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Oral and Oropharyngeal Cancer - Overview

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2013

ON THIS PAGE: You will find some basic information about these diseases and the parts of the body they may affect. This is the first page of Cancer.Net’s Guide to Oral and Oropharyngeal Cancer. To see other pages, use the menu on the side of your screen. Think of that menu as a roadmap to this full guide.

Cancer begins when normal cells change and grow uncontrollably, forming a mass called a tumor. A tumor can be benign (noncancerous) or malignant (cancerous). Cancerous cells can invade nearby tissue and sometimes spread to other parts of the body through the bloodstream and the body’s lymphatic system.

Two of the most common types of cancer that develop in the head and neck region are cancer of the oral cavity (mouth and tongue) and cancer of the oropharynx (the middle of the throat, from the tonsils to the tip of the voice box). The oral cavity includes the lips, buccal mucosa (lining of the lips and cheeks), gingiva (upper and lower gums), front two-thirds of the tongue, floor of the mouth under the tongue, hard palate (roof of the mouth), and the retromolar trigone (small area behind the wisdom teeth).The oropharynx begins where the oral cavity stops. It includes the soft palate at the back of the mouth, the part of the throat behind the mouth, the tonsils, and the base of the tongue. The oral cavity and oropharynx, along with other parts of the head and neck, contribute to our ability to chew, swallow, breathe, and talk.

More than 90% of oral and oropharyngeal cancers are squamous cell carcinoma, meaning they begin in the flat, squamous cells in the lining of the mouth and throat. The most common sites for cancer in the oral cavity are the tongue, tonsils, oropharynx, gums, and floor of the mouth.

Oral and oropharyngeal cancers are among the main types of cancer in the head and neck region, a grouping called head and neck cancer. Although oral cancer and oropharyngeal cancer are commonly combined using one phrase, it is important to identify exactly where the cancer began because there are differences in treatment between the two locations.

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Oral and Oropharyngeal Cancer - Statistics

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2013

ON THIS PAGE: You will find information about how many people learn they have oral or oropharyngeal cancer each year and some general survival information. To see other pages, use the menu on the side of your screen.

This year, an estimated 42,440 adults (30,220 men and 12,220 women) in the United States will be diagnosed with oral or oropharyngeal cancer. Rates of oral and oropharyngeal cancer are more than twice as high in men as women. Cancer of the oral cavity ranks as the eighth most common cancer among men and is increasing, probably because of infection with a virus called HPV (see the Risk Factors section for more information).

It is estimated that 8,390 deaths (5,730 men and 2,660 women) from these two diseases will occur this year. For all stages and sites combined, about 83% of patients survive at least one year after diagnosis. The five-year survival rate is the percentage of people who survive at least five years after the cancer is detected, excluding those who die from other diseases. The five-year survival rate of people with oral or oropharyngeal cancer is 62%, and the ten-year survival rate is 51%. However, survival rates for oral and oropharyngeal cancer vary widely depending on the original location, whether the person has HPV, and the extent of the disease.

Cancer survival statistics should be interpreted with caution. These estimates are based on data from thousands of people with this type of cancer in the United States each year, but the actual risk for a particular individual may differ. It is not possible to tell a person how long he or she will live with oral or oropharyngeal cancer. Because survival statistics are often measured in multi-year intervals, they may not represent advances made in the treatment or diagnosis of this cancer. Learn more about understanding statistics.

Statistics adapted from the American Cancer Society’s publication, Cancer Facts and Figures 2014.

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Oral and Oropharyngeal Cancer - Risk Factors and Prevention

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2013

ON THIS PAGE: You will find out more about what factors increase the chance of these types of head and neck cancer. To see other pages, use the menu on the side of your screen.

A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do. However, knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.

Two factors that greatly increase the risk of oral and oropharyngeal cancer are:

Tobacco. Use of tobacco—including cigarettes, cigars, pipes, chewing tobacco, and snuff—is the single largest risk factor for head and neck cancer. Eighty-five percent (85%) of head and neck cancer is linked to tobacco use. Pipe smoking in particular has been linked to cancer in the part of the lips that touch the pipe stem. Chewing tobacco or snuff is associated with a 50% increase in the risk of developing cancer in the cheeks, gums, and inner surface of the lips where the tobacco has the most contact. Secondhand smoke may also increase a person’s risk of head and neck cancer.

Alcohol. Frequent and heavy consumption of alcohol increases the risk of head and neck cancer, and using alcohol and tobacco together increases this risk even more.

Other factors that can raise a person’s risk of oral and oropharyngeal cancer include:

Prolonged sun exposure. Prolonged sun exposure is linked to cancer in the lip area. To reduce your risk of lip cancer, decrease your exposure to sunlight and other sources of ultraviolent (UV) light. Read more about protecting your skin from the sun.

Human papillomavirus (HPV). Research indicates that infection with this virus is a risk factor for oral and oropharyngeal cancer. In fact, HPV-related oropharyngeal cancer in the tonsils and the base of the tongue has become more frequent in recent years. HPV is most commonly passed from person to person during sexual activity, including oral sex. There are different types, or strains, of HPV, and some strains are more strongly associated with certain types of cancers. HPV vaccines protect against certain strains of the virus.

To reduce your risk of HPV infection, limit your number of sexual partners because having many partners increases the risk of HPV infection. Using a condom cannot fully protect you from HPV during sex.

Gender. Men are more likely to develop oral and oropharyngeal cancer than women.

Fair skin. Fair skin is linked to a higher risk of lip cancer.

Age. People over 45 are at increased risk for oral cancer, although this type of cancer can develop in people of any age.

Oral hygiene. People with poor oral hygiene/dental care may have an increased risk of oral cavity cancer. Poor dental health or ongoing irritation from poorly fitting dentures, especially in people who use alcohol and tobacco products, may contribute to an increased risk of oral and oropharyngeal cancer. Regular examinations by a dentist can help to find oral cavity cancer and some oropharyngeal cancers at an earlier stage.

Poor diet/nutrition. A diet low in fruits and vegetables, a vitamin A deficiency, and chewing betel nuts (a nut containing a mild stimulant that is popular in Asia) increase the risk of oral and oropharyngeal cancer.

