The treatment plan that your mouth cancer doctor chooses for you will depend on three major factors:
Where your mouth cancer is located, the stage it is in, and the type it is
Your overall health
Your preferences in terms of treatment plans
Now that medical technology had advanced tremendously from the early days when doctors were beginning to notice mouth cancer, you have several choices in terms of treatment plans. They are:
- Surgery
- Radiation therapy
- Chemotherapy
- Hyperthermia therapy
- Hormone therapy
- Targeted therapy
Surgery
If your tumour (s) are of a particular stage, type, and location, your doctor may choose to surgically remove them and a small area of surrounding healthy tissue to ensure that your tumours don’t grow back. Depending on the type, severity, and stage, doctors may have to remove the following as well:
- Sections of your tongue
- Parts of your jawbone
- Your lymph nodes
Your doctor will order reconstructive surgery if the initial surgery substantially and negatively affects your outer appearances, your ability to talk, and your ability to eat.
Radiation therapy
Many doctors prefer radiation therapy for mouth cancer because they respond well to the treatments. Radiation therapy kills the timorous cells, and they rarely grow back. If your doctor chooses this treatment plan, he or she will direct powerful and high-energy x-ray or radioactive particle beams at your tumours and wait for the tumours to be destroyed. These energy beams kill the cells by damaging their DNA. This keeps them from dividing into dysfunctional daughter cells.
There are two types of beams used in radiation therapy. They are:
- External beam radiation
- Brach therapy
External beam radiation
Your doctor will point a particular machine emitting radioactive particle beams at your tumours to destroy them.
Brach therapy
This is designed for tumours that have metastasized into other organs in your body – vital or not. Your doctor will zap the tumours with needles that are filled with radiation or radioactive light energy. The type of energy that is most commonly used is a high-energy called ionizing radiation. Doctors prefer this therapy for early-stage tongue cancer. However, as beautiful as this therapy is, it is no wonder therapy because it has specific side effects, which include:
- Decaying teeth
- Sores in your mouth
- Bleeding gums
- Stiff jaws
- Extreme tiredness
- Reactions to your skin. Skin burns are a good example.
However, it’s possible to receive radiation therapy and not experience any side effects. If you do experience side effects, you should know that they are determined by certain key factors, which include:
- The area of your body being subjected to radiation therapy
Your overall health - The type and dosage of radiation therapy, which you receive
You can experience two types of side effects:
- Short-term
- Long-term
Short-term side effects
- These include:
- Intense fatigue
- Hair loss
- Diarrhoea
- Changes in skin colour, composition, and consistency
- Nausea and vomiting
Another negative side effect, which can be both short and long-term, is depression and anxiety. Doctors have been advised to check all patients who undergo any type of mouth cancer treatment for this. It will adversely affect their mental and physical health, and it may prolong their treatment, not keep cancer in remission for as long, have the mouth cancer treatment not work as well as it should, and even kill them. Your doctor will ask you to visit a psychiatrist and a psychologist or counsellor if he or she thinks you have become extremely depressed/anxious because of your treatment.
Long-term side effects
You may or may not develop long-lasting side effects. It depends on the nature, type, stage of your mouth cancer, and the location at which it is being treated. Some of the more common (and sometimes severe) side effects include:
- Difficulty in breathing or lowered heart function/pumping ability if you receive radiation therapy in the chest
Thyroid problems can trigger severe hormonal issues. This specifically happens when you radiation therapy in your neck. - Lymphedema. Your lymph nodes fill up with fluid, and you experience a great deal of localized and general body pain.
- Hormonal changes
The bad news is that you are at a slightly higher risk of developing another type of cancer because of the high doses of radiation, which you receive. However, remember, that you may never experience any long-term side effects. It just depends on your health, body type, and type and stage of mouth cancer.
Please note that doctors still do not entirely understand how or why this therapy works so well – they just know that it works. While radiation therapy can be used as a standalone therapy, doctors commonly combine it with other types of powerful therapies, which include chemotherapy and surgery. If your doctor does include radiation therapy in your treatment plan, you will receive one of two types of radiation therapy:
- External beam radiation therapy
- Internal beam radiation therapy
External beam radiation therapy
If you get radiation therapy, you will probably get this type because it is the most popularly used type of radiation therapy. The examiner will ask you to lie down on a table. A machine that emits radiation beams is placed close to your affected areas. If your cancer is on the surface and is superficial, you will likely only need light-energy radiation beams. However, if your cancer has metastasized and is inside your body, high-energy rays may be necessary because they can kill these types of cancerous tumours.
Internal radiation therapy
You can receive many types of internal radiation therapy. They either the implant or inject radiation energy or radioactive materials inside of you. This energy will kill the cancerous tumours and keep them from growing back. The brachytherapy is a commonly used form of internal radiation therapy. You’ll have a device containing radioactive material inserted close to the affected area(s) in your body. This device may stay with you for the rest of your life, depending on the type, severity, extent, and stage of cancer. You may also be asked to drink or receive radioactive liquid injections. This poisonous liquid is designed only to target the cancerous cells/tumours and kill them.
