Surgery

Surgery is the most common treatment for cancers of the lip and oral cavity. The doctor will remove the tumor and a margin of healthy tissue. The doctor may also remove any nearby tissue that the tumor has invaded, as well as lymph nodes in the neck (neck dissection). In more advanced cases, the tumor may have invaded adjacent structures, and the doctor may need to remove these as well. These may include part of the jaw bone, the hard bone in the roof of the mouth, part of the tongue, the cheekbone, and possibly other areas, depending on where the cancer is located. After an extensive surgery such as this, the doctor may recommend plastic surgery to restore the appearance of the face. For some small tumors on the lip, the doctor may recommend Mohs surgery. In this procedure, the doctor removes very thin layers of skin and examines them under a microscope for cancer cells. The doctor will keep removing thin layers of tissue until no more cancer cells are present. Mohs surgery is a good option to minimize discomfort and scarring.

Radiation Therapy

External radiation therapy uses waves of high energy rays produced by a machine to destroy cancer cells. Radiation therapy is commonly given after surgery to kill any remaining cancer cells and prevent the cancer from returning. For more widespread tumors, radiation therapy may be used as a palliative treatment to shrink tumors and relieve symptoms. In some cases, radiation therapy may also be combined with chemotherapy (chemoradiation) to make both more effective.

Proton beam radiation therapy

Proton therapy is an advanced type of radiation therapy that uses “protons” rather than X-ray “photons” to deliver radiation to the tumor. In conventional radiotherapy, the photon beams can deposit radiation and damage healthy cells as they pass through the body. Proton therapy deposits most of the radiation directly at the tumor site, resulting in less damage to healthy tissue and fewer side-effects.

• Please see Understanding Proton Therapy to learn more.

Chemotherapy

Chemotherapy is the use of drugs to target rapidly growing cells in an effort to destroy cancer cells. Chemotherapy may be given before surgery to shrink the tumor, or after surgery, to remove any remaining cancer cells and reduce the risk of the cancer returning. Chemotherapy may be combined with radiation therapy (chemoradiation) in some cases to make both treatments more effective.

Targeted Therapy

Targeted therapy drugs are designed to stop or slow the growth and speed of cancer by acting at the cellular level.  Cancer cells rely on specific molecules--ofter proteins--for survival, multiplication and invasion into surround tissues.  These molecules are typically produced by cancer-causing genes or the cancer cells themselves.  Targeted therapies work by interfering with these critical molecules or the genes responsible for producing them.

In case for oral cancer, targeted therapy is currently used only for treating metastatic disease.

Immunotherapy

New and exciting treatments target the patient's immune system to better fight their tumor. Many cancers decrease the immune function in humans allowing tumors to grow and spread. New drugs block the tumor's ability to decrease the immune function resulting in shrinkage of the tumor or in some cases complete disappearance. Immunotherapy treatments, while having side effects, are usually less than standard chemotherapy.

Clinical Trials

Clinical trials allow patients to try a new treatment before it is available to the general public. In some cases, this may be a new drug that has not been used in humans before, or it may be a drug or drug combination that is not currently used for that specific type of cancer. Early phase clinical trials are often used to test side effects of a drug or drug combination, while later phase clinical trials are used to see how effective a new treatment might be for a certain type of cancer. Clinical trials allow doctors and researchers to improve the treatment of cancers with possibly more effective therapies. A clinical trial may be a new, groundbreaking drug or it may have no effect. It is important to talk with your doctor about the pros and cons of clinical trials for your particular situation.