Weakened immune system. People with a weakened immune system have a higher risk of oral and oropharyngeal cancer.

Marijuana use. Recent studies have suggested that people who have used marijuana may be at higher than average risk for head and neck cancer.

Prevention

Research continues to look into what factors cause this type of cancer and what people can do to lower their personal risk. There is no proven way to completely prevent this disease, but there may be steps you can take to lower your cancer risk. Although some of the risk factors of NPC cannot be controlled, such as age, several can be avoided by making lifestyle changes. Stopping the use of all tobacco products is the most important thing a person can do to reduce the risk of NPC, even for people who have been smoking for many years.

Talk with your doctor if you have concerns about your personal risk of developing this type of cancer.

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Oral and Oropharyngeal Cancer - Symptoms and Signs

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2013

ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. To see other pages, use the menu on the side of your screen.

Often, a dentist is the first person to find this type of cancer during a routine examination. People with oral or oropharyngeal cancer may experience the following symptoms or signs. Sometimes, people with oral or oropharyngeal cancer do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer. If you are concerned about a symptom or sign on this list, please talk with your doctor.

  • Sore in the mouth or on the lip that does not heal (the most common symptom)
  • Red or white patch on the gums, tongue, tonsil, or lining of the mouth
  • Lump on the lip, mouth, neck, or throat or a feeling of thickening in the cheek
  • Persistent sore throat or feeling that something is caught in the throat
  • Hoarseness or change in voice
  • Numbness of the mouth or tongue
  • Pain or bleeding in the mouth
  • Difficulty chewing, swallowing, or moving the jaws or tongue
  • Ear and/or jaw pain
  • Chronic bad breath
  • Changes in speech
  • Loosening of teeth or toothache
  • Dentures that no longer fit
  • Unexplained weight loss
  • Fatigue
  • Loss of appetite, especially when prolonged; this may happen later in the course of the illness.

People who notice any of these warning signs should consult a doctor and/or dentist as soon as possible. When detected early, cancers of the oral cavity and oropharynx have a much better chance of cure.

Your doctor will ask you questions about the symptoms you are experiencing to help find out the cause of the problem, called a diagnosis. This may include how long you’ve been experiencing the symptom(s) and how often.

If cancer is diagnosed, relieving symptoms and side effects remains an important part of cancer care and treatment. This may also be called symptom management, palliative care, or supportive care. Be sure to talk with your health care team about symptoms you experience, including any new symptoms or a change in symptoms.

Because many of the symptoms listed above can be caused by other, noncancerous health conditions as well, it is important for people to receive regular health and dental screenings, especially those who routinely drink alcohol, currently use tobacco products, or have used tobacco products in the past. People who use alcohol and tobacco should receive a general screening examination at least once a year. This is a simple, quick procedure in which the doctor looks in the nose, mouth, and throat for abnormalities and feels for lumps in the neck. If anything unusual is found, the doctor will recommend a more extensive examination using one or more of the diagnostic procedures mentioned in the diagnosis section.

The next section helps explain what tests and scans may be needed to learn more about the cause of the symptoms. Use the menu on the side of your screen to select Diagnosis, or you can select another section, to continue reading this guide.

Oral and Oropharyngeal Cancer - Diagnosis

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2013

ON THIS PAGE: You will find a list of the common tests, procedures, and scans that doctors can use to find out what’s wrong and identify the cause of the problem. To see other pages, use the menu on the side of your screen.

Doctors use many tests to diagnose cancer and find out if it has metastasized (spread). Some tests may also determine which treatments may be the most effective. For most types of cancer, a biopsy is the only way to make a definitive diagnosis of cancer. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. Imaging tests may be used to find out whether the cancer has spread. This list describes options for diagnosing this type of cancer, and not all tests listed will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:

  • Age and medical condition
  • Type of cancer suspected
  • Signs and symptoms
  • Previous test result

The following tests may be used to diagnose oral or oropharyngeal cancer:

Physical examination. Dentists and doctors often find lip and oral cavity cancers during routine check-ups. If a person shows signs of oral or oropharyngeal cancer, the doctor will take a complete medical history, asking about the patient’s symptoms and risk factors. The doctor will feel for any lumps on the neck, lips, gums, and cheeks. Since patients with oral or oropharyngeal cancer have a higher risk of other cancers elsewhere in the head and neck region, the area behind the nose, the larynx (voice box), and the lymph nodes of the neck are also examined.

Endoscopy. This test allows the doctor to see inside the mouth and throat. Typically, an endoscope (a thin, flexible tube with an attached light and view lens) is inserted through the nose to examine the head and neck areas. Sometimes, a rigid endoscope (a hollow tube with a light and view lens) is placed into the back of the mouth to see the back of the throat in more detail. The examination has different names depending on the area of the body that is examined, such as laryngoscopy (larynx), pharyngoscopy (pharynx), or a nasopharyngoscopy (nasopharynx). To make the patient more comfortable, these examinations are performed using an anesthetic spray to numb the area. If tissue looks suspicious, the doctor will take a biopsy. Tests are often done in the doctor’s office; however, sometimes, an endoscopy must be performed in an operating room at a hospital using a general anesthesia.

Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. The sample removed during the biopsy is analyzed by a pathologist (a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease). The type of biopsy performed will depend on the location of the cancer. In a fine needle aspiration biopsy, cells are withdrawn using a thin needle inserted directly into the tumor. The cells are examined under a microscope for cancer cells (called cytologic examination).

Oral brush biopsy. During routine dental examinations, some dentists are using a newer, simple technique to detect oral cancer in which a dentist uses a small brush to gather cell samples of a suspicious area. The specimen is then sent to a laboratory for analysis. This oral brush biopsy procedure is easy and can be done right in the dentist’s chair with very little or no pain. If cancer is found using this method, it is recommended that a traditional biopsy (see above) be done to confirm the results.

X-ray. An x-ray is a way to create a picture of the structures inside of the body, using a small amount of radiation. A dentist may take extensive x-rays of the mouth, including a panorex (panoramic view; see below).

