Rak podniebienia miękkiego
Leczenie
Leczenie raka podniebienia miękkiego wymaga wielodyscyplinarnego podejścia, uwzględniającego chirurgię, radioterapię, chemioterapię oraz nowoczesne metody, takie jak terapie celowane i immunoterapia. Chirurgia, często pierwsza linia terapii we wczesnych stadiach, polega na całkowitym usunięciu guza z marginesem zdrowych tkanek, a w przypadku zajęcia węzłów chłonnych szyi wykonuje się dysekcję szyi. Radioterapia, stosowana samodzielnie lub jako leczenie uzupełniające, wymaga dawki około 70 Gy dla skutecznej kontroli ogniska pierwotnego, z wynikami kontroli miejscowej na poziomie 80-90% dla zmian T1, 60-70% dla T2 i 55-65% dla T3. Chemioterapia, zwłaszcza w schemacie indukcyjnym z cisplatyną i 5-FU, wykazuje wskaźniki odpowiedzi 60-90%, a chemioradioterapia stanowi standard opieki w miejscowo zaawansowanych przypadkach, poprawiając kontrolę miejscowo-regionalną kosztem zwiększonej toksyczności. Terapie celowane (np. cetuksymab przeciw EGFR) oraz inhibitory PD-1 (niwolumab, pembrolizumab) są stosowane w zaawansowanych i nawrotowych postaciach choroby.
- Leczenie raka podniebienia miękkiego
- Chirurgia jako metoda leczenia
- Radioterapia
- Chemioterapia
- Chemioradioterapia
- Terapie celowane i immunoterapia
- Chirurgia rekonstrukcyjna
- Rehabilitacja i opieka wspomagająca
- Strategie leczenia w zależności od stadium zaawansowania
- Porównanie skuteczności metod leczenia
- Nowe kierunki w leczeniu raka podniebienia miękkiego
- Rehabilitacja i opieka po leczeniu
- Podsumowanie i rokowania
Leczenie raka podniebienia miękkiego
Leczenie raka podniebienia miękkiego wymaga kompleksowego podejścia, uwzględniającego wiele czynników takich jak lokalizacja i wielkość guza, stadium zaawansowania choroby, stan ogólny pacjenta oraz potencjalne skutki terapii dla funkcji jamy ustnej. Plan leczenia jest zwykle tworzony przez wielodyscyplinarny zespół, w skład którego wchodzą chirurdzy, radioterapeuci, onkolodzy kliniczni, a także specjaliści zajmujący się rehabilitacją mowy i połykania.12
Chirurgia jako metoda leczenia
Chirurgia jest często pierwszą linią leczenia raka podniebienia miękkiego, szczególnie we wczesnych stadiach zaawansowania. Celem zabiegu jest całkowite usunięcie nowotworu wraz z marginesem zdrowych tkanek, aby zwiększyć prawdopodobieństwo usunięcia wszystkich komórek nowotworowych.12
Zakres zabiegu zależy od wielkości guza i stopnia jego zaawansowania. W przypadku małych, dobrze zdefiniowanych zmian podniebienia miękkiego, może być wykonane proste wycięcie, natomiast przy większych zmianach konieczne mogą być bardziej rozległe operacje.34
Gdy rak rozprzestrzenia się do węzłów chłonnych szyi, co często ma miejsce w przypadku raka podniebienia miękkiego, wykonuje się operację usunięcia węzłów chłonnych szyjnych (nazywaną dysekcją szyi). Nawet jeśli nie ma wyraźnych oznak zajęcia węzłów chłonnych, niekiedy usuwa się je profilaktycznie, aby zmniejszyć ryzyko nawrotu choroby.15
Nowoczesne techniki chirurgiczne, takie jak chirurgia minimalnie inwazyjna czy chirurgia robotowa (TORS – transoral robotic surgery), są coraz częściej stosowane w leczeniu raka podniebienia miękkiego, ponieważ pozwalają na precyzyjne usunięcie guza przy jednoczesnym zachowaniu większej ilości zdrowych tkanek i funkcji jamy ustnej.678
Radioterapia
Radioterapia wykorzystuje wysokoenergetyczne promieniowanie do niszczenia komórek nowotworowych. W przypadku raka podniebienia miękkiego może być stosowana jako:910
- Leczenie samodzielne – szczególnie w przypadku małych guzów lub u pacjentów, którzy nie kwalifikują się do operacji
- Leczenie pooperacyjne (adjuwantowe) – w celu zniszczenia ewentualnych pozostałych komórek nowotworowych
- Leczenie przedoperacyjne (neoadjuwantowe) – aby zmniejszyć guz przed operacją
- Element leczenia skojarzonego wraz z chemioterapią (chemioradioterapia)
Ze względu na trudności w odpowiedniej rekonstrukcji po rozległych zabiegach, radioterapia była w przeszłości preferowanym leczeniem dla raków podniebienia miękkiego i nadal pozostaje główną metodą leczenia w wielu ośrodkach dla zmian T1, T2 i T3.12
Przy zastosowaniu radioterapii jako podstawowego leczenia, kontrola ogniska pierwotnego osiągana jest w 80-90% przypadków zmian T1, 60-70% zmian T2 i 55-65% zmian T3. Wskaźnik ten spada do poniżej 50% dla zmian T4. Skuteczne leczenie ogniska pierwotnego wymaga dawki około 70 Gy.1213
Nowoczesne techniki radioterapii, takie jak radioterapia z modulacją intensywności wiązki (IMRT), pozwalają na precyzyjne dostarczenie promieniowania do guza przy jednoczesnym oszczędzeniu otaczających zdrowych tkanek, co zmniejsza skutki uboczne leczenia.1415
Chemioterapia
Chemioterapia wykorzystuje silne leki do niszczenia komórek nowotworowych. W leczeniu raka podniebienia miękkiego może być stosowana:910
- Po operacji, aby zniszczyć ewentualne pozostałe komórki nowotworowe
- Jednocześnie z radioterapią (chemioradioterapia), ponieważ zwiększa skuteczność radioterapii
- Przed operacją (indukcyjna), aby zmniejszyć guz i ułatwić zabieg
- Jako leczenie paliatywne przy zaawansowanej chorobie lub nawrotach
W chemioterapii indukcyjnej (neoadjuwantowej) stosowano różne schematy lekowe. Połączenie cisplatyny i fluorouracylu (5-FU) zyskało znaczną popularność ze względu na wysokie wskaźniki odpowiedzi przy akceptowalnym poziomie toksyczności. U wcześniej nieleczonych pacjentów odnotowano wskaźniki odpowiedzi na poziomie 60-90%, z całkowitą odpowiedzią kliniczną u 20-40% pacjentów.17
Chemioradioterapia
Jednoczesne stosowanie chemioterapii i radioterapii (chemioradioterapia) jest często wykorzystywane w leczeniu raka podniebienia miękkiego, szczególnie w przypadkach zaawansowanych lub gdy istnieje znaczące ryzyko nawrotu choroby. Ta metoda leczenia skojarzonego ma na celu zwiększenie kontroli miejscowo-regionalnej nowotworu dzięki addytywnemu lub synergistycznemu działaniu obu metod.1418
Kilka randomizowanych badań wykazało poprawę kontroli miejscowo-regionalnej i przeżycia wolnego od choroby przy jednoczesnym stosowaniu jednolekowej chemioterapii i radioterapii w porównaniu z samą radioterapią. Jednak toksyczność jednoczesnej wielolekowej chemioterapii i radioterapii jest znacząca.1819
Chemioradioterapia stanowi obecnie standard opieki dla pacjentów z miejscowo zaawansowanym rakiem płaskonabłonkowym głowy i szyi, w tym podniebienia miękkiego.19
Terapie celowane i immunoterapia
W leczeniu zaawansowanego raka podniebienia miękkiego lub w przypadku nawrotów choroby coraz częściej stosowane są nowoczesne metody leczenia, takie jak terapie celowane i immunoterapia.910
Terapie celowane
Terapie celowane wykorzystują leki, które atakują specyficzne substancje chemiczne w komórkach nowotworowych. Blokując te substancje, leczenie celowane może prowadzić do śmierci komórek nowotworowych. Terapia celowana jest stosowana w leczeniu raka podniebienia miękkiego, który rozprzestrzenił się do innych części ciała lub nawrócił po leczeniu.10
Jednym z potencjalnych celów w raku jamy ustnej i gardła jest receptor naskórkowego czynnika wzrostu (EGFR). Cetuximab, przeciwciało monoklonalne skierowane przeciwko EGFR, był pierwszą terapią celowaną zatwierdzoną w leczeniu raka jamy ustnej i gardła. Może być stosowany w połączeniu z radioterapią lub chemioterapią.2021
