Without a doubt, cancer is a frightening disease. The most deadly aspect of cancer is its ability to spread or metastasize. For mouth cancer, it tends to spread to the lymph nodes of the neck first before it metastasizes to other areas. Based on where the tumour is and how serious, your doctor would advise the most effective treatment for you. However, since each situation is unique, always get a second opinion before you decide to start a particular treatment method. Now, let’s talk about the advanced metastatic mouth cancer treatments stage by stage.
The medical term for this stage is “carcinoma in situ.” It is the stage when the tumour is still on the surface layer and has not spread to the normal tissue nearby. This tumour has the possibility to grow unless treated as soon as possible. The most common treatment for tumours at this stage is surgery. Mohs surgery is usually the first choice because the cure rate is high and it removes a thin layer of a skin cancer. Usually, patients at this early stage of cancer may survive a long time without the need to undergo some more series of intensive treatments. Though it is very important to adopt a healthy lifestyle (no smoking please) so the cancer cells will not be active again in the future.
Stages I and II
The best treatment for patients with stage I or II mouth cancer is surgery, followed by radiation therapy. Some patients do not require radiation therapy though, as every situation is unique. Another option is by having chemotherapy together with radiation. It all comes down to the patient’s preferences. You must also consider the physical side effects of these treatments. For tumours on the lips, surgery is still the best option. Radiation might work too, at the first treatment, followed by surgery to remove the tumour later. Surgery is the first option for oral cavity type of cancer as well. If it looks like the cancer is still there after the surgery, a combination of radiation and chemo might be needed.
Stages III, IV, and IVA
At this stage, cancer has metastasized to the nearby tissue and a surgery combined with radiation is strongly advised. For cancers on the tongue, inner cheeks, and other types of oral cavity cancers, the first treatment would be surgery to remove cancer, including lymph node removal (partial). For cancer that starts in the oropharynx area, a combination of chemotherapy and radiation is needed. Further metastasis to the neck lymph node will require a lymph node dissection after the chemoradiation is completed.
Stages IVB and IVC
For this last stage, the advanced metastatic mouth cancer treatments are usually a mix of chemotherapy and cetuximab. Some patients may not require both of them. It all depends on the patient’s fitness to receive treatments, size of cancer, and a few other factors.
In the future, if the cancer comes back, then further and more intensive treatment will be needed. An internal radiation is mostly used to control the spreading of cancer if it is spotted at the same place like before. The latest treatment option called immunotherapy is advised when chemo stops working. The immunotherapy drugs will strengthen the body’s immune system to fight the cancer cells. Whatever treatment you choose, always consult with your doctor and get a second and third or even fourth opinion to understand your options better.
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