Oral and maxillofacial surgeons diagnose and treat the full spectrum of cysts and
tumors in the oral cavity which includes benign as well as malignant tumors.
Because the mouth and jaws are composed of many different types of tissues, such
as bone, muscle, glands and mucosa they are more susceptible to developing abnormal
growths than other parts of the body.
Although tumors and cysts of the jaw can affect anyone, a number of risk factors
have been identified that increase a person's chance of developing them. The main
risk factors are tobacco and alcohol use. Others include poor oral hygiene, irritation
caused by ill-fitting dentures, rough surfaces on teeth and poor nutrition.
Oral cancer can develop in any part of the oral cavity. Most oral cancers begin
in the tongue and in the floor of the mouth.
When oral cancer spreads (metastasizes), it usually travels through the lymphatic
system. Cancer cells that enter the lymphatic system are carried along by lymph,
a clear, watery fluid. The cancer cells often appear first in nearby lymph nodes
in the neck.
Surgeries for Oral Cancers include
- Mandibulectomy (removal of the mandible or
lower jaw or part of it)
- Glossectomy (tongue removal, can be total,
hemi or partial)
- Radical neck dissection
- Combinational e.g. glossectomy and laryngectomy
- Feeding tube to sustain nutrition.
Owing to the vital nature of the structures in the head and neck area, surgery for
larger cancers is technically demanding. Reconstructive surgery may be required
to give an acceptable cosmetic and functional result. Bone grafts and surgical flaps
such as the radial forearm flap are used to help rebuild the structures removed
during excision of the cancer. An oral prosthesis may also be required. Most oral
cancer patients depend on a feeding tube for their hydration and nutrition. Some
will also get a port for the chemo to be delivered.
Survival rates for oral cancer depend on the precise site, and the stage of the
cancer at diagnosis. Overall, survival is around 50% at five years when all stages
of initial diagnosis are considered. Survival rates for stage 1 cancers are 90%,
hence the emphasis on early detection to increase survival outcome for patients.
Following treatment, rehabilitation may be necessary to improve movement, chewing,
swallowing, and speech. Speech and language pathologists may be involved at this
Chemotherapy is useful in oral cancers when used in combination with other treatment
modalities such as radiation therapy. It is not used alone as a monotherapy. When
cure is unlikely it can also be used to extend life and can be considered palliative
but not curative care.
Treatment of oral cancer will usually be by a multidisciplinary team, with treatment
professionals from the realms of radiation, surgery, chemotherapy, nutrition, maxillofacial
surgeons, and even psychology all possibly involved with diagnosis, treatment, rehabilitation,
and patient care.