Immunoterapia
Immunoterapia to leczenie lekami, które pomagają układowi odpornościowemu organizmu zwalczać komórki nowotworowe. Układ odpornościowy zwalcza choroby, atakując drobnoustroje i inne komórki, które nie powinny znajdować się w organizmie. Komórki nowotworowe przeżywają, ukrywając się przed układem odpornościowym. Immunoterapia pomaga komórkom układu odpornościowego znaleźć i zniszczyć komórki nowotworowe.10
Inhibitory PD-1, takie jak niwolumab i pembrolizumab, są często stosowane w immunoterapii raka jamy ustnej i gardła. Te leki mogą być wykorzystywane, gdy nowotwór rozprzestrzenia się do innych części ciała i inne metody leczenia nie przyniosły efektów.2221
Chirurgia rekonstrukcyjna
Chirurgia rekonstrukcyjna jest często niezbędna po rozległych zabiegach usunięcia raka podniebienia miękkiego, aby przywrócić funkcję i wygląd tej okolicy. Rekonstrukcja ma kluczowe znaczenie dla zachowania funkcji mowy, połykania i oddychania.2324
Techniki rekonstrukcyjne mogą obejmować:2425
- Przeszczepy skóry – pobierane z brzucha lub nogi i wykorzystywane do naprawy małych obszarów błony śluzowej jamy ustnej
- Płaty miejscowe – gdzie tkanka jest przemieszczana z pobliskich obszarów, takich jak skóra głowy, policzek, czoło, szyja lub klatka piersiowa
- Mikrochirurgia naczyniowa – wykorzystująca płaty wolne, gdzie tkanka jest pobierana z odległych części ciała i przeszczepiana z połączeniem naczyń krwionośnych pod mikroskopem
- Protezy podniebienne (obturatory) – które zastępują funkcje podniebienia miękkiego
Czas rekonwalescencji po chirurgii rekonstrukcyjnej jest różny. Przy mniejszych rekonstrukcjach, takich jak przeszczep skóry, może być wymagane tylko dwa lub trzy dni rekonwalescencji w szpitalu. Jeśli potrzebna jest rozległa rekonstrukcja, pacjent może wymagać pobytu w szpitalu przez tydzień lub dłużej.27
Rehabilitacja i opieka wspomagająca
Leczenie zaawansowanego raka podniebienia miękkiego może wpływać na zdolność mowy i jedzenia. Praca ze specjalistycznym zespołem rehabilitacyjnym może pomóc w radzeniu sobie ze zmianami wynikającymi z leczenia nowotworów.910
Usługi rehabilitacyjne po leczeniu raka podniebienia miękkiego mogą obejmować:2328
- Terapię mowy – pomagającą w przywróceniu zdolności komunikacyjnych
- Terapię połykania – pomagającą w przywróceniu zdolności przyjmowania pokarmów
- Wsparcie dietetyczne – zapewniające odpowiednie odżywianie podczas i po leczeniu
- Wsparcie psychologiczne – pomagające w radzeniu sobie z emocjonalnymi skutkami choroby i leczenia
- Opiekę stomatologiczną – niezbędną dla utrzymania zdrowia jamy ustnej
Strategie leczenia w zależności od stadium zaawansowania
Wybór strategii leczenia raka podniebienia miękkiego zależy w dużej mierze od stadium zaawansowania nowotworu, choć istotne są również inne czynniki, takie jak stan ogólny pacjenta.5
Rak we wczesnym stadium
W przypadku raka podniebienia miękkiego we wczesnym stadium (I i II), gdy nowotwór jest niewielki i nie rozprzestrzenił się poza miejsce pierwotne, leczenie może obejmować:531
- Samodzielną chirurgię – często wystarczającą do całkowitego wyleczenia
- Samodzielną radioterapię – szczególnie gdy operacja nie jest możliwa lub wskazana
- Połączenie chirurgii i radioterapii – gdy istnieje ryzyko pozostania komórek nowotworowych
Większość pacjentów z rakiem podniebienia miękkiego w stadium I lub II ma dobre wyniki leczenia przy zastosowaniu chirurgii i/lub radioterapii. Wskaźniki 5-letniego przeżycia dla raków w stadium I-II wynoszą około 80%.2917
Rak w stadium zaawansowanym
W przypadku zaawansowanego raka podniebienia miękkiego (stadium III i IV), gdy nowotwór jest większy lub rozprzestrzenił się do węzłów chłonnych, leczenie jest zwykle bardziej złożone i może obejmować:519
- Chirurgię z następową radioterapią lub chemioradioterapią
- Chemioradioterapię jako leczenie podstawowe, szczególnie gdy operacja nie jest możliwa
- Indukcyjną chemioterapię, a następnie radioterapię lub chemioradioterapię
- Leczenie skojarzone z uwzględnieniem terapii celowanych
Dla pacjentów z rakiem w stadium III-IV wskaźniki 5-letniego przeżycia wynoszą około 30-40%, choć dla stadium IVA/B wskaźnik 5-letniego przeżycia związanego z nowotworem może przekraczać 50%.1713
Leczenie nawrotów
W przypadku nawrotu raka podniebienia miękkiego opcje leczenia zależą od lokalizacji i wielkości nawrotu, wcześniej zastosowanych metod leczenia oraz ogólnego stanu zdrowia pacjenta:5
- Jeśli nowotwór nawraca w tym samym obszarze, a pierwotnym leczeniem była radioterapia, często kolejnym leczeniem jest operacja (o ile nowotwór można całkowicie usunąć)
- Jeśli nawrót występuje w węzłach chłonnych szyi, często usuwa się je chirurgicznie (dysekcja węzłów chłonnych), a następnie stosuje radioterapię lub chemioradioterapię
- Jeśli nowotwór nawraca w odległym miejscu, często stosuje się chemioterapię, terapie celowane lub immunoterapię
Porównanie skuteczności metod leczenia
Wybór optymalnej metody leczenia raka podniebienia miękkiego zależy od wielu czynników, a każda z dostępnych opcji ma swoje zalety i ograniczenia.12
W przeszłości, ze względu na trudności w odpowiedniej rekonstrukcji, radioterapia była preferowanym leczeniem dla raków podniebienia miękkiego. Mimo postępów w technikach rekonstrukcyjnych i rekonstrukcji protetycznej, które umożliwiły bardziej efektywną resekcję chirurgiczną i rehabilitację pacjentów z rakiem podniebienia miękkiego, radioterapia pozostaje główną metodą leczenia w wielu ośrodkach dla zmian T1, T2 i T3, z wynikami porównywalnymi do chirurgii.12
Badania wykazały, że 75% do 100% pacjentów z wczesnym stadium raka podniebienia miękkiego żyło pięć lat po diagnozie, co świadczy o wysokiej skuteczności leczenia we wczesnych stadiach.29
Radioterapia stosowana samodzielnie lub z chemioterapią jest podstawowym leczeniem dla umiarkowanych lub zaawansowanych nowotworów w celu zachowania podniebienia miękkiego i jego funkcji.14
W przypadku zastosowania chirurgii laserowej mikrochirurgia przezousta może zachować normalne tkanki, powoduje mniejszy ból i może pomóc w zachowaniu mowy i połykania, co jest szczególnie istotne w przypadku raka podniebienia miękkiego.7
W przypadku zaawansowanego raka podniebienia miękkiego coraz częściej stosuje się leczenie skojarzone, takie jak chemioradioterapia, która wykazuje wyższą skuteczność niż pojedyncze metody leczenia, choć kosztem zwiększonej toksyczności.18
Nowe kierunki w leczeniu raka podniebienia miękkiego
Badania nad nowymi metodami leczenia raka podniebienia miękkiego stale się rozwijają, a pacjenci mają coraz więcej możliwości terapeutycznych.535
Wśród innowacyjnych podejść do leczenia raka podniebienia miękkiego można wymienić:3637
- Hiperfrakcjonowaną radioterapię – nieznacznie niższa dawka promieniowania podawana więcej niż raz dziennie (na przykład dwa razy dziennie przez 7 tygodni)
- Przyspieszoną frakcjonowaną radioterapię – standardowa dawka promieniowania podawana każdego dnia, ale w krótszym czasie (5 do 6 tygodni) zamiast zwyczajowych 7 tygodni
- Hipofrakcjonowaną radioterapię – nieznacznie wyższa dawka promieniowania podawana każdego dnia, aby zmniejszyć liczbę zabiegów
Badania kliniczne nowych leków immunoterapeutycznych i terapii celowanych dają nadzieję na bardziej skuteczne i mniej toksyczne metody leczenia raka podniebienia miękkiego, szczególnie w przypadkach zaawansowanych lub nawrotowych.4041
