Treatment According to Stage of Disease

Since the size of the tumor and presence or absence of lymph node metastasis is strongly related to the difficulty of treating cancer, a strong correlation exists between the TNM classification of the disease and the outcome of the treatment program. To learn about TNM classifications, visit Staging.

Patients who have an early cancer of the oral cavity, such as T1 or T2, have a much better cure rate than patients who have T3 or T4. The presence of tumors in cervical lymph nodes reduces cure rates considerably. Knowing whether there is such nodal metastasis is important in determining treatment.

Treatment for T1 and T2 Tumors

Patients who have small tumors (T1 or T2) of the oral cavity are usually treated by surgery alone, depending on what needs to be removed along with the tumor. For instance, patients with a T1 cancer of the tongue would simply have the cancer and some surrounding 9/29/05re complex procedure, such as removing a tumor from a jawbone, might in some instances require reconstructive surgery as well.

Some patients have lymph nodes in the neck that are noticeably swollen. The swelling is evident by simply looking, by feeling the neck, or through imaging studies. These people usually undergo an operation called a neck dissection to remove the cancer. In this procedure, the surgeon removes the lymph nodes and surrounding structures as well as the tumor in the mouth.

Patients without swollen lymph nodes may undergo a so-called selective neck dissection, because approximately one-third of these patients have microscopic cancer already present in the lymph nodes.

Treatment for T3 and T4 Tumors

Patients with more advanced disease, including T3 and T4 tumors, or early T tumors with advanced neck disease, must be treated in a more aggressive way to remove the tumor. After surgery, these patients are often then treated with radiation and chemotherapy.

Possible long-lasting side effects of radiation treatment include:

• loss of sense of taste
• loss of saliva
• loss of ability to feel pain injury to the soft tissue and bone structures of the mouth