from the neck as well as additional normal tissue of at least 2 cm surrounding the tumor, as well as removing the lymph nodes from the neck. In a radical dissection not only is the affected tissue removed, but also nearby tissue that may be affected (but not clearly identified as such).
* Mouth reconstruction - if surgery significantly changed the appearance of the face, or the patient's ability to talk and/or eat, surgeons may transplant grafts of skin, muscle or bone form other parts of the body to reconstruct the face. To help in eating, implants may replace the patient's natural teeth.

Radiotherapy (radiation therapy) - about 40% of all types of cancer patients undergo some kind of radiotherapy. It involves the use of beams of high-energy X-rays or particles (radiation) to destroy cancer cells. Radiotherapy works by damaging the DNA inside the tumor cells, destroying their ability to reproduce. Radiation therapy can be delivered from outside the body (external beam radiation) or from radioactive seeds and wires that are placed near the cancer inside the body (brachytherapy). Oral cancers are especially sensitive to radiotherapy.

Internal radiotherapy (brachytherapy) - often used to treat patients with early stages of cancer of the tongue. Radioactive wires or needles are stuck directly into the tumor while the patient is under a general anesthetic. The wires/needles release a dose of radiation into the tumor. While the patient is receiving internal radiation therapy he/she will stay in a single room at the hospital. Although levels of radiation are generally safe, hospital staff will only be able to spend short periods in the same room during treatment. This is because staff members are dealing with radiation every day of their lives and their exposure, although small each time, can accumulate over the long-term.
Most courses of brachytherapy last from 1 to 8 days.
The patient's mouth will swell and he/she will have some pain five to ten days after the implants are taken out. Within a few weeks the pain will ease and go away. Patients may find that consuming cool, plain, soft foods is easier. Smoking tends to make the pain worse.
Individuals in early-stage mouth cancer may be fortunate enough to have radiation therapy as their only treatment.
Radiation therapy is often used before and after surgery. It is usually given after surgery to help prevent recurrence (cancer coming back). It is sometimes used in combination with chemotherapy.
For those with advanced cancer radiation therapy may help relieve pain.

Chemotherapy - When the cancer is widespread chemotherapy is commonly used with radiotherapy. If there is a significant risk of recurrence (cancer coming back) chemotherapy combined with radiotherapy may be used.
Chemotherapy involves using powerful medicines that kill cancer; they damage the DNA of the cancer cells, undermining their ability to reproduce.
Targeted drug therapy (monoclonal antibodies) - this involves drugs that change aspects of cancer cells that help them grow. Cetuximab (Ebitux) is used for some head and neck cancers - it stops the action of a protein found in many kinds of healthy cells, but is more prevalent in the surface some cancer cells. The protein is called epidermal growth factor receptors (EGFR).
Sometimes targeted drugs are used in combination with radiotherapy or chemotherapy.
Cetuximab is given through a drip into the vein over a period of a few hours during the first administration - subsequent weekly doses take about an hour each.