Barium swallow. There are two types of these tests that are generally used to look at the oropharynx and check a patient’s swallowing. The first is a traditional barium swallow. During an x-ray exam, the patient is asked to swallow liquid barium so the doctor can look for any changes in the structure of the oral cavity and throat and see whether the liquid passes easily to the stomach. A modified barium swallow, or videofluoroscopy, is used to evaluate swallowing. The patient is asked to swallow liquid barium, pudding, and a cracker coated with barium.

Panorex. This is a rotating, or panoramic, x-ray of the upper and lower jawbones to detect bone destruction from cancer or to evaluate teeth before radiation therapy or chemotherapy.

Computed tomography (CT or CAT) scan. A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. A CT scan can also be used to measure the tumor’s size. Sometimes, a contrast medium (a special dye) is injected into a patient’s vein or given orally (by mouth) to provide better detail. A CT scan can help a doctor decide whether the tumor can be surgically removed and determine whether the cancer has spread to lymph nodes in the neck or lower jawbone.

Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body, especially images of soft tissue, such as the tonsils and base of the tongue. A contrast medium may be injected into a patient’s vein or given orally to create a clearer picture.

Ultrasound. An ultrasound uses sound waves to create a picture of the internal organs. This test can detect the spread of cancer to the lymph nodes in the neck (called the cervical lymph nodes).

Positron emission tomography (PET) scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive substance is injected into a patient’s body. This substance is absorbed mainly by organs and tissues that use the most energy. Because cancer tends to use energy actively, it absorbs more of the radioactive substance. A scanner then detects this substance to produce images of the inside of the body.

After these diagnostic tests are done, your doctor will review all of the results with you. If the diagnosis is cancer, these results also help the doctor describe the cancer; this is called staging.

The next section helps explain the different stages for this type of cancer. Use the menu on the side of your screen to select Stages, or you can select another section, to continue reading this guide.

Oral and Oropharyngeal Cancer - Stages and Grades

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2013

ON THIS PAGE: You will learn about how doctors describe a cancer’s growth or spread. This is called the stage. To see other pages, use the menu on the side of your screen.

Staging is a way of describing where a cancer is located, if or where it has spread, and whether it is affecting other parts of the body. Doctors use diagnostic tests to determine the cancer’s stage, so staging may not be complete until all the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient’s prognosis. There are different stage descriptions for different types of cancer.

One tool that doctors use to describe the stage is the TNM system. TNM is an abbreviation for tumor (T), node (N), and metastasis (M). Doctors look at these three factors to determine the stage of cancer:

  • How large is the primary tumor and where is it located? (Tumor, T)
  • Has the tumor spread to the lymph nodes? (Node, N)
  • Has the cancer metastasized to other parts of the body? (Metastasis, M)

The results are combined to determine the stage of cancer for each person. There are five stages: stage 0 (zero) and stages I through IV (one through four). The stage provides a common way of describing the cancer, so doctors can work together to plan the best treatments.

Here are more details on each part of the TNM system for oral and oropharyngeal cancer.

Tumor. Using the TNM system, the "T" plus a letter or number (0 to 4) is used to describe the size and location of the tumor. Some stages are also divided into smaller groups that help describe the tumor in even more detail. Specific tumor stage information is listed below.

TX: The primary tumor cannot be evaluated.

T0: No evidence of a tumor is found.

Tis: Describes a stage called carcinoma (cancer) in situ. This is a very early cancer where cancer cells are found only in one layer of tissue.

T1: The tumor is 2 centimeters (cm) at its greatest dimension.

T2: The tumor is larger than 2 cm, but not larger than 4 cm.

T3: The tumor is larger than 4 cm.

T4: Describes any of the following conditions:

T4a (lip): The tumor began on the lip but has invaded adjacent tissue, such as the bone floor of the mouth or the skin of the face.

T4a (oral cavity): The tumor has invaded through the cortical bone deep into structures in the mouth, such as the muscle of the tongue or into the sinuses.

T4a (oropharynx): The tumor has spread to the larynx, tongue, or jawbone.

T4b (oral cavity): The tumor has invaded the base of the skull and/or encases the internal arteries.

T4b (oropharynx): The tumor has moved into the nasopharynx, skull base, or nearby arteries and muscles.

Node. The “N” in the TNM staging system is for lymph nodes, the tiny, bean-shaped organs that help fight infection. Lymph nodes near where the cancer started are called regional lymph nodes. Lymph nodes in other parts of the body are called distant lymph nodes. There are many lymph nodes in the head and neck area, and careful assessment of lymph nodes is an important part of staging.

NX: The regional lymph nodes cannot be evaluated.

N0: There is no evidence of cancer in the regional lymph nodes.

N1: The cancer has spread to a single lymph node on the same side as the primary tumor, and the cancer found in the node is 3 cm or smaller.

N2: Describes any of these conditions:

N2a: Cancer has spread to a single lymph node on the same side as the primary tumor and is larger than 3 cm, but not larger than 6 cm.

N2b: Cancer has spread to more than one lymph node on the same side as the primary tumor, and none measure larger than 6 cm.

N2c: Cancer has spread to more than one lymph node on either side of the body, and none measure larger than 6 cm.

N3: The cancer found in the lymph nodes is larger than 6 cm.

Distant metastasis. The "M" in the TNM system describes cancer that has spread to other parts of the body.

MX: Distant metastasis cannot be evaluated.

M0: Cancer has not spread to other parts of the body.

M1: Cancer has spread to other parts of the body.

Cancer stage grouping

Doctors assign the stage of the cancer by combining the T, N, and M classifications.

Stage 0: Describes a carcinoma in situ (Tis) with no spread to lymph nodes (N0) or distant metastasis (M0).

Stage I: Describes a small tumor (T1) with no spread to lymph nodes (N0) and no distant metastasis (M0).

Stage II: Describes a tumor that is smaller than 4 cm (T2) and has not spread to lymph nodes (N0) or to distant parts of the body (M0).

Stage III: Describes a larger tumor (T3) with no spread to lymph nodes (N0) or metastasis (M0), as well as smaller tumors (T1, T2) that have spread to regional lymph nodes (N1) but have no sign of metastasis (M0).

Stage IVA: Describes any invasive tumor (T4a) with either no lymph node involvement (N0) or spread to only a single, same-sided lymph node (N1) but no metastasis (M0). It is also used for any tumor (any T) with more significant nodal involvement (N2) but no metastasis (M0).