Dla wielu pacjentów z rakiem podniebienia miękkiego udział w badaniu klinicznym może być najlepszą opcją leczenia, dając dostęp do najnowszych terapii, które mogą być skuteczniejsze niż standardowe metody.542
Rehabilitacja i opieka po leczeniu
Leczenie raka podniebienia miękkiego, szczególnie zaawansowanego, może prowadzić do znaczących zmian w funkcjonowaniu jamy ustnej, wpływając na mowę, połykanie i ogólną jakość życia. Kompleksowa rehabilitacja jest kluczowym elementem procesu leczenia.910
Zaburzenia połykania
Dysfagia (trudności w połykaniu) jest częstym powikłaniem po leczeniu raka podniebienia miękkiego. Radioterapia i chirurgia mogą wpłynąć na język, jamę ustną lub gardło, powodując dysfagię. Jest to potencjalnie poważny problem, ponieważ oprócz ryzyka niedożywienia istnieje możliwość, że małe cząstki pokarmu mogą dostać się do dróg oddechowych i utkwić w płucach, wywołując infekcję klatki piersiowej, znaną jako zachłystowe zapalenie płuc.43
Terapia połykania prowadzona przez specjalistów może pomóc w przywróceniu tej funkcji oraz nauczyć pacjenta technik bezpiecznego połykania.28
Zaburzenia mowy
Podobnie jak połykanie, zdolność do wyraźnego mówienia jest regulowana przez złożoną interakcję mięśni, kości i tkanek, w tym języka, zębów, warg i podniebienia miękkiego. Radioterapia i chirurgia mogą wpłynąć na ten proces i utrudnić wymowę pewnych dźwięków. W poważnych przypadkach pacjent może mieć problemy z komunikacją.44
Terapia mowy może pomóc pacjentom w nauce nowych sposobów formowania dźwięków i poprawie zrozumiałości mowy.27
Wsparcie odżywiania
Problemy z jedzeniem i połykaniem mogą prowadzić do niedożywienia. Dietetycy mogą pomóc pacjentom w opracowaniu planów żywieniowych, które zapewnią odpowiednie odżywianie pomimo trudności z jedzeniem. Może to obejmować suplementy żywieniowe, modyfikacje konsystencji pokarmów lub czasowe żywienie przez zgłębnik.4528
Opieka stomatologiczna
Leczenie raka podniebienia miękkiego może pogorszyć istniejące problemy z dziąsłami i zębami oraz skomplikować opiekę po leczeniu. Ważna jest opieka stomatologiczna przed, w trakcie i po leczeniu, aby zapewnić długoterminowe zdrowie i funkcję zębów i dziąseł.46
Specjaliści stomatologii onkologicznej mogą wykonać niezbędne zabiegi przed leczeniem oraz zapewnić protetykę po leczeniu, aby przywrócić wygląd i funkcję jamy ustnej.4647
Wsparcie psychologiczne
Niektórzy pacjenci mają trudności z przystosowaniem się do zmian w ich ciele po leczeniu raka podniebienia miękkiego. Wsparcie psychologiczne i grupy wsparcia mogą pomóc pacjentom radzić sobie z emocjonalnymi aspektami choroby i jej leczenia.2948
Podsumowanie i rokowania
Leczenie raka podniebienia miękkiego wymaga kompleksowego podejścia, uwzględniającego chirurgię, radioterapię, chemioterapię oraz nowsze metody, takie jak terapie celowane i immunoterapia. Wybór strategii leczenia zależy od stadium zaawansowania nowotworu, jego lokalizacji, ogólnego stanu zdrowia pacjenta oraz potencjalnego wpływu leczenia na funkcje jamy ustnej.12
We wczesnych stadiach raka podniebienia miękkiego rokowania są zazwyczaj dobre, z wysokimi wskaźnikami wyleczenia przy zastosowaniu chirurgii lub radioterapii. Badania pokazują, że 75% do 100% pacjentów z wczesnym stadium raka podniebienia miękkiego żyło pięć lat po diagnozie.29
W przypadku zaawansowanego raka podniebienia miękkiego leczenie jest bardziej złożone i często wymaga połączenia różnych metod. Mimo to, przy odpowiednim leczeniu, 5-letni wskaźnik przeżycia związanego z nowotworem dla stadium IVA/B może przekraczać 50%.13
Kluczowe znaczenie dla powodzenia leczenia ma wczesne wykrycie nowotworu oraz kompleksowa opieka wielodyscyplinarna, obejmująca nie tylko leczenie samego nowotworu, ale również rehabilitację funkcjonalną i wsparcie psychologiczne.4950
Postępy w technikach chirurgicznych, radioterapii, nowych lekach i metodach rehabilitacji stale poprawiają wyniki leczenia i jakość życia pacjentów z rakiem podniebienia miękkiego.5135
Kolejne rozdziały
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Materiały źródłowe
- #1 Soft palate cancer – Diagnosis and treatment – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/soft-palate-cancer/diagnosis-treatment/drc-20445530
Treatment for soft palate cancer often includes surgery followed by radiation, chemotherapy or both. Your healthcare team considers many factors when creating a treatment plan. These might include the cancer’s location and how fast it’s growing. The team also may look at whether the cancer has spread to other parts of your body and the results of tests on the cancer cells. Your care team also considers your age and your overall health. […] During surgery for soft palate cancer, the surgeon removes the cancer and some of the healthy tissue around it. This ensures that all the cancer cells are removed. […] When soft palate cancer spreads, it often goes to the lymph nodes in the neck first. If there are signs that the cancer has spread to the lymph nodes, you might need surgery to remove some lymph nodes, called a neck dissection. Even if there are no signs of cancer in the lymph nodes, you may have some of them removed as a precaution. Removing the lymph nodes removes the cancer and helps your healthcare team decide if you need other treatments.
- #2 Soft palate cancer | Altru Health Systemhttps://www.altru.org/health-library/conditions/soft-palate-cancer
Soft palate cancer is considered a type of throat cancer. It is treated similarly to the way other types of throat cancers are treated. This may include a combination of surgery, radiation therapy and chemotherapy. […] Treatment for soft palate cancer often includes surgery followed by radiation, chemotherapy or both. Your healthcare team considers many factors when creating a treatment plan. These might include the cancer’s location and how fast it’s growing. The team also may look at whether the cancer has spread to other parts of your body and the results of tests on the cancer cells. Your care team also considers your age and your overall health. […] During surgery for soft palate cancer, the surgeon removes the cancer and some of the healthy tissue around it. This ensures that all the cancer cells are removed.
- #3 Soft palate cancer: Symptoms, treatment, and morehttps://www.medicalnewstoday.com/articles/soft-palate-cancer
Treatment options for soft palate cancer depend on several factors, such as: […] Many doctors recommend a wide local excision to treat soft palate cancer. The procedure involves surgically removing the palate. […] If the cancer is aggressive or has spread, a surgeon may also remove lymph nodes or tissues in the neck. […] After this type of surgery, the surgical team may perform a reconstructive procedure. This may help restore as much speech and swallowing function as possible and preserve appearance. […] Doctors use chemotherapy, radiation therapy, or a combination of the two, known as chemoradiation, to treat some cases of soft palate cancer. […] A doctor may recommend radiation, chemotherapy, or chemoradiation after surgery, particularly for people with aggressive cancer or cancer that has spread.
