Treatment by stage for mouth cancer
This page describes the treatment for particular stages of cancer of the mouth and oropharynx. You can read about
If the affected area in the mouth or oropharynx is very small, your doctor may completely remove it during a biopsy. Or you may need to have minor surgery. If the precancerous cells continue to come back, your doctor may suggest a course of radiotherapy.
Stage 1 and 2
The treatment for early stage mouth and oropharyngeal cancers depends on where your cancer is, and the likely side effects of treatment in that area. Your doctor may recommend surgery or radiotherapy or surgery followed by radiotherapy. Sometimes chemotherapy is given alongside the radiotherapy (chemoradiation).
Stage 3 and 4
If you have surgery you may also have radiotherapy or chemotherapy (or both). If your cancer is too big or awkward to remove using surgery you are most likely to have radiotherapy, sometimes with chemotherapy. Or you may have radiotherapy combined with biological therapy.
Advanced cancer that is unlikely to get better (palliative treatment)
Palliative treatment aims to control symptoms. It won't cure your cancer, although it may slow it down or shrink it. For example, if your tumour is beginning to block your airway, your doctor may recommend surgery to remove all or part of the tumour to make breathing easier. They may also suggest surgery combined with radiotherapy, or chemotherapy, either alone or with radiotherapy (chemoradiation).
You can view and print the quick guides for all the pages in the Treating mouth cancer section.
Because saying mouth and oropharyngeal cancer is a bit long, we've tended to just say mouth cancer in the text on this page. Stage means the size of the cancer and whether it has spread into surrounding tissues or to other parts of the body.
Stage 0 is really a precancerous stage. Doctors call this carcinoma in situ or CIS. There are cancer cells but they are all contained within the lining of the mouth or oropharynx. If the precancerous cells are not treated, there is a high chance of the cells developing into a cancer that could then spread into surrounding tissues.
If the affected area is very small, your doctor may completely remove it during a biopsy. Or you may need to have minor surgery. Your doctor will remove the cancer cells by taking a thin layer of tissue from the affected area. Most people who have this stage of mouth cancer will never need major surgery.
If you have this early stage mouth or oropharyngeal cancer your dentist or doctor will keep a very close eye on you after treatment. If the precancerous cells come back, your doctor may suggest a course of radiotherapy.
If you smoke and continue to do so, it is much more likely that you will develop cancerous cells again in the future.
The treatment for early stage mouth and oropharyngeal cancers depends on which part of your mouth or oropharynx your cancer is in. It also depends on the likely side effects of treatment in that area. Your doctors may recommend surgery or radiotherapy or surgery followed by radiotherapy. Sometimes chemotherapy is given alongside the radiotherapy and this is called chemoradiation.
Your doctors will take several things into account when deciding which treatment is best for you. For example, surgery to some parts of the mouth or oropharynx may cause speech changes and affect your ability to swallow. Radiotherapy may cause long term side effects such as a dry mouth. If you have radiotherapy you may need to go to the hospital every weekday for treatment lasting several weeks. This may not be easy for some people and you and your doctor may then consider surgery a better option in your particular case.
If you have stage 3 or 4 mouth cancer your doctor may recommend one of the following treatments
- Surgery to remove the cancer followed by radiotherapy
- Radiotherapy alone or combined with biological therapy
- Chemotherapy combined with radiotherapy (chemoradiation)
- Surgery, radiotherapy and chemotherapy
If you have surgery it will usually include removing some of the lymph nodes in the neck during an operation called a neck dissection. This is because there is a high risk that the cancer has spread to the lymph nodes. If the cancer has spread into the nodes, you will usually also have radiotherapy to the neck after your surgery. This is to try and kill off any remaining cancer cells.
Researchers and doctors are looking into giving chemotherapy, radiotherapy or both of these before surgery. Doctors call this neoadjuvant therapy. The aim is to shrink the tumour before you have your surgery. The idea is that you will then be able to have a smaller operation and so the after effects of the operation will be less severe.
If your cancer is too big or cannot be removed using surgery you are most likely to have radiotherapy. Your doctors may recommend chemotherapy or biological therapy alongside the radiotherapy. Researchers are developing more drugs for these types of cancer. So you may have new chemotherapy drugs or biological therapies as part of a clinical trial.
Palliative treatment aims to control symptoms caused by a disease. The treatment won't cure your cancer but it may slow its growth or shrink it for a while. For example, if your mouth or oropharyngeal tumour is large and beginning to block your airway, your doctor may recommend surgery to remove all or part of the tumour to make breathing easier. They may also suggest
- Surgery combined with radiotherapy
- Chemotherapy alone or with radiotherapy (chemoradiation)
Treatments that are still in development may be another option for you. This will mean taking part in a clinical trial. There is information about new treatments under development in the section about mouth and oropharyngeal cancer research.
If your cancer has spread, your doctor is also likely to refer you to a palliative care team to help control your symptoms and support you.
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