Stage IVB: Describes any tumor (any T) with extensive nodal involvement (N3) but no metastasis (M0).

Stage IVC: Indicates there is evidence of distant spread (any T, any N, M1).

Recurrent: Recurrent cancer is cancer that has come back after treatment. If there is a recurrence, the cancer may need to be staged again (called re-staging) using the system above.

Tumor grade (G). Doctors also describe a primary tumor by its grade, which is determined by using a microscope to examine tissue from a tumor (called a histologic examination). The doctor compares the tumor tissue with healthy tissue, and the grade describes how closely the cancer cells resemble normal tissue under a microscope. Normal tissue contains many different types of cells grouped together, which is called differentiated. Tissue from tumors usually has cells that look more alike each other (called poorly differentiated). Generally, the more differentiated the tissue, the better the prognosis. A tumor's grade is described using the letter "G" and a number.

GX: The grade cannot be evaluated.

G1: The cells look more like normal tissue (well differentiated).

G2: The cells are only moderately differentiated.

G3 and G4: The cells don’t resemble normal tissue (poorly differentiated).

Used with permission of the American Joint Committee on Cancer (AJCC), Chicago, Illinois. The original source for this material is the AJCC Cancer Staging Manual, Seventh Edition (2010), published by Springer-Verlag New York, www.cancerstaging.net.

Information about the cancer’s stage will help the doctor recommend a treatment plan.  The next section helps explain the treatment options for this type of cancer. Use the menu on the side of your screen to select Treatment Options, or you can select another section, to continue reading this guide.

Oral and Oropharyngeal Cancer - Treatment Options

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2013

ON THIS PAGE: You will learn about the different ways doctors use to treat people with oral or oropharyngeal cancer. To see other pages, use the menu on the side of your screen.

This section outlines treatments that are the standard of care (the best proven treatments available) for these specific types of cancer. When making treatment plan decisions, patients are also encouraged to consider clinical trials as an option. A clinical trial is a research study to test a new treatment to evaluate whether it is safe, effective, and possibly better than the standard treatment. Your doctor can help you review all treatment options. For more information, see the Clinical Trials and Latest Research sections.

Treatment overview

Oral and oropharyngeal cancer can often be cured, especially if the cancer is found in an early stage. Although curing the cancer is the primary goal of treatment, preserving the function of the nearby nerves, organs, and tissues is also very important. When doctors plan treatment, they consider how treatment might affect a person’s quality of life, such as how the person feels, looks, talks, eats, and breathes.

In many cases, a team of doctors will work together with the patient to create the best treatment plan. Head and neck cancer specialists often form a multidisciplinary team to care for each patient. This team may include medical oncologists (doctors who specialize in treating cancer with medication), radiation oncologists (doctors who specialize in giving radiation therapy to treat cancer), surgeons, otolaryngologists (ear, nose, and throat doctors), maxillofacial prosthodontists (specialists who perform restorative surgery to the head and neck area), dentists, physical therapists, speech pathologists, mental health professionals, nurses, dietitians, and social workers. It is crucial that a comprehensive treatment plan is established before treatment begins, and people may need to be seen and evaluated by several specialists before such a plan can be created.

There are three main treatment options for oral and oropharyngeal cancer: surgery, radiation therapy, and chemotherapy. One of these therapies, or a combination of them, may be used. Descriptions of the most common treatment options for oral and oropharyngeal cancer are listed below. Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, and the patient’s preferences and overall health. Take time to learn about your treatment options and be sure to ask questions about things that are unclear. Also, talk about the goals of each treatment with your doctor and what you can expect while receiving the treatment. Learn more about making treatment decisions.

Surgery

Surgery is the removal of the tumor and surrounding tissue during an operation. It is important that a person seeks the opinion of different members of the multidisciplinary team prior to deciding on a specific treatment. Even though surgery is the fastest way to eliminate cancerous tissues, other treatment methods do exist and may be equally effective in treating the cancer. People are encouraged to ask about other treatment options.

During surgery, a surgeon performs an operation to remove the cancerous tumor and some of the healthy tissue around it (called a margin). A surgical oncologist is a doctor who specializes in treating cancer using surgery. The goal of surgery is to remove all of the tumor and leave negative margins, which means there is no trace of cancer in the healthy tissue. Sometimes surgery is followed by radiation therapy and/or chemotherapy. Depending on the location, stage, and pathology of the cancer, some people may need more than one operation to remove the cancer and to help restore the appearance and function of the tissues affected.

Any surgical procedure should be done with the assistance of frozen section biopsy (a biopsy in which a slice of tissue is immediately frozen to speed the process of examination) of the margins at the time of surgery. This will require removal of additional tissue to obtain a margin free of cancer cells. The use of micrographic surgery, which is very frequent in the treatment of skin cancer, can occasionally be utilized for oral cavity tumors, and it is one way to minimize the amount of healthy tissue removed. This technique is often used with cancer of the lip and involves removing the visible tumor, in addition to small fragments of the edge around the area where the tumor was located. Each small fragment is examined under a microscope until all cancer is removed.

The most common surgical procedures for oral and oropharyngeal cancer include:

Primary tumor surgery. The tumor and an area of surrounding tissue are removed to decrease chances that any of the cancer will be left behind. The tumor can be removed through the mouth or through an incision in the neck. A mandibulotomy, in which the jawbone is split to access the tumor, may also be required.

Glossectomy. This is the partial or total removal of the tongue.

Mandibulectomy. If the tumor has entered a jawbone but not spread into the bone, then a piece of the jawbone or the whole jawbone is removed. If there is evidence of destruction of the jawbone on an x-ray, then the entire bone may need to be removed.

Maxillectomy. This surgery removes part or all of the hard palate, which is the bony roof of the mouth. Prostheses (artificial devices), or more recently, the use of flaps of soft tissue with and without bone can be placed to fill gaps from this operation.

Neck dissection. Cancer of the oral cavity and oropharynx often spreads to lymph nodes in the neck, and it may be necessary to remove some or all of these lymph nodes in a surgical procedure called a neck dissection.