You are asked to go for the treatment plan, which includes external beam and internal radiation therapy. It will depend on many factors, which include:
- The type of cancer you have
- The stage your cancer is in
- Tumour size
- Tumour location and the nature of surrounding tissues
- Your health and age
- Other treatments
What to expect?
Your doctor will thoroughly discuss your entire treatment plan with you, including the results and side effects with you before the treatment starts. You may be asked to undergo a CAT or MRI scan before beginning treatment to help your doctor understand the exact location, type, and nature of your tumours. He or she may mark your skin permanently with a small mark to ensure that the radiation beam targets the desired destinations.
Chemotherapy
If your doctor includes chemotherapy in your plan to treat mouth cancer, you will be taking several courses of powerful medicines. They are designed to kill your mouth cancer cells and keep them from spreading (keep your mouth cancer in remission.) Your doctor will refer to these medicines as cytotoxic or anti-cancer medicines. Since these medicines circulate throughout your bloodstream and target-specific mouth cancer cells and tumours, they are generally given through intravenous injection. Doctors refer to this type of therapy as systemic treatment because it is continuous and works in a predictable and systematic method throughout your entire body (system.)
Chemotherapy targets cells that are currently undergoing mitosis. You will receive chemotherapy at three distinct phases in the course of your treatment of mouth cancer:
- Before starting surgery or chemotherapy
- In combination with radiotherapy
- To mitigate the severity of symptoms
Before starting surgery or chemotherapy
This is a rare treatment plan, mainly because of the enormous risks involved. If you do receive chemotherapy before undergoing surgery, it will be to kill off cancer cells to shrink the size of your tumours to make them easier to operate on. You will be more likely to go into remission, stay in remission for longer, and experience higher survival rates. You will also be healthier. The medical community refers to it as neoadjuvant therapy. Though it is used in treating mouth cancer, the fact that it is a rare procedure means very little research exists regarding its short and long-term effectiveness and side effects. This is one reason why researchers are very keen on studying patients undergoing neoadjuvant therapy.
In combination with radiotherapy
If you receive chemotherapy while undergoing radiotherapy, you are officially undergoing chemoradiotherapy. Many doctors prefer this treatment plan because they find that radiation has higher success, remission, and survival rates when supported by chemotherapy. Though it is rarely prescribed for smallmouth tumours and lesions, it is commonly prescribed for cancer, which has metastasized into local tissues or your lymph nodes.
To mitigate the severity of symptoms
If you have advanced-stage cancer, your doctor may prescribe chemotherapy to help you feel better, improves the health and quality of life. It is also commonly used if you have experienced a recent relapse in your mouth cancer. Chemotherapy has been proven successful in mitigating the severity of mouth cancer symptoms and slowing or stopping the growth of tumours by shrinking them.
Types of chemotherapy
Many brands and classes of medicines, which are used in chemotherapy, are currently on the market. Some of these are:
- Cisplatin – this is effective in treating different types of mouth cancer
- Fluorouracil – its informal names are FU and 5FU. This is one of the most popular medicine in the chemotherapy arsenal to fight mouth cancer
- Carboplatin
- Bleomycin
- Methotrexate
- Docetaxel
How is chemotherapy administered?
If your doctor prescribes chemotherapy for you, he or she will ask you to appear at the clinic once every three weeks. You will be undergoing a different chemotherapy cycle every time you show up at the clinic. Depending on the type, stage, and severity of your cancer, you may be asked to undergo anywhere from 2-6 cycles of chemotherapy.
Since chemotherapy medicines work their magic in your bloodstream, a nurse will thread an IV tube through your veins and connect you to a particular machine, which contains the chemotherapy medicines in individual plastic bags. The pressure of the device will force the medicine into your bloodstream through the IV tube. If your cancer is severe or is in the advanced stages, you may need a central line, which will stay, in your vein for a few months. If this is the case, you will likely receive medicines through a constant IV drip, which is done in a hospital or clinic.
You generally have chemotherapy done in a hospital or clinical setting. Since chemotherapy is a complex process, the IV drip will proceed slowly. This means that you will be in the hospital or clinic for at least a few hours. If you need chemotherapy to be done daily over several weeks or months, your doctor will give you a portable machine, which you can take home to do the chemo.
What to know and do before starting chemotherapy?
Your doctor will order a litany of blood tests, and most likely, the complete blood test, to ensure that you are strong and healthy enough to undergo and survive the rigours of chemotherapy. Though not common, many people have died from numerous minor and severe strokes, which have been caused by chemotherapy. Since the information from the blood tests needs to be current, you will likely be undergoing much blood draws no earlier than 2-3 days before starting your planned course of chemotherapy.
