Treatments for oral cancer

If you have oral cancer, your healthcare team will create a treatment plan just for you. It will be based on your health and specific information about the cancer. When deciding which treatments to offer for oral cancer, your healthcare team will consider:

  • the size of the cancer
  • the stage of the cancer
  • the location of the cancer
  • your overall health and ability to recover from surgery, radiation therapy or chemotherapy
  • how a treatment will affect appearance and function (such as your speech and ability to swallow and chew)
  • your personal preferences

Your healthcare team may include a number of healthcare professionals with special training in treating people with oral cancer, including:

  • head and neck surgeon (also called an otolaryngologist or ear, nose and throat (ENT) doctor) (specializes in surgery of the mouth, jaw, face and neck)
  • head and neck reconstructive surgeon (specializes in reconstruction around the head and neck and facial plastic surgery)
  • oral and maxillofacial surgeon (specializes in surgery of the mouth, jaw and face)
  • medical oncologist (specializes in treating cancer with drugs)
  • radiation oncologist (specializes in treating cancer with radiation therapy)
  • maxillofacial prosthodontist (specializes in replacing lost head and neck tissues and teeth with prosthetics)
  • dentist
  • speech therapist (speech-language pathologist)
  • registered dietitian
  • social worker

Oral cancer can make it difficult to eat, so you may not eat enough and you may lose weight. Before you start treatment, a dietitian may do a nutritional assessment to see how oral cancer has affected your nutrition. If you aren’t getting good enough nutrition, you may need to have a feeding tube placed before you start treatment. This is to make sure you get enough nutrition to maintain your weight and strength during treatment.

It is important to assess if and how oral cancer has affected your speech. You will often see a speech therapist when you are first diagnosed and throughout your treatment to help manage any speech problems you may have as a result of oral cancer or its treatment.

It is also important to have a complete dental exam as you may need dental work done before treatment can start.

If you are a smoker, your healthcare team will talk to you about how they can help you quit. Smoking can limit how well your cancer treatment works, so it is important to quit before you start treatment.

Oral cancer is usually treated with surgery first. Surgery may be followed with radiation therapy or sometimes radiation therapy and chemotherapy. Reconstruction may be needed to repair structures in the mouth and jaw or to help with speech and swallowing. Reconstruction is planned at the same time as treatment. It is important for the healthcare team involved in reconstruction to assess and talk to you about what your expectations are before any surgery or other treatments are done.

Expert review and references

  • American Society of Clinical Oncology. Oral and Oropharyngeal cancer. 2016: http://www.cancer.net/cancer-types/oral-and-oropharyngeal-cancer/view-all.
  • Cancer Care Ontario. Evidence-Based Series 5-3: The Management of Head and Neck Cancer in Ontario. 2009.
  • Cancer Research UK. The Mouth and Oropharynx. Cancer Research UK; 2016.
  • Koch WM, Stafford E, Chung C, Quon H . Cancer of the oral cavity. Harrison LB, Sessions RB, Kies MS. Head and Neck Cancer: A Multidisciplinary Approach. 4th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2014: 16A:335-356.
  • National Cancer Institute. Lip and Oral Cavity Cancer Treatment (PDQ®). 2016.
  • National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancers (Version 1.2015). 2015.

Treatments for stage 0 oral cancer

The following are treatment options for stage 0 (carcinoma in situ) oral cavity cancer. The types of treatments given are based on the unique needs of the person with cancer.

Treatments for early-stage oral cancer

The following are treatment options for early-stage oral cancer. The types of treatments given are based on the location of the cancer in the oral cavity and the unique needs of the person with cancer.

Treatments for locally advanced oral cancer

The following are treatment options for locally advanced oral cancer. The types of treatments given are based on the location of the tumour in the oral cavity and the unique needs of the person with cancer.

Treatments for metastatic oral cancer

The following are treatment options for stage IV oral cavity cancer. The types of treatments given are based on the location of the primary tumour in the oral cavity and the unique needs of the person with cancer.

Treatments for recurrent oral cancer

The following are treatment options for recurrent oral cavity cancer. The types of treatments given are based on where the cancer comes back (recurs), the treatment used to treat the original cancer and the extent of the recurrent cancer.

Surgery for oral cancer

Most people with oral cancer will have surgery. The type of surgery depends mainly on the size, stage and location of the tumour.

Radiation therapy for oral cancer

Radiation therapy uses high-energy rays or particles to destroy cancer cells. It is sometimes used to treat oral cancer.

Chemotherapy for oral cancer

Chemotherapy is sometimes used to treat oral cavity cancer.

Immunotherapy for oral cancer

Immunotherapy is sometimes used to treat oral cancer. Immunotherapy helps to strengthen or restore the immune system’s ability to fight cancer. Immunotherapy is sometimes called biological therapy.

Follow-up after treatment for oral cancer

Oral cavity cancer behaves differently in each person, and a standard follow-up schedule would not work for everyone. People with oral cavity cancer should talk to their doctor about a follow-up plan that suits their individual situation. Follow-up care is often shared among the cancer specialists and family doctor.