Laryngectomy. A laryngectomy (complete or partial removal of the larynx or voice box) is rarely necessary for treatment of oral or oropharyngeal cancer. The larynx is critical to swallowing because it protects the airway from food and liquid entering the trachea or windpipe and reaching the lungs, which can cause pneumonia. When there is a large tumor of the tongue or oropharynx, the doctor may also need to remove the larynx to protect the airway during swallowing. If the larynx is removed, the windpipe is reattached to the skin of the neck where a hole, called a stoma, is made, through which the patient breathes. Rehabilitation is required to learn a new way of speaking.

Tracheostomy. If cancer is blocking the throat or is too large to completely remove, a hole called a tracheostomy is made in the neck, and a tracheostomy tube is placed through which the person breathes. A tracheostomy can be temporary or permanent.

Gastrostomy tube. If cancer is inhibiting the ability to swallow, a feeding device called a gastrostomy tube is placed through the skin and muscle of the abdomen directly into the stomach. If the swallowing problem is temporary, a nasogastric (NG) tube (inserted through the nose, down the esophagus, and into the stomach) may be used instead of a tube into the stomach. Tubes placed into the stomach may also be temporary methods for maintaining nutrition until the person can safely and adequately swallow by mouth.

Reconstruction. If treatment requires removing large areas of tissue, reconstructive surgery may be necessary to help the patient swallow and speak again. Healthy bone or tissue may be taken from other parts of the body to fill gaps left by the tumor or to replace part of the lip, tongue, palate, or jaw. A prosthodontist (a dental specialist with expertise in the restoration and replacement of broken teeth with crowns, bridges, or removable prosthetics [dentures]) may be able to make an artificial dental or facial part to help with swallowing and speech. A speech pathologist can teach the patient to communicate using new techniques or special equipment. A speech-language pathologist can also help restore the ability to swallow in patients who have difficulty eating by mouth after surgery or after radiation therapy.

In general, surgery for oral and oropharyngeal cancer often causes swelling, making it difficult to breathe. It may cause permanent loss of voice or impaired speech; difficulty chewing, swallowing, or talking; numbness of the ear; weakness raising arms above the head; lack of movement in the lower lip; and facial disfigurement. Surgery can decrease functioning of the thyroid gland, especially after a total laryngectomy and/or radiation therapy to the area. Talk with your health care team beforehand about what to expect from your specific surgery and how side effects will be managed.

Learn more about cancer surgery.

Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. The most common type of radiation treatment is external-beam radiation therapy, which is radiation given from a machine outside the body. External-beam radiation therapy is conducted with a radiation beam aimed at the tumor and is generally done as an outpatient procedure. When radiation treatment is given using implants, it is called internal radiation therapy or brachytherapy. Internal radiation therapy involves tiny pellets or rods containing radioactive materials that are surgically implanted in or near the cancer site. The implant is left in place for several days while the person stays in the hospital. A radiation therapy regimen (schedule) usually consists of a specific number of treatments given over a set period of time.

A newer method of external radiation therapy, known as intensity modulated radiation therapy (IMRT), allows for more effective doses of radiation therapy to be delivered while reducing the damage to healthy cells, thus causing fewer side effects. Proton therapy (also called proton beam therapy) is a type of external-beam radiation therapy that uses protons rather than x-rays. At high energy, protons can destroy cancer cells.

Radiation therapy can be the main treatment for oral cavity cancer, or it can be used after surgery to destroy small areas of cancer that could not be removed surgically.

Before beginning radiation treatment for any head and neck cancer, people should receive a thorough examination from an oncologic dentist (a dentist with experience in treating people with head and neck cancer). Since radiation therapy can cause tooth decay, damaged teeth may need to be removed. Often, tooth decay can be prevented by proper treatment from a dentist before beginning treatment. Learn more about dental health during cancer treatment.

It is also important that people receive counseling and evaluation from an oncologic speech pathologist (a speech pathologist with experience treating people with head and neck cancer).  Since radiation therapy can cause damage to healthy tissue, people often have difficulty speaking and/or swallowing after radiation therapy. These problems may occur long after radiation therapy is completed. Speech pathologists can provide exercises and techniques to prevent long-term speech and swallowing problems.

Hearing may also be affected in patients who receive radiation therapy to the head. Sometimes, patients may need to be evaluated by an audiologist (hearing specialist) to determine hearing abilities and/or loss.

Other side effects from radiation therapy to the head and neck may include redness or skin irritation to the treated area, dry mouth or thickened saliva from damage to salivary glands (which can be temporary or permanent), bone pain, nausea, fatigue, mouth sores, and/or sore throat.

Along with difficulty swallowing and speaking, patients who receive radiation therapy may also experience difficulty opening the mouth; loss of appetite, due to a change in sense of taste; hearing loss, due to buildup of fluid in the middle ear or nerve damage; and buildup of earwax, which dries out because of the radiation therapy’s effect on the ear canal. Radiation therapy may also cause a condition called hypothyroidism in which the thyroid gland (located in the neck) slows down, causing the patient to feel tired and sluggish. Every patient who receives radiation therapy to the neck area should have his or her thyroid checked regularly.

Learn more about radiation therapy.

Chemotherapy

Chemotherapy is the use of drugs to destroy cancer cells, usually by stopping the cancer cells’ ability to grow and divide. Systemic chemotherapy is delivered through the bloodstream to reach cancer cells throughout the body. Chemotherapy is given by a medical oncologist. Some people may receive chemotherapy in their doctor's office or outpatient clinic; others may go to the hospital. A chemotherapy regimen (schedule) usually consists of a specific number of cycles given over a set period of time. A patient may receive one drug at a time or combinations of different drugs at the same time.

The use of chemotherapy in combination with radiation therapy (called concomitant radiochemotherapy) is commonly recommended. The combination of these two treatments can sometimes control tumor growth, and it often is more effective than either treatment given alone. However, the side effects can be greater when combining these treatments.

Chemotherapy may be used as a neoadjuvant therapy (the initial treatment before surgery, radiation therapy, or both) or an adjuvant therapy (the treatment after surgery, radiation therapy, or both).

Chemotherapy for oral cavity cancer is most often given as part of a clinical trial (a research study). Many combined treatments (chemotherapy and radiation therapy) are performed as part of a clinical trial.

