Oral Cancer Treatment
in Pasadena, TX
Oral cancer often appears in the mouth as a white, or red, spot or sore that is so small it goes unnoticed. Because many people do not realize they have oral cancer, a diagnosis may not be made until cancer has become more advanced, making treatment more difficult. Early detection of cancer and precancerous conditions increases the likelihood of a cure. Regular dental examinations are an invaluable part of early cancer detection and treatment.
Oral cancer can be caused or exacerbated by heavy alcohol and tobacco use, and sun exposure. It may appear on the lips, gums, inner cheeks, or tongue, or on the hard or soft palate.
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How fast does oral cancer spread?
Oral cancer tends to spread primarily to the lymph nodes of the neck first before it spreads or metastasizes to other areas. A second level spread would likely be the lungs. Whether or not oral cancer will spread to the lymph nodes depends largely on its size, depth of invasion, and invasion into the small nerves and vessels in the area. Imaging tests will help Dr. Covell when screening for metastasis.
There aren’t any hard and fast timelines for whether or when oral cancer will spread. Size is more a determinant. For a moderate-sized oral cancer, there is roughly a 20 to 30 percent chance that it has already spread to the lymph nodes at the time of diagnosis. This is especially true if the patient hasn’t consistently adhered to seeing Dr. Covell every six months for professional cleanings and exams.
Who is most at risk for developing oral cancer?
Many people think, wrongly, that if they don’t smoke or drink heavily that oral cancer isn’t something they need to worry about. Truth is 25% of all oral cancers occur in people who don’t smoke and who only drink occasionally. Over the past few years, we’ve found more and more of our oral cancer patients now are young, healthy, nonsmoking individuals that have the human papillomavirus (HPV). You may have heard of this virus in connection with cervical cancer, but it also greatly increases the risk of oral cancer.
What happens if you spot oral cancer early on?
The key to successfully treating oral cancer is early detection. That’s why Dr. Covell stresses the need to maintain the schedule of seeing us twice every year for your professional exams and cleanings. We can spot these cancers early and the success rate is dramatically higher. Look at these numbers involving five-year survival rates:
- 83 percent for localized oral cancer that hasn’t spread. This would be stage 1 cancer.
- 64 percent for oral cancer that has spread to nearby lymph nodes. Stage 3 cancer.
- 38 percent for oral cancer that has spread to other parts of the body. Stage 4 cancer.
Are there different types of oral cancer?
- Squamous cell carcinoma — Of the cancerous oral tumors, over 90 percent are called squamous cell carcinoma. You’ve probably heard of squamous cell carcinoma because it is the second most common skin cancer, but the throat and mouth are lined with squamous cells. This form of oral cancer develops when these cells mutate and become abnormal.
- Verrucous carcinoma — About 5 percent of all oral cancers are verrucous carcinoma, a type of very slow-growing cancer also made up of squamous cells. This type of oral cancer rarely spread to other parts of the body, although it can invade nearby tissue.
- Minor salivary gland carcinomas — These types of oral cancer may develop on the minor salivary glands, which are located throughout the lining of the mouth and throat. These include adenoid cystic carcinoma, mucoepidermoid carcinoma, and polymorphous low-grade adenocarcinoma.
- Lymphoma — This is when oral cancer develops in the lymph tissue. The tonsils and base of the tongue both contain lymphoid tissue.
Symptoms Of Oral Cancer
Symptoms of oral cancer may include:
- A sore that bleeds easily or does not heal
- Red or white patches in the mouth
- A change in color of any parts of the mouth
- A lump, thickened tissue, rough spot, or crusted or eroded area
- Pain, tenderness, or numbness anywhere in the mouth or on the lips
- Difficulty chewing, swallowing or speaking, or moving the jaw or tongue
- Sore throat or hoarseness
- A change in the way the teeth fit together
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When is surgery necessary for oral cancer?
Surgery is usually the first treatment used. The goal of surgery is to remove cancer while preserving your physical appearance and ability to speak and swallow.
Is a biopsy necessary for diagnosis?
In addition to the methods used by Dr. Covell at your twice-yearly exams, he may need a biopsy to confirm a diagnosis or to determine the makeup of a suspicious-looking area. There is a brush biopsy, but even if these return positive results, a scalpel biopsy is necessary for confirmation. Dr. Covell may try and excise the entire visible area. He may also use a laser to take a biopsy.
How is surgery used for oral cancer treatment?
There are different methods where surgery is used for oral cancer treatment:
- Surgery to remove the tumor — The tumor and a margin of healthy tissue surrounding it are removed with surgery. These procedures can be small if the cancer was caught early, or they may involve removing a portion of the jawbone or the tongue.
- Surgery to remove cancer that has spread to the neck — If oral cancer has spread to the lymph nodes in the neck, or if the size of your cancer means it will likely do so, the lymph nodes and related tissue in the neck are removed. This is called a neck dissection.
- Surgery to reconstruct the mouth — Surgery may be necessary to rebuild the mouth after the removal of large areas of cancerous tissue. This can involve transplant grafts of skin, muscle, or bone. Dental implants may be necessary to replace teeth.
What are the non-surgical treatment options for oral cancer?
There are different methods for treating oral cancer beyond surgery:
- Radiation therapy — An oncologist aims radiation beams at the tumor once or twice a day, five days a week, for two to eight weeks.
- Chemotherapy — This uses drugs that kill cancer cells. The medications are given to you orally or through an IV.
- Targeted therapy — Targeted therapy drugs will bind to specific proteins on cancer cells and this interferes with the growth of those cells.
- Immunotherapy — These newer treatments activate your body’s own immune system to attack the cancer cells.
How long will it take to recover after oral cancer surgery?
Most people can go home within several days after surgery to remove oral cancer. It will take a few weeks to feel better, depending, of course, on what degree of tissue needed to be removed. There are so many different variations involved with these procedures that trying to provide a specific timeline is almost impossible. After all, some patients will need to have teeth removed as part of this surgery. Others may have part or all of their tongue removed. Part of the jawbone may need to be removed. Once we know your particular situation, Dr. Covell will give you a much better idea of what you can expect as milestones during your recovery after this surgery.
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Can oral cancer be completely cured?
If Dr. Covell spots your oral cancer early on, the chances of a complete cure are quite high. As mentioned above, the time of diagnosis directly affects the chances of curing the patient. Once oral cancer has spread to other parts of the body in stage 4 cancer, the chances of curing it are less than 40 percent, while they are 83 percent for stage 1 oral cancer.
How can I prevent oral cancer?
There are various things you can do to prevent oral cancer:
- Don’t smoke or use tobacco products.
- Drink only in moderation.
- Eat a healthy diet, especially rich in vegetables with vitamin A.
- Limit your sun exposure and cover your lips and skin with sunscreen.
- There is a link between the HPV virus and oral cancer, so some types of sexual contact can increase the risk of developing oral cancer.
How can Dr. Covell detect oral cancer early?
Oral cancer is not difficult to diagnose. It shows the symptoms listed above. When you come to see us for your twice-yearly cleanings and exams, that’s when Dr. Covell pulls on your tongue, checks throughout your mouth, press on your lymph nodes in your throat, and performs other diagnostic tests — he’s looking for any signs of oral cancer. We look for lumps or irregular tissue changes in the mouth, head, face, and neck. We look for sores or discolored tissue and inquire about any of the symptoms we list above.
Not to be repetitive, but early diagnosis is key to successfully spotting and treating oral cancer.