- #4 Treatment – Oral Cancer Foundation | Information and Resources about Oral Head and Neck Cancerhttps://oralcancerfoundation.org/cdc/treatment/
Small, well-defined lesions of the soft palate may be excised, but because these lesions are multifocal, recurrence of soft palate tissues at the margin will likely occur unless patients are carefully selected. Radiotherapy is commonly used because it leaves the patient functionally intact with no need for a prosthesis or elaborate reconstruction. […] The basic radiotherapy technique for soft palate cancer involves parallel-opposed portals to the primary site and neck. If the lesion is located very much to one side of the mouth, it can sometimes be treated with a single ipsilateral portal arrangement or other field arrangements using 3-D treatment planning, so that contralateral salivary tissue is spared. Often the initial 15-20 Gy is administered via an intraoral cone as a reverse boost to limit the volume of tissues receiving high-dose radiotherapy.
- #5 Oral Cavity (Mouth) Cancer Treatment Options, by Stage | American Cancer Societyhttps://www.cancer.org/cancer/types/oral-cavity-and-oropharyngeal-cancer/treating/by-stage.html
Surgery is usually done first and includes taking out some of the neck lymph nodes (lymph node dissection). Surgery is most often followed by radiation alone or chemoradiation. […] People with stage IVB cancers that cannot be removed by surgery or who are too weak for surgery might be treated with radiation alone. Depending on a person’s overall health, chemoradiation or chemotherapy first followed by radiation might be options. Chemotherapy alone may also be recommended. […] When cancer comes back after treatment, it’s called recurrent cancer. Treatment options for recurrent cancers depend on the location and size of the cancer, what treatments have already been used, and the person’s general health. […] If the cancer comes back in the same area and radiation therapy was used as the first treatment, surgery is often the next treatment, if the cancer can be removed completely and the patient is healthy enough for surgery.
- #5 Oral Cavity (Mouth) Cancer Treatment Options, by Stage | American Cancer Societyhttps://www.cancer.org/cancer/types/oral-cavity-and-oropharyngeal-cancer/treating/by-stage.html
Treatment for oral cavity cancer is based largely on the stage (extent) of the cancer, but other factors can also be important. […] Most experts agree that treatment in a clinical trial should be considered for any cancer in the head and neck area. This way, people might have the chance of getting new treatments that may be better than standard ones. […] The usual treatment is surgery (usually Mohs surgery, surgical stripping, or thin resection) to remove the top layers of tissue along with a small margin (edge) of normal tissue. Follow-up is important to watch for any signs that the cancer has come back. Carcinoma in situ that keeps coming back after surgery may also need to be treated with radiation therapy. […] Most patients with stage I or II oral cavity cancers do well when treated with surgery and/or radiation therapy. Chemotherapy (chemo) given along with radiation (called chemoradiation) is another option.
- #6 Soft Palate Cancer: Symptoms, Causes & Treatmenthttps://my.clevelandclinic.org/health/diseases/24791-soft-palate-cancer
Soft palate cancer is often found before it can spread, making it easier to treat with surgery to remove the tumor. […] Providers use several types of treatment depending on the cancer stage: Surgery: Providers remove the tumor with surgery, including a minimally invasive surgery called transoral robotic surgery (TORS). […] Radiation therapy may be first-line or initial treatment for larger tumors that have spread into nearby tissues and/or lymph nodes. […] Providers may use chemotherapy as an initial treatment for soft palate cancer that has spread to other areas of your body. […] As it sounds, chemoradiation combines chemotherapy and radiation therapy. This treatment is for soft palate cancer that’s spread to your lymph nodes but not to other areas of your body. […] You may need additional surgery. You may need a prosthetic device (soft palate obturator) that replaces your soft palate.
- #7 Palate Cancer | Cedars-Sinaihttps://www.cedars-sinai.org/health-library/diseases-and-conditions/p/palate-cancer.html
Laser microsurgery is used for small and medium-sized tumors in the soft palate. […] Transoral laser microsurgery can preserve normal tissues, causes less pain, and can help maintain speech and swallowing. […] Surgery is the preferred treatment for cancer of the hard palate. […] Cancer of the palate can be treated with surgery, radiation and chemotherapy.
- #8 Palate Resection ⣠Cancer Treatment ⣠THANC Guidehttps://thancguide.org/cancer-basics/treatments/surgery/ablative/palate-resection/
A soft palate resection involves the removal of part or all of the soft palate, the non-bony portion of the palate just behind the hard palate. Depending on the size and location of the tumor, this surgery can be performed through a transoral or open approach, or via transoral robotic-assisted surgery (TORS). Additionally, a neck dissection will likely be performed with a soft palate resection to remove cervical lymph nodes. […] A palate resection is the removal of all or part of the palate (the roof of the mouth). This type of surgery is generally required when cancer approaches or invades the hard palate (the bony portion of the palate) or soft palate (the area located behind the hard palate).
- #9 Soft palate cancer – Diagnosis and treatment – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/soft-palate-cancer/diagnosis-treatment/drc-20445530
Radiation therapy uses powerful energy beams to kill cancer cells. The energy can come from X-rays, protons or other sources. During radiation therapy, a machine directs beams of energy to specific points on the body to kill the cancer cells. […] Chemotherapy uses strong medicines to kill cancer cells. Chemotherapy may be used after surgery to kill any remaining cells. Sometimes chemotherapy is done at the same time as radiation therapy because it makes the radiation work better. […] Targeted therapy uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die. Targeted therapy is used to treat soft palate cancer that spreads to other parts of the body or comes back after treatment. […] Immunotherapy is a treatment with medicine that helps your body’s immune system kill cancer cells. Your immune system fights off diseases by attacking germs and other cells that shouldn’t be in your body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the immune system cells find and kill the cancer cells. Immunotherapy might be used when the cancer spreads to other parts of the body and other treatments haven’t helped. […] Treatment for advanced soft palate cancer can impact your ability to speak and eat. Working with a skilled rehabilitation team can help you cope with changes that result from cancer treatment.
- #10 Soft palate cancer | Altru Health Systemhttps://www.altru.org/health-library/conditions/soft-palate-cancer
Radiation therapy uses powerful energy beams to kill cancer cells. The energy can come from X-rays, protons or other sources. During radiation therapy, a machine directs beams of energy to specific points on the body to kill the cancer cells. […] Chemotherapy uses strong medicines to kill cancer cells. Chemotherapy may be used after surgery to kill any remaining cells. Sometimes chemotherapy is done at the same time as radiation therapy because it makes the radiation work better. […] Targeted therapy uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die. Targeted therapy is used to treat soft palate cancer that spreads to other parts of the body or comes back after treatment. […] Immunotherapy is a treatment with medicine that helps your body’s immune system kill cancer cells. Your immune system fights off diseases by attacking germs and other cells that shouldn’t be in your body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the immune system cells find and kill the cancer cells. Immunotherapy might be used when the cancer spreads to other parts of the body and other treatments haven’t helped. […] Treatment for advanced soft palate cancer can impact your ability to speak and eat. Working with a skilled rehabilitation team can help you cope with changes that result from cancer treatment.
- #11 Radiation Therapy for Oral Cavity and Oropharyngeal Cancer | American Cancer Societyhttps://www.cancer.org/cancer/types/oral-cavity-and-oropharyngeal-cancer/treating/radiation-therapy.html
Radiation therapy uses high-energy x-rays or particles to destroy cancer cells or slow their growth. Depending on the stage of the oral cavity or oropharyngeal cancer and other factors, radiation therapy might be used: […] Alone as the main treatment for small cancers or for people who can’t have surgery. […] After surgery (adjuvant therapy), either alone or with chemotherapy (chemoradiation), to try to kill any cancer cells that might have been left behind because they were too small to be seen with the naked eye during surgery. […] Before surgery (neoadjuvant therapy) with chemotherapy (chemoradiation) or after chemotherapy to try to shrink some larger cancers. […] With a targeted drug for larger cancers, if chemotherapy is not an option. […] To help ease symptoms of advanced cancer, such as pain, bleeding, trouble swallowing, and problems caused by cancer spread to lungs or bones.
