Staging and Treatment:
Oral Cancer staging is based on following parameters:
- The size of the lesion/lump/tumor
- Whether the cancer is localized to the oral tissues only
- Whether cancer has spread to the cervical lymph nodes
- Whether the cancer has spread to other parts of the body
TNM staging system
The TNM system takes in to account.
- Tumor size (T stands for tumor)
- Lymph node involvement (N stands for node)
- Whether the cancer has metastasized (M stands for metastasis), or moved beyond the oral cavity to other parts of the body.
Potentially Malignant Disorders (preceding full-fledged cancer formation) are managed by various Medical (eg. antioxidants, topical analgesics etc.) & Surgical modalities (eg. Excision, cryosurgery, LASER etc.)
Your individual oral cancer treatment is planned based on following factors:
- Tumour factors – primary site, size, location, proximity to bone, status of neck lymph nodes, previous treatment, and histology.
- Patient factors – patient’s age, general medical condition, tolerance of treatment, occupation of the patient, acceptance and compliance by the patient, lifestyle and other socioeconomic considerations.
- Physician factors – Expertise in various disciplines including surgery, radiotherapy, chemotherapy, rehabilitation services, dental and prosthetic support, and psycho-social support.
Oral Cancer, at the early stages, is managed using one or a combination of the following modalities:
Early oral cancer-
- Most early-stage oral cancers can be locally excised or treated with radiotherapy, with no or minimal functional and physical morbidity.
- Elective neck dissection to remove lymph nodes may be considered in selected cases.
- Postoperative radiotherapy is indicated in patients with positive or involved resected margins who are not candidates for re-excision.
- External beam radiotherapy (by focusing a beam of radiation from a machine to its target, the area of the body affected by cancer) and brachytherapy (uses an implant to deliver radiation to the cancer site), either alone or in combination, is an alternative to surgery for early stage oral cancers.
Locally advanced cancers–
- Surgery followed by postoperative radiotherapy is the preferred modality for patients with deep infiltrative tumors and those with bone infiltration. Postoperative concurrent chemo-radiation has been found to be superior in those with surgical margins showing cancerous changes, than radiotherapy alone.
- Primary radiotherapy, with or without chemotherapy, is a reasonable option for locally advanced tumors without bone involvement.
- Only palliative/supportive treatment is provided.