Each drug or combination of drugs can cause specific side effects. While some can be permanent, most are temporary and can typically be well controlled. In general, chemotherapy may cause fatigue, nausea, vomiting, hair loss, dry mouth, hearing loss, loss of appetite (often due to a change in sense of taste), difficulty eating food, weakened immune system, diarrhea and/or constipation, and open sores in the mouth (which can lead to infection).

Learn more about chemotherapy and preparing for treatment. The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions by using searchable drug databases.

Immunotherapy

Immunotherapy (also called biologic therapy) is designed to boost the body’s natural defenses to fight cancer. It uses materials made either by the body or in a laboratory to improve, target, or restore immune system function. Learn more about immunotherapy.  

Targeted therapy

Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells while limiting damage to normal cells.  

Currently, antibodies directed against a cellular receptor called the epidermal growth factor receptor (EGFR) are being used in combination with radiation therapy for head and neck cancers. Talk with your doctor about possible side effects for a specific treatment and how they can be managed.

Recent studies show that not all tumors have the same targets. To find the most effective treatment, your doctor may run tests to identify the genes, proteins, and other factors in your tumor. As a result, doctors can better match each patient with the most effective treatment whenever possible. In addition, many research studies are taking place now to find out more about specific molecular targets and new treatments directed at them.

Learn more about targeted treatments.

Getting care for symptoms and side effects

Cancer and its treatment often cause side effects. In addition to treatment to slow, stop, or eliminate the cancer, an important part of cancer care is relieving a person’s symptoms and side effects. This approach is called palliative or supportive care, and it includes supporting the patient with his or her physical, emotional, and social needs.

Palliative care can help a person at any stage of illness. People often receive treatment for the cancer and treatment to ease side effects at the same time. In fact, patients who receive both often have less severe symptoms, better quality of life, and report they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, and other therapies. You may also receive palliative treatments similar to those meant to eliminate the cancer, such as chemotherapy, surgery, and radiation therapy. Talk with your doctor about the goals of each treatment in the treatment plan.

Before treatment begins, talk with your health care team about the possible side effects of your specific treatment plan and supportive care options. And during and after treatment, be sure to tell your doctor or another health care team member if you are experiencing a problem so it is addressed as quickly as possible. Learn more about palliative care.   

Recurrent oral or oropharyngeal cancer

A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called “no evidence of disease” or NED. 

A remission can be temporary or permanent. This uncertainty leads to many survivors feeling worried or anxious that the cancer will come back. While many remissions are permanent, it’s important to talk with your doctor about the possibility of the cancer returning. Understanding the risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence

If the cancer does return after the original treatment, it is called recurrent cancer. It may come back in the same place (called a local recurrence), nearby (regional recurrence), or in another place (distant recurrence).

When this occurs, a cycle of testing will begin again to learn as much as possible about the recurrence, including whether the cancer’s stage has changed. After testing is done, you and your doctor will talk about your treatment options. Often the treatment plan will include the therapies described above (such as surgery, chemotherapy, and radiation therapy), but they may be used in a different combination or given at a different pace. Your doctor may also suggest clinical trials that are studying new ways to treat this type of recurrent cancer.

People with recurrent cancer often experience emotions such as disbelief or fear. Patients are encouraged to talk with their health care team about these feelings and ask about support services to help them cope. Learn more about dealing with cancer recurrence.

Metastatic oral or oropharyngeal cancer

If cancer has spread to another location in the body, it is called metastatic cancer. Patients with this diagnosis are encouraged to talk with doctors who are experienced in treating this stage of cancer because there can be different opinions about the best treatment plan. Learn more about seeking a second opinion before starting treatment, so you are comfortable with the treatment plan chosen. This discussion may include clinical trials studying new treatments.

Your health care team may recommend a treatment plan that includes a combination of surgery, radiation therapy, chemotherapy, immunotherapy, or targeted therapy. Supportive care will also be important to help relieve symptoms and side effects.

For most patients, a diagnosis of metastatic cancer is very stressful and, at times, difficult to bear. Patients and their families are encouraged to talk about the way they are feeling with doctors, nurses, social workers, or other members of the health care team. It may also be helpful to talk with other patients, including through a support group.

If treatment fails

Recovery from cancer is not always possible. If treatment is not successful, the disease may be called advanced or terminal cancer.

This diagnosis is stressful, and this is difficult to discuss for many people. However, it is important to have open and honest conversations with your doctor and health care team to express your feelings, preferences, and concerns. The health care team is there to help, and many team members have special skills, experience, and knowledge to support patients and their families. Making sure a person is physically comfortable and free from pain is extremely important.

Patients who have advanced cancer and who are expected to live less than six months may want to consider a type of palliative care called hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to think about where you would be most comfortable: at home, in the hospital, or in a hospice environment. Nursing care and special equipment can make staying at home a workable alternative for many families. Learn more about advanced cancer care planning.

After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and bereavement.

The next section helps explain clinical trials, which are research studies. Use the menu on the side of your screen to select About Clinical Trials, or you can select another section, to continue reading this guide.

Oral and Oropharyngeal Cancer - About Clinical Trials

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2013

ON THIS PAGE: You will learn more about clinical trials, which are the main way that new medical approaches are tested to see how well they work. To see other pages, use the menu on the side of your screen.

Doctors and scientists are always looking for better ways to treat patients with oral or oropharyngeal cancer. To make scientific advances, doctors create research studies involving volunteers, called clinical trials.

Many clinical trials are focused on new treatments, evaluating whether a new treatment is safe, effective, and possibly better than the current (standard) treatment. These types of studies evaluate new drugs, different combinations of existing treatments, new approaches to radiation therapy or surgery, and new methods of treatment. Patients who participate in clinical trials are often among the first to receive new treatments, such as new chemotherapy drugs, before they are widely available. However, there is no guarantee that the new treatment will be safe, effective, or better than a standard treatment.

There are also clinical trials that study new ways to ease symptoms and side effects during treatment and managing the late effects that may occur after treatment. Talk with your doctor about clinical trials regarding side effects. In addition, there are ongoing studies about ways to prevent the disease.

Patients decide to participate in clinical trials for many reasons. For some patients, a clinical trial is the best treatment option available. Because standard treatments are not perfect, patients are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Other patients volunteer for clinical trials because they know that these studies are the only way to make progress in treating oral and oropharyngeal cancer. Even if they do not benefit directly from the clinical trial, their participation may benefit future patients with oral or oropharyngeal cancer.