- #12 Malignant Tumors of the Palate Treatment & Management: Preoperative Details, Intraoperative Details, Follow-uphttps://emedicine.medscape.com/article/847807-treatment
Specific treatment of palate cancer depends on the location of the tumor (hard vs soft palate), stage of the tumor (see Staging), and pathologic type of the cancer. For this reason, management of SCC and carcinomas of minor salivary gland origin are discussed separately. […] Because of difficulties in adequate reconstruction, radiation therapy has been the recommended treatment for soft palate cancers in the past. Although advances in reconstructive techniques and prosthetic reconstruction have allowed for more effective surgical resection and rehabilitation for patients with soft palate cancers, radiation therapy remains the primary treatment modality in many centers for T1, T2, and T3 lesions, with results comparable with those of surgery. […] Using radiotherapy as the primary treatment, control of the primary lesion is achieved in 80-90% of T1 lesions, 60-70% of T2 lesions, and 55-65% of T3 lesions. This rate drops to less than 50% for T4 lesions. Effective treatment for the primary lesion requires a dose of approximately 70 Gy.
- #13 Radiation treatment of soft palate squamous cell carcinoma – PubMedhttps://pubmed.ncbi.nlm.nih.gov/31773865/
To report our institution’s experience treating soft palate squamous cell carcinoma with radiotherapy alone or combined with adjuvant chemotherapy and/or neck dissection for residual disease. […] The likelihood of cure after definitive radiotherapy is relatively high in patients with stage I-III disease with soft palate carcinoma. Patients with stage IVA/B disease have a lower cure rate but with a 5-year CSS exceeding 50%.
- #14 Palate Cancer | Cedars-Sinaihttps://www.cedars-sinai.org/health-library/diseases-and-conditions/p/palate-cancer.html
Radiation therapy, including intensity modulated radiation therapy, stops cancer cells from dividing and slows the growth of the tumor. Radiotherapy also destroys cancer cells and can shrink or eliminate tumors. Intensity modulated radiation therapy allows the use of more effective radiation doses with fewer side effects than conventional radiotherapy techniques. […] Chemotherapy is prescribed for different reasons: Together with radiotherapy as an alternative to surgery (called chemoradiation), After surgery to decrease the risk of the cancer returning, To slow the growth of a tumor and control symptoms when the cancer cannot be cured (palliative treatment). […] This is a combination of radiation therapy and chemotherapy. […] Radiation therapy used alone or with chemotherapy is the primary treatment for moderate or advanced cancers in order to preserve the soft palate and its function.
- #15 Mouth Cancer Treatment – San Diego – Scripps Healthhttps://www.scripps.org/services/cancer-care/mouth-cancer-treatment
Depending on the cancer type, location and stage, Scripps surgeons may perform several types of surgical treatments for mouth cancer. […] Whenever possible, Scripps surgeons use minimally invasive robotic surgical techniques, which can mean smaller incisions, faster recovery time and less bleeding and scarring. […] Radiation therapy may be the main treatment for small tumors, or part of a mouth cancer treatment plan that also includes surgery and other therapies. Scripps provides the most advanced radiation treatments for mouth cancer, including: Intensity-modulated radiation therapy (IMRT) is an advanced form of radiation therapy. […] Chemotherapy may be used in combination with radiation therapy for advanced-stage lip and oral cavity cancers that cannot be treated by surgery. It also may be given before surgery to shrink large tumors, or after surgery to eliminate any remaining cancer cells. […] Targeted therapy uses specific drugs to target receptors on the surface of cancer cells and slow or stop their growth. The drug certuximab, which is a monoclonal antibody, can be effective in treating oral cancer cells. Certuximab may be combined with radiation or chemotherapy, or used alone.
- #16 Mouth cancer – Diagnosis and treatment – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/mouth-cancer/diagnosis-treatment/drc-20351002
Radiation therapy treats cancer with powerful energy beams. The energy can come from X-rays, protons or other sources. Radiation therapy for mouth cancer is most often delivered by a machine that moves around the body. The machine aims radiation to precise points. This kind of radiation therapy is called external beam radiation. […] Sometimes radiation therapy for mouth cancer involves placing radioactive material inside the body. This kind of radiation therapy is called brachytherapy. […] Chemotherapy treats cancer with strong medicines. Chemotherapy is often used after surgery to kill any cancer cells that remain. Chemotherapy may increase the effectiveness of radiation therapy, so the two treatments are often combined. If the cancer spreads to other parts of the body, chemotherapy can help control it.
- #17 Treatment – Oral Cancer Foundation | Information and Resources about Oral Head and Neck Cancerhttps://oralcancerfoundation.org/cdc/treatment/
Local control with radiotherapy is achieved in approximately 85% of T1, 75% of T2, 60% of T3, and 20% of T4 tumors. Five-year survival rates of about 80% are achieved for stage I-II cancers; stage III-IV patients have 5-year survival rates of about 30-40%. […] Chemotherapy has been used in attempts to improve survival or to reduce the incidence of distant metastases, to serve as an adjunct to radiotherapy for organ preservation, and to select patients for subsequent therapy based on their response to chemotherapy. However, how much chemotherapy actually contributes to achieving these goals remains controversial. […] Chemotherapy has been applied as induction (so-called neoadjuvant therapy), concurrently with radiotherapy and as post-treatment adjuvant therapy. Neoadjuvant therapy has been widely studied in recent years; a number of drug regimens have been used. The combination of cisplatin and fluorouracil (5-FU) has achieved considerable popularity because of high rates of response with acceptable rates of toxicity. In previously untreated patients, response rates of 60-90% have been reportedâwith a complete clinical response in 20-40% of patients.
- #18 Treatment – Oral Cancer Foundation | Information and Resources about Oral Head and Neck Cancerhttps://oralcancerfoundation.org/cdc/treatment/
Concomitant chemotherapy and radiotherapy has been used to try to increase the rate of local-regional control, on the theory that these might be either an additive or synergistic interaction between the two treatments. Both single and multiagent chemotherapy have been used. Several randomized trials have shown an improvement in local-regional control and disease-free survival with concurrent single-agent chemotherapy and radiotherapy compared with radiotherapy alone. Unfortunately, the toxicity of concurrent multiagent chemotherapy and radiotherapy is significant.
- #19 Head and Neck Cancer Treatment Protocols: Treatment Protocolshttps://emedicine.medscape.com/article/2006216-overview
Surgery is the preferred approach except for some patients who may have early-stage lip, retromolar trigone, and soft palate cancers. […] Radiation therapy is preferred for patients who may not be able to tolerate surgery. […] The radiation dose depends on tumor size; however, for early-stage disease, doses of 66-72 Gy may be used with adequate results. […] Surgery should be considered for locally advanced disease; however, definitive radiation therapy, concurrent chemoradiation alone or after surgery, and induction therapy followed by concurrent chemoradation are alternative options for patients who are not candidates for surgery alone. […] Concurrent chemoradiation therapy is the current standard of care for patients with locally advanced squamous cell carcinoma of the head and neck.
- #20 Oral Cancer Treatment Options & Advanced Therapieshttps://www.cancercenter.com/cancer-types/oral-cancer/treatments
As with chemotherapy, radiation may be ordered before oral cancer surgery to help shrink larger cancers. […] Oral cancer patients are often treated with two primary types of radiation therapy: […] Brachytherapy (internal radiation): Delivers high or low doses of radiation from implants placed close to, or inside, the tumor(s) in the body. Brachytherapy may be an alternative to surgery for some oral cancer patients. […] Oral cancer that is detected at an early stage, before the cancer cells have spread to other areas of the body, is generally treated with surgery. Surgery also may be used to treat patients with advanced-stage oral cancer and recurrent cancers, often in combination with radiation therapy, chemotherapy or targeted therapy. […] One potential target in oral cancer is the epidermal growth factor receptor (EGFR). […] Your oncologist may recommend an EGFR-targeted drug in combination with chemotherapy or radiation therapy to treat oral cancer. […] Immunotherapy drugs harness the power of your immune system to find and destroy cancer cells.