Since each person’s nature of mouth cancer is different, each person responds to chemotherapy differently and needs a different plan and customized drugs. A pharmacist will make a unique cocktail of medicines, which are designed to best treat your mouth cancer with as few side effects as possible. The medications you will be given, and the type of chemotherapy you will undergo will depend entirely on your weight, height, and overall health, which the results of your complete blood test will indicate.
Side effects
Though chemotherapy works wonders for many people who have mouth cancer and can save their lives, it is no wonder therapy that works miracles!’ It has many side effects, some of which include:
- Constant feeling of severe illness
- Appetite loss
- Weight loss
- Constant and extreme fatigue
- Lowered immune system – they will be more likely to suffer from severe infections, and they will suffer from these infections much more often than the general population.
- Ease in bleeding and bruising
- Loss of hair
- Diarrhoea and constipation
Though many of these side effects are minor, some are severe and life-threatening. You should always inform your doctor if you experience any side effects while undergoing chemotherapy. Inform your doctor immediately if you feel incredibly lethargic and unwell after a cycle of chemotherapy, or if you have a temperature that is higher than 101 degrees Celsius. It could save your life since it could be a signal of a life-threatening infection or illness, which your body could be developing because of its lowered immunity.
The side effects you may experience will depend on many factors. Some of these are:
- The types of drugs used in your chemotherapy cocktail
- The number of medications you are given
- How the body and mind of the patient will respond to these medicines?
The good news is that most side effects are minor and temporary (they don’t last more than a week.) This is the reason why most people can tolerate and respond exceptionally well to most types of chemotherapy.
What to do after treatment?
You will be sent home after your cancer has gone into remission. However, this is when the hard work begins because it is very hard on your mind, body, and soul. You may experience severe anxiety and depression after many chemotherapy cycles. Contact your doctor immediately if this is the case so that they can refer you to a mental health counselor and psychiatrist for spiritual help. Doing so could save your life since constant depression can make your cancer worse, can make you very unhealthy, and can even take away your life.
Be wary of taking herbal and dietary supplements. The ingredients in these drugs can fatally interact with the chemotherapy medicines you are taking. Always consult with your doctor before taking any drugs not approved by general medicine and food regulatory agency.
Hyperthermia therapy
Doctors refer to this type of treatment as thermal therapy or thermotherapy because it uses extreme heat to kill mouth cancer cells and shrink tumours. The average temperature used in most instances of hyperthermia therapy is 113 degrees Fahrenheit. Your doctor will probably prefer this type of treatment for you, especially if your cancer is severe, is in the advanced stages, or if you are experiencing a relapse. This is because several years of solid research have produced substantial proven evidence that hyperthermia therapy is effective at permanently killing mouth cancer cells and making tumours disappear entirely. Your overall survival and remission prospects will be much higher and longer. You’ll also enjoy better overall health and quality of life.
Hyperthermia is useful because it kills cancer cells by destroying the proteins, which form their structures and provide them with nourishment. If your doctor prescribes hyperthermia for you, he or she will always prescribe another form of therapy in your treatment plan, whether it’s chemotherapy or surgery. This is because hyperthermia has been proven more potent in these situations.
There are many different types of hyperthermia. They are:
- Local hyperthermia – extreme heat is applied to a small local area like an isolated tumour. It uses a variety of techniques to zap the tumour through intense heat therapy. Depending on the size and nature of your tumours, you may receive microwave, radiofrequency, and ultrasound heat waves. This type of energy can be delivered using various kinds of local hypothermia.
- External hyperthermia – If you receive this type of hyperthermia, your doctor will place external applicators above your tumours to provide the heat energy, which will kill them
Intraluminal or endocavitary hyperthermia – It kills cancer cells and cysts found in the body cavities. These regions are generally neck or mouth. Your doctor will place probes in or near these areas to deliver heat directly to problem areas. - Interstitial hyperthermia – this approach treats tumours, which are located deep within your body. A good example would be in the insides of your neck. Your tumours will be heated to death using a machine that is capable of delivering extremely high temperatures of heat energy. You’ll either be given general or local anaesthesia because you’ll be receiving this heat energy through probes that are connected to the machine. Your doctor will use an ultrasound or other types of advanced imaging techniques to help them determine the exact location of the tumours. A popular type of interstitial hyperthermia is radiofrequency ablation. This uses high energy and intense radio waves to kill mouth cancer cells and tumours.
- Regional hyperthermia, which includes:
- Deep tissue hyperthermia
- Regional perfusion
- Continuous hyperthermic peritoneal infusion
- Whole-body hyperthermia
You can live after having being diagnosed with mouth cancer
While traumatic and life-changing, receiving a diagnosis of mouth cancer is no longer a death sentence or life destroyer, it was even 30 years ago. You can live a healthy life and possibly stay in remission for the rest of your life if you are diagnosed in time and receive the proper treatment!