Sometimes people have concerns that, by participating in a clinical trial, they may receive no treatment by being given a placebo or a “sugar pill.” The use of placebos in cancer clinical trials is rare. When a placebo is used in a study, it is done with the full knowledge of the participants. Find out more about placebos in cancer clinical trials.

To join a clinical trial, patients must participate in a process known as informed consent. During informed consent, the doctor should list all of the patient’s options, so that the person understands how the new treatment differs from the standard treatment. The doctor must also list all of the risks of the new treatment, which may or may not be different than the risks of standard treatment. Finally, the doctor must explain what will be required of each patient in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment.

For specific topics being studied for oral and oropharyngeal cancer, learn more in the Latest Research section.

Patients who participate in a clinical trial may stop participating at any time, for any personal or medical reason. This may include that the new treatment is not working or there are serious side effects. Clinical trials are also closely monitored by experts who watch for any problems with each study. It is important that patients participating in a clinical trial talk with their doctor and researchers about who will be providing their treatment and care during the clinical trial, after the clinical trial ends, and/or if the patient chooses to leave the clinical trial before it ends. 

Cancer.Net offers a lot of information about cancer clinical trials in other areas of the website, including a complete section on clinical trials and places to search for clinical trials for a specific type of cancer.

The next section helps explain the areas of research going on today about this type of cancer. Use the menu on the side of your screen to select Latest Research, or you can select another section, to continue reading this guide.

Oral and Oropharyngeal Cancer - Latest Research

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2013

ON THIS PAGE: You will read about the scientific research being done now to learn more about oral and oropharyngeal cancer and how to treat them. To see other pages, use the menu on the side of your screen.

Doctors are working to learn more about oral and oropharyngeal cancer, ways to prevent them, how to best treat them, and how to provide the best care to people diagnosed with these diseases. The following areas of research may include new options for patients through clinical trials. Always talk with your doctor about the diagnostic and treatment options best for you.

New treatments. Many new treatments have become available as a result of improvement in the knowledge of the biology of cancer. Some of these treatments, including biologic therapy and targeted therapy, are available through clinical trials. Therapies being researched include tyrosine kinase inhibitors, antiangiogenic therapy (which prevents blood vessel formation that is needed for tumor growth), immune modulating approaches, and agents that trigger cancer cell death. These and other treatment approaches are in various stages of research.

Radiofrequency thermal ablation (RFA). RFA uses heat to destroy cancer cells. It is a minimally invasive treatment option that may be useful for localized tumors that cannot be removed with surgery.

Supportive care. Clinical trials are underway to find better methods of reducing the symptoms and side effects of current oral and oropharyngeal treatments to improve patients’ comfort and quality of life.

To find clinical trials specific to your diagnosis, talk with your doctor or search online clinical trial databases now.

The next section addresses how to cope with the symptoms of the disease or the side effects of its treatment. Use the menu on the side of your screen to select Coping with Side Effects, or you can select another section, to continue reading this guide.  

Oral and Oropharyngeal Cancer - Coping with Side Effects

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2013

ON THIS PAGE: You will find out more about steps to take to help cope with physical, social, and emotional side effects. This page includes several links outside of this guide to other sections of this website. To see other pages, use the menu on the side of your screen.

Fear of treatment side effects is common after a diagnosis of cancer, but it may help to know that preventing and controlling side effects is a major focus of your health care team. This is called palliative or supportive care, and it is an important part of the overall treatment plan, regardless of the stage of disease.

Common side effects from each treatment option for oral or oropharyngeal cancer are described in detail within the Treatment Options section. Learn more about the most common side effects of cancer and different treatments, along with ways to prevent or control them. Side effects depend on a variety of factors, including the cancer’s stage, the length and dosage of treatment(s), and your overall health.

Before treatment begins, talk with your doctor about possible side effects of each type of treatment you will be receiving. Ask which side effects are most likely to happen, when they are likely to occur, and what can be done to prevent or relieve them. And, ask about the level of caregiving you may need during treatment and recovery, as family members and friends often play an important role in the care of a person with oral or oropharyngeal cancer. Learn more about caregiving.

In addition to physical side effects, there may be psychosocial (emotional and social) effects as well. Patients and their families are encouraged to share their feelings with a member of their health care team who can help with coping strategies. Learn more about the importance of addressing such needs, including concerns about managing the cost of your cancer care

During and after treatment, be sure to tell the health care team about the side effects you experience, even if you feel they are not serious. Sometimes, side effects can last beyond the treatment period, called a long-term side effect. A side effect that occurs months or years after treatment is called a late effect. Treatment of both types of effects is an important part of survivorship care. Learn more by reading the After Treatment section or talking with your doctor.

The next section helps explain medical tests and check-ups needed after finishing cancer treatment. Use the menu on the side of your screen to select After Treatment, or you can select another section, to continue reading this guide.

Oral and Oropharyngeal Cancer - After Treatment

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2013

ON THIS PAGE: You will read about your medical care after cancer treatment is finished and why this follow-up care is important. To see other pages, use the menu on the side of your screen.

After treatment for oral or oropharyngeal cancer ends, talk with your doctor about developing a follow-up care plan. This plan may include regular physical examinations and/or medical tests to monitor your recovery for the coming months and years. ASCO offers cancer treatment summary forms to help keep track of the cancer treatment you received and develop a survivorship care plan once treatment is completed.

People treated for oral or oropharyngeal cancer should receive regular follow-up medical and dental examinations to check for signs of recurrent cancer or a secondary cancer (a different type of cancer). Most recurrences of oral and oropharyngeal cancer happen within the first two to three years after diagnosis, so follow-up visits will be more frequent in the years immediately following treatment.

A common follow-up schedule is every two months for the first year, every four months for the second year, every six months for the third year, and once a year thereafter. If recurrent cancer is found, testing and treatment must begin again. If surgery or radiation therapy may have affected the person’s thyroid gland, thyroid function tests should be part of follow-up care testing. Special dental care may also be needed to manage or avoid long-term dental problems due to the cancer or its treatment.