- #21 Treatment of Oral Cancer |Treatments for oral cancer by doctorhttps://www.patientsengage.com/conditions/oral-cancer/treatments
Chemotherapy – Combinations of various drugs are used to slow down the cancer cell progress and kill the cancer cells. They damage DNA of cancer cells and kill them. Chemotherapy drugs are given orally and intravenously. Sometimes it is indicated before surgery to shrink tumour and ease surgical resection. It can be used as the primary treatment modality for advanced or unresectable oral cancers, either alone or in combination with radiation therapy (chemo radiotherapy). […] Targeted therapy – These are aimed at the altered cells due to cancer. It is used in cases where cancer has genetic mutations or resistant to other treatment. The molecules involved in cancer growth and progression are specifically targeted in this therapy. Commonly used drugs are cetuximab or pembrolizumab. […] Immunotherapy These are used alone or in combination with other treatments for advanced or recurrent oral cancer. It boosts the body’s immune system to recognize cancer cells, control the progression and kill them. Nivolumab and pembrolizumab are commonly used for oral cancer.
- #22 Soft palate cancer: Symptoms, treatment, and morehttps://www.medicalnewstoday.com/articles/soft-palate-cancer
If soft palate cancer spreads to other areas, a doctor may recommend chemotherapy or immunotherapy. […] Immunotherapy involves a qualified healthcare professional administering drugs called PD-1 inhibitors. They encourage the immune system to target cancer cells, which can trick the immune system into avoiding or even protecting them. […] Sometimes, doctors recommend immunotherapy and chemotherapy for cancer that has reached other parts of the body.
- #23 Soft palate cancer – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutubehttps://www.augustahealth.com/disease/soft-palate-cancer/
Chemotherapy. Chemotherapy uses drugs to destroy cancer cells. Chemotherapy may be combined with radiation therapy. […] Reconstructive surgery. Depending on where the cancer is located and how far it has spread, reconstructive surgery may be necessary. […] Rehabilitative services. Rehabilitation specialists in speech therapy, swallowing therapy, dietetics, physical therapy and occupational therapy help with rehabilitation that may be necessary after surgery or radiation therapy. […] Palliative care. Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care.
- #24 Reconstructive Surgery for Oral Cancer | NYU Langone Healthhttps://nyulangone.org/conditions/oral-cancer/treatments/reconstructive-surgery-for-oral-cancer
NYU Langone surgeons often perform reconstructive surgery to restore the soft tissue, bone, and teeth that may need to be removed during surgery for oral cancer. Reconstruction is done at the same time the cancer is removed. […] Reconstruction may involve transferring tissue or bone from another area of the body to the oral cavity. Doctors may transfer this tissue using microvascular surgery, in which they cut and sew together small blood vessels under a microscope. This helps restore blood flow to the tissue in the area of repair. […] Microvascular reconstructive surgery is often used to rebuild structures that help with the mouths functions, such as chewing and swallowing food and speaking. Dental implants may also be necessary, if teeth are removed. […] Surgeons may use a variety of approaches to reconstruct soft tissue, including skin grafts, local or free flaps, or nerve grafts.
- #25 Reconstructive Surgery for Oral Cancer | NYU Langone Healthhttps://nyulangone.org/conditions/oral-cancer/treatments/reconstructive-surgery-for-oral-cancer
Reconstructive surgeons can repair soft tissue in parts of the tongue, the lining of the mouth, and the lips using a portion of skin called a graft. Grafts may be taken from the abdomen or leg and used to repair small portions of the mucosa, which is the lining of the mouth. […] Sometimes, larger areas of soft tissue that are removed from the oral cavity can be replaced with a portion of healthy tissue called a flap. This tissue may consist of skin, muscle, and fat. […] Flaps can often be moved from nearby areas, such as the scalp, cheek, forehead, neck, or chest, without disconnecting the blood vessels that feed the flap. […] Surgeons at NYU Langone are experts in reconstructing the upper and lower jawbones. Before surgery, specialists use CT scans of the tumor and jaw to create three-dimensional, computer-generated models of the areas to be reconstructed.
- #26 Treatment of Oral Cancer |Treatments for oral cancer by doctorhttps://www.patientsengage.com/conditions/oral-cancer/treatments
Treatment of oral cancer involves surgery, radiotherapy, chemotherapy, targeted therapy or immunotherapy. Treatment plan is decided based on severity, stage of the cancer and patients condition. Doctors may recommend some of the following: […] Surgical treatment is planned based on size, stage of cancer and patients condition. […] Tumor excision – It is done to remove the tumour and surrounding healthy tissue margins to ensure complete destruction of cancer cells. Excision depends on the size and location of the tumour. […] Neck dissection and removal of lymph nodes are done if it has spread into lymph nodes. This will prevent further spread of the cancer. Types of neck dissection include selective, modified radical, or radical neck dissection. […] Reconstruction surgery – It is performed to restore functions and aesthetic for improving quality of life of the patient. It involves flap reconstruction, skin grafting or the use of implants. If jaw bone is affected in advanced cancer, jaw is reconstructed with the help of bone grafting. In case of tongue involvement, reconstructive surgery is done to preserve speech and swallowing functions.
- #27 Reconstructive Surgery for Oral Cancer | NYU Langone Healthhttps://nyulangone.org/conditions/oral-cancer/treatments/reconstructive-surgery-for-oral-cancer
To rebuild the jaw, doctors may use a piece of the fibula, a bone from the lower leg. Other bones in the face can also be reconstructed. […] After the jawbone is restored, periodontal surgeons may use dental implants and prosthetic teeth to restore the mouths appearance and your ability to chew. […] Recovery time after reconstructive surgery varies. Minor reconstruction, such as when a skin graft is performed, may require only two or three days of recuperation in the hospital. If you need extensive reconstruction, such as the removal and replacement of the jaw or a large portion of soft tissue, you may need to stay in the hospital for up to a week or more. […] After surgery, NYU Langone therapists are available to help restore your speech and swallowing abilities.
- #28 Oral cancer – UF Healthhttps://ufhealth.org/conditions-and-treatments/oral-cancer
Surgery to remove the tumor is recommended if the tumor is small enough. […] If the tumor has spread to more tissue or nearby lymph nodes, a larger surgery is done. The amount of tissue and the number of lymph nodes that are removed depend on how far the cancer has spread. […] Surgery may be used together with radiation therapy and chemotherapy for larger tumors. […] Other treatments may include: Targeted therapy, which uses drugs to stop cancer from growing and spreading. […] Immunotherapy, which uses substances made by the body or in a lab to help the immune system work harder or in a more targeted way to fight cancer. […] Depending on what type of treatment you require, supportive treatments that may be needed include: Speech therapy. […] Therapy to help with chewing and swallowing. […] Learning to eat enough protein and calories to keep your weight up. Ask your provider about liquid food supplements that can help. […] Help with dry mouth.
- #29 Soft Palate Cancer: Symptoms, Causes & Treatmenthttps://my.clevelandclinic.org/health/diseases/24791-soft-palate-cancer
Some people have trouble adjusting to changes in their bodies after soft palate treatment. […] Surgery and radiation therapy to treat soft palate cancer may affect your ability to swallow and speak as you did before treatment. […] Healthcare providers may be able to cure many early-stage soft palate cancers with surgery to remove tumors or radiation therapy. […] Studies show that 75% to 100% of people with early-stage soft palate cancer were alive five years after diagnosis.
- #30 Mouth cancer – Diagnosis and treatment – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/mouth-cancer/diagnosis-treatment/drc-20351002
Surgery carries a risk of bleeding and infection. Surgery for mouth cancer may affect your appearance. It also may affect the ability to speak, eat and swallow. Physical therapy and other rehabilitation services can help you cope with these changes. […] Reconstructive surgery may be needed when parts of the face, jaw or neck are removed during surgery. Healthy bone or tissue may be taken from other parts of the body and used to fill gaps left by the cancer. This tissue can replace part of the lip, tongue, palate or jaw, face, throat, or skin. Dental implants also may be used to replace your natural teeth. […] When mouth cancer spreads, it often goes to the lymph nodes in the neck first. If there are signs that the cancer has spread to the lymph nodes, you might need surgery to remove some lymph nodes, called a neck dissection. Even if there are no signs of cancer in the lymph nodes, you may have some of them removed as a precaution. Removing the lymph nodes removes the cancer and helps your healthcare team decide if you need other treatments.
- #31 Treatment Options For Mouth And Oropharyngeal Cancer | Cancer Research UKhttps://www.cancerresearchuk.org/about-cancer/mouth-cancer/treatment/treatment-decisions
Surgery is a common treatment for mouth and early stage oropharyngeal cancer. It is sometimes the only treatment you need. You may have radiotherapy after your surgery. It aims to kill any remaining cancer cells after surgery and helps to stop your cancer from coming back. […] Radiotherapy uses high energy x-rays to destroy cancer cells. External beam radiotherapy directs radiotherapy treatment at the cancer from a machine. […] You might have chemotherapy if your cancer has come back or spread to other parts of the body (advanced cancer), such as the lungs, bones or liver. […] You might have chemotherapy together with radiotherapy. This is called chemoradiotherapy. […] Targeted cancer drugs work by targeting the differences in cancer cells that help them to grow and survive. Other drugs help the immune system to attack cancer. They are called immunotherapies. […] Your treatment depends on the stage of your cancer.
- #32 Head & Neck/Oral Cancers Treatment Options – NYC | Herbert Irving Comprehensive Cancer Center (HICCC) – New Yorkhttps://www.cancer.columbia.edu/cancer-types-care/types/head-and-neck-oral-cancers/treatments
You may have surgery, radiation, or chemotherapy to treat head, neck, and oral cancer. Your treatment will be tailored to you based on the type of cancer you have, its size, location, whether it has spread, and your overall health. […] If you have early-stage cancer with a tumor that is smaller than 2 cm and hasnt spread to nearby tissue or lymph nodes (stage I and II), youll probably have surgery or radiation therapy alone. […] If you have advanced-stage cancer (stage III, IVA and IVB), your care will be more complex. These stages include larger tumors and cancer cells that have spread to nearby tissue and lymph nodes. Our goal is to preserve your organ while destroying the cancer and managing symptoms. You will likely have a combination of surgery, radiation, and chemotherapy. […] If you have late-stage cancer that has spread to distant organs like your lungs (stage IVC), you might also receive experimental therapies to control the disease and prolong your life.
- #33 Malignant Tumors of the Palate Treatment & Management: Preoperative Details, Intraoperative Details, Follow-uphttps://emedicine.medscape.com/article/847807-treatment
An alternative is the use of chemotherapy combined with radiotherapy, followed by surgical resection. Cisplatin and 5-fluorouracil are the chemotherapeutic agents used. […] Combined external beam radiation followed by brachytherapy is an alternative to surgery for the management of advanced lesions, reserving surgery for salvage. […] For small tumors treated primarily with radiotherapy, N0 and N1 necks can be controlled adequately with radiotherapy alone. For N2 and greater neck metastasis, 74% of patients still have residual SCC following radiotherapy. Hence, treat N2 and greater regional metastasis with planned combined therapy, including neck dissection followed by radiotherapy.
- #34 Oral Cavity (Mouth) Cancer Treatment Options, by Stage | American Cancer Societyhttps://www.cancer.org/cancer/types/oral-cavity-and-oropharyngeal-cancer/treating/by-stage.html
If the cancer comes back in the lymph nodes in the neck, the nodes are often removed with surgery (lymph node dissection). This may be followed by radiation or chemoradiation. […] If the cancer comes back in a distant area, chemo (and/or cetuximab) is often used. Immunotherapy with or without chemo might be an option as well.
- #35 Oropharyngeal Cancer > Fact Sheets > Yale Medicinehttps://www.yalemedicine.org/conditions/oropharyngeal-cancer
Targeted therapy uses drugs to kill rapidly producing cancer cells without harming normal cells. […] Immunotherapy activates the immune system to specifically kill cancer cells. […] For some patients with oropharynx cancer, Dr. Burtness says, the expectation of cure is very high, above 90%. […] Our team has the expertise to accurately identify patients who are at a high risk of recurrence. In many cases, we may be able to offer a clinical trial that includes immunotherapy or genome profiling as part of the care plan, explains Dr. Burtness.
- #36 Radiation Therapy for Oral Cavity and Oropharyngeal Cancer | American Cancer Societyhttps://www.cancer.org/cancer/types/oral-cavity-and-oropharyngeal-cancer/treating/radiation-therapy.html
To treat cancer that has come back after treatment (recurrence). […] Chemoradiation (radiation given at the same time as chemotherapy) often works better than radiation alone, but it also has more side effects. […] External beam radiation therapy (EBRT) is the type of radiation therapy most often used to treat oral cavity or oropharyngeal cancer or its spread to other organs. […] Brachytherapy is rarely used to treat oral cavity or oropharyngeal cancers as a first treatment, but it might be used if the cancer recurs (comes back). […] If you are going to get radiation therapy, it’s important to ask your doctor about the possible side effects so you know what to expect. […] Hyperfractionation radiation is a slightly lower radiation dose given more than once a day (for example, twice a day for 7 weeks).
- #37 Radiation Therapy for Oral Cavity and Oropharyngeal Cancer | American Cancer Societyhttps://www.cancer.org/cancer/types/oral-cavity-and-oropharyngeal-cancer/treating/radiation-therapy.html
Accelerated fractionation radiation is the standard dose of radiation given each day but over a shorter time (5 to 6 weeks) instead of the usual 7 weeks. […] Hypofractionation radiation is a slightly higher radiation dose given each day to lessen the number of treatments. […] The drawback is that treatments given on these schedules also tend to have more severe side effects.
- #38 Oral (Mouth) Cancer Treatment: Surgery, Radiation & Chemotherapyhttps://resources.healthgrades.com/right-care/cancer/treatment-options-for-oral-mouth-cancer
As many as 54,000 Americans will be diagnosed this year with oral cancer. If you are one of them, you will likely have at least one of these three treatments: surgery, chemotherapy or radiation. You may also have combinations of these treatments, as well as reconstructive surgery. Newer, experimental treatments such as immunotherapy are also offering new options for oral cancer patients. […] Surgery is the most common oral cancer treatment, though this will depend on the size, stage and location of your tumors. […] Sometimes doctors use radiation to treat mouth cancer without surgery. This can be done with certain small tumors, where surgery isnât necessary, or in cases where a patient canât have surgery. Radiation also is commonly used after surgery to ensure any remaining cancer cells are destroyed.
- #39 Hard palate cancer: Signs, treatment, outlook, and morehttps://www.medicalnewstoday.com/articles/hard-palate-cancer
Treatment typically involves surgery and radiation therapy. […] There are two main treatment options for hard palate cancers: surgery and radiation therapy. […] The goal of surgery is to remove as many tumors from the hard palate as possible. Surgery may damage parts of the mouth, so people may need additional operations, such as reconstructive surgery, to restore the appearance and function of their oral cavity. […] Radiation therapy uses radiation to kill cancer cells or slow their growth. Doctors may recommend this before surgery to help shrink any growths. They may also recommend radiation therapy after surgery to kill any remaining cancer cells. […] Scientists are currently running trials for other hard palate cancer treatments, such as chemotherapy, hyper-fractionated radiation therapy (radiation therapy in smaller doses), and hyperthermia therapy, which involves heating cancer cells to kill them or make them more sensitive to other treatments. […] Healthcare professionals typically recommend surgery and radiation therapy to treat hard palate cancers. While it is an aggressive form of the disease, the outlook for many hard palate cancers is positive. Treatment may involve surgery and radiation therapy.
- #40 Immunotherapy for Head and Neck Cancer | CRIhttps://www.cancerresearch.org/cancer-types/head-and-neck-cancer
Immunotherapy for head and neck cancer provides exciting new treatment options for patients, especially those with HPV-related cancers, and without the potentially devastating side effects of conventional treatments. […] Though head and neck cancer is generally considered to be highly treatable and curable with surgery or radiation when detected in early stage, other options are needed for patients. […] Treatment for head and neck cancer depends on individual factors, including the exact location of the tumor, stage of the tumor, and a personâs general health. These conventional treatments for head and neck cancer (surgery, radiation, and chemotherapy) may be used alone or in combination, depending on stage and location. […] Head and neck cancer is highly curableâoften with single-modality therapy (surgery or radiation)âif detected early. More advanced head and neck cancers are generally treated with various combinations of surgery, radiation, and chemotherapy.