People treated for oral and oropharyngeal cancer have a higher risk of developing secondary cancers. Researchers are evaluating the benefits of chemotherapy to prevent second cancers from developing, called chemoprevention.

If you smoke, it is important to be monitored for possible secondary cancers in the lung, esophagus, and head and neck, even without recurrence of the initial cancer. This is one of the reasons for medical follow-up. Enrolling in prevention clinical trials may also be an option.

Rehabilitation is a major part of follow-up care after head and neck cancer treatment. People may need physical therapy and speech and swallowing therapy. Supportive care to manage symptoms and maintain nutrition during treatment may be recommended. Some people may need to learn new ways to eat or to eat foods prepared differently.

Any treatment for oral or oropharyngeal cancer will make swallowing normal food more difficult. It is important for people who have been treated for oral or oropharyngeal cancer to continue to swallow their saliva and any food they can as much as possible, throughout their treatment, to prevent long-term swallowing problems. Special nutritional care and support is often needed during treatment and immediately following treatment while the body’s reaction to the treatment, such as swelling of tissues, subsides. Speech pathologists can assist people in regaining their normal functions, which becomes an important part of treatment planning and rehabilitation.

Depending on the size and location of the tumor and the type of cancer treatment selected, the abilities to chew and move the food through the mouth and pharynx to the stomach may be impaired. If the cancer treatment changes oral structures or limits their movement, speech will become more difficult to understand. Pre-treatment evaluation of speech and swallowing abilities is necessary to maximize post-treatment functioning and quality of life. 

People may look different, feel tired, and be unable to talk or eat the way they did before treatment. They may experience swelling in the area, called lymphedema. Many people experience depression. The health care team can help people adjust and connect them with both physical and emotional support services. Again, it is important that people meet with all members of the multidisciplinary team before their head and neck cancer treatment begins (see the Treatment Options section for more details) to reduce long-term problems.

People recovering from oral and oropharyngeal cancer are encouraged to follow established guidelines for good health, such as maintaining a healthy weight, avoiding all tobacco products, eating a balanced diet, and having recommended cancer screening tests. Talk with your doctor to develop a plan that is best for your needs. Moderate physical activity can help rebuild your strength and energy level. Your doctor can help you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn more about the next steps to take in survivorship, including making positive lifestyle changes.

The next section offers a list of questions you may want to ask. Use the menu on the side of your screen to select Questions to Ask the Doctor, or you can select another section, to continue reading this guide.

Oral and Oropharyngeal Cancer - Questions to Ask the Doctor

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2013

ON THIS PAGE: You will find some questions to ask your doctor or other members of your health care team, to help you better understand your diagnosis, treatment plan, and overall care. To see other pages, use the menu on the side of your screen.

Talking often with the doctor is important to make informed decisions about your health care. These suggested questions are a starting point to help you learn more about your cancer care and treatment. You are also encouraged to ask additional questions that are important to you. You may want to print this list and bring it to your next appointment, or download Cancer.Net’s free mobile app for an e-list and other interactive tools to manage your care.

  • What type of oral or oropharyngeal cancer do I have? Where exactly is it located?
  • What is the stage and grade of the cancer? What does this mean?
  • Can you explain my pathology report (laboratory test results) to me?
  • What are the treatment options?
  • What clinical trials are open to me?
  • What treatment plan do you recommend? Why?
  • What is the goal of each treatment? Is it to eliminate the cancer, help me feel better, or both?
  • Should I get an additional consultation or second opinion?
  • Who will be part of my health care team, and what does each member do?
  • Who will be coordinating my overall treatment and follow-up care?
  • What are the possible side effects of each treatment option, both in the short term and the long term?
  • What can be done to prevent or relieve the possible side effects?
  • What functional deficits (in speech, swallowing, or shoulder motion) will likely occur, and what rehabilitation services are available?
  • If I have surgery, will there be need for major reconstruction? If so, how will this affect my ability to speak and eat?
  • If surgery is done, will there be a need for a neck dissection (removal of lymph nodes)? If so, what type of dissection will be done? What does this mean?
  • Will this surgery affect my appearance in any way?
  • How likely is it that I will lose my voice box (larynx)? If this is necessary, what are the options available for voice/speech rehabilitation?
  • If I receive radiation therapy, what are the lasting side effects of such treatment, including loss of saliva, loss of taste, and permanent difficulty in swallowing?
  • How will my nutrition be maintained if the treatment affects my ability to eat the foods I am used to eating?
  • Can you recommend an oncologic dentist before treatment begins?
  • Can you recommend an oncologic speech pathologist before treatment begins?
  • Should I see other specialists prior to treatment? Should I specifically talk with a radiation oncologist, medical oncologist, or a plastic surgeon?
  • What will rehabilitation after treatment consist of?
  • If I am a smoker, will quitting help this treatment have a better outcome? Can you help me quit?
  • Could this treatment affect my sex life? If so, how and for how long?
  • Could this treatment affect my ability to become pregnant or have children? If so, should I talk with a fertility specialist before cancer treatment begins?
  • After treatment, what follow-up tests will be needed, and how often will I need them?
  • What are the chances this tumor will recur?
  • What are the chances of developing a secondary cancer?
  • If I’m worried about managing the costs related to my cancer care, who can help me with these concerns?
  • What support services are available to me? To my family?
  • Whom should I call for questions or problems?

The next section offers some more resources that may be helpful to you. Use the menu on the side of your screen to select Additional Resources, or you can select another section, to continue reading this guide.

Oral and Oropharyngeal Cancer - Additional Resources

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2013

ON THIS PAGE: You will find some helpful links to other areas of Cancer.Net that provide information about cancer care and treatment. This is the final page of Cancer.Net’s Guide to Oral and Oropharyngeal Cancer. To go back and review other pages, use the menu on the side of your screen.

Cancer.Net includes many other sections about the medical and emotional aspects of cancer, both for the person diagnosed and their family members and friends. This website is meant to be a resource for you and your loved ones from the time of diagnosis, through treatment, and beyond. Here are a few sections that may get you started in exploring the rest of Cancer.Net:

This is the end of Cancer.Net’s Guide to Oral and Oropharyngeal Cancer. Use the menu on the side of your screen to select another section to continue reading this guide.