- #41 Immunotherapy for Head and Neck Cancer | CRIhttps://www.cancerresearch.org/cancer-types/head-and-neck-cancer
Immunotherapy is class of treatments that take advantage of a personâs own immune system to help kill cancer cells. There are currently four approved immunotherapy options for head and neck cancer. […] Head and neck cancer patients with advanced disease should consider participating in a clinical trial if eligible.
- #42 Oral Cancer | Fred Hutchinson Cancer Centerhttps://www.fredhutch.org/en/diseases/oral-cancer.html
While many cancers of the head and neck are curable, treatment depends on where the cancer is, the severity of the disease, and the patient’s age and overall health. The primary method of treatment is surgery (removing the cancer cells). Radiation (using high-dose X-rays to kill cancer cells) and chemotherapy (using high-dose anti-cancer medication) are also used. […] Fred Hutch was formed, in part, to bring promising new treatments to patients faster. For the cancer patient, this means more treatment options at Fred Hutch than might be found elsewhere, including participation in one of the many clinical research studies conducted at Fred Hutch and UW Medicine. […] Many patients at Fred Hutch receive promising therapies by taking part in clinical trials. These research studies are done by physician-scientists from Fred Hutch and UW Medicine. They test new treatments or new ways to use current treatments.
- #43 Mouth cancer | NHS informhttps://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/mouth-cancer/
Cetuximab is a new type of medication, known as a biologic, used to treat advanced cases of mouth cancer. It is usually used in combination with radiotherapy or chemotherapy. Cetuximab targets proteins on the surface of cancer cells, known as epidermal growth factor receptors. These receptors help the cancer to grow, so by targeting these proteins, cetuximab prevents the cancer from spreading. […] Complications of treatment for mouth cancer can include dysphagia (difficulty swallowing), speech problems and emotional disruption. Dysphagia is the medical term for difficulty swallowing. Its easy to take your ability to swallow food and liquid for granted, but in reality, the process relies on a complex interaction of muscles, which can be easily disrupted. […] Radiotherapy and surgery can affect your tongue, mouth or throat, resulting in dysphagia. Dysphagia is a potentially serious problem because, aside from the risk of malnutrition, there is a chance that small particles of food could enter your airways and become lodged in your lungs. This can trigger a chest infection, known as aspiration pneumonia.
- #44 Mouth cancer | NHS informhttps://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/mouth-cancer/
Much like swallowing, your ability to speak clearly is governed by a complex interaction of muscles, bones and tissue, including your tongue, teeth, lips and soft palate (a section of tissue found at the back of the mouth). Radiotherapy and surgery can affect this process and make it difficult to pronounce certain sounds. In severe cases, you may have problems making yourself understood.
- #45 Treatment of Oral Cancer |Treatments for oral cancer by doctorhttps://www.patientsengage.com/conditions/oral-cancer/treatments
Microvascular surgeries are performed to transplant tissue from another part of the body to reconstruct the affected area. […] After surgery, medicine and liquid nutrition support is given through a tube inserted from nose to stomach. Semi solid food can be given to patient after sutures have healed. […] Nutritional support and physiotherapy, rehabilitation services including swallow and, speech therapy help patients to regain optimal function after surgery. […] Radiotherapy It plays an important role in cancer therapy as definitive treatment or an adjuvant therapy. It kills cancer cells and stops them from multiplying. It is given through high energy beams of radiation directed towards the cancerous tissue. Radiotherapy is given in multiple sessions over months to allow healthy tissue to recover. It is recommended after surgery in patients who have high chance of the cancer recurring.
- #46 6 Innovative Oral Cancer Treatment Options | MD Anderson Cancer Centerhttps://www.mdanderson.org/cancer-types/oral-cancer/oral-cancer-treatment.html
Different types of radiation therapy are used to treat oral cancer, including the following: […] Chemotherapy drugs kill cancer cells, control their growth or relieve disease-related symptoms. Chemotherapy may involve a single drug or a combination of two or more drugs, depending on the type of cancer and how fast it is growing. […] For oral cancer, targeted therapy is used to treat metastatic disease only. […] For oral cancer, immunotherapy is used to treat recurrent or metastatic disease only. […] MD Anderson has clinical trials for all stages of oral cancer. Your doctor may offer you a clinical trial as a treatment option. […] Treatments for oral cancer can worsen existing problems in the gums and teeth and make care after treatments much more complicated. MD Andersons oral cancer team includes dentists who specialize in caring for cancer patients. Prior to treatment, they evaluate patients and perform any procedures needed to ensure long-term health and function of the teeth and gums. If part of the jaw is removed during treatment, these dentists make custom prosthetics for the patient to help restore appearance and function.
- #47 Mouth (Oral) Cancer Treatment | Memorial Sloan Kettering Cancer Centerhttps://www.mskcc.org/cancer-care/types/mouth/mouth-cancer-treatment
Individualized treatment plans designed by our rehabilitation experts help you manage problems with speech, swallowing, and other side effects of mouth cancer and its treatment. […] Our dental oncologists and maxillofacial prosthodontists work closely with the other members of your care team to perform dental procedures and create prosthetics you may need during and after your care.
- #48 Treatment – Oral Cancer Foundation | Information and Resources about Oral Head and Neck Cancerhttps://oralcancerfoundation.org/treatment/
After a definitive diagnosis has been made and the cancer has been staged, treatment may begin. Treatment of oral cancers is ideally a multidisciplinary approach involving the efforts of surgeons, radiation oncologists, chemotherapy oncologists, dental practitioners, nutritionists, and rehabilitation and restorative specialists. The actual curative treatment modalities are usually surgery and radiation, with chemotherapy added to decrease the possibility of metastasis, to sensitize the malignant cells to radiation, or for those patients who have confirmed distant metastasis of the disease. […] Whether a patient has surgery, radiation and surgery, or radiation, surgery, and chemotherapy, is dependent on the stage of development of the cancer. Each case is individual. […] Patients with cancers treated in their early stages, may have little in the way of post treatment disfigurement. For those whose cancer is caught at a later stage, the results of surgical removal of the disease may require reconstruction of portions of their oral cavity or facial features. There may be adjunctive therapy required to assist in speech, chewing of foods, the problems associated with the lack of salivary function, as well as the fabrication of dental or facial prostheses.
- #49 Soft Palate Cancer- Causes, Symptoms and Treatment | Apollo Hospitalshttps://www.apollohospitals.com/diseases-and-conditions/soft-palate-cancer
To restore the normal functions of your mouth, such as swallowing, you may need rehabilitative services after surgery or radiation therapy. […] Most types of oral cancer, including soft palate cancer, are usually curable if detected early. […] People with soft palate cancer survive for five years or more. The earlier the stage at diagnosis, the higher the chances of survival after the treatment.
- #50 Soft Palate Cancer: 3 Promising Interventionshttps://worldofdentistry.org/soft-palate-cancer/
Doctors and medical professionals have ways to help cure soft palate cancer, especially when it is found in the early stages. They can use surgery to remove small tumors or radiation therapy to treat the cancer. Early-stage cancer means that the tumors are still small and haven’t spread. Even some cancers that are found in later stages can also be cured with the right treatments.
- #51 Soft Palate Cancer: Causes, Symptoms, and Treatmenthttps://www.healthline.com/health/cancer/soft-palate-cancer
Soft palate cancer is a type of throat cancer that affects your soft palate, which is the muscular area at the roof of your mouth toward your throat. […] Treatment for soft palate cancer involves surgery to remove the cancerous cells, chemotherapy, and radiation. […] Treatment for soft palate cancer usually involves surgery to remove the tumor and some healthy tissue around it. Doctors often follow surgery with chemotherapy and radiation therapy. […] Surgery for soft palate cancer provides better outcomes compared with nonsurgical treatment options, but it can cause complications. This includes difficulties with talking, chewing, and swallowing. You may need additional reconstructive surgery to help treat these complications. […] Your outlook with soft palate cancer depends on how early healthcare professionals detect the cancer. Soft palate cancer is highly treatable when diagnosed early. […] Soft palate cancer is a type of throat cancer that causes a tumor to form on the roof of the back of your mouth. Treatment typically involves surgery, chemotherapy, and radiation.