Staging
Treatment Options
Stage I Lip and Oral Cavity Cancer
Treatment of stage I lip and oral cavity cancer depends on where cancer is located.
Lip: If cancer is diagnosed on the lip, treatment may include the following:
  • Surgery (wide local excision).
  • Internal radiation with or without external radiation therapy.
Front of the tongue: If cancer detected on the front of the tongue, treatment may include the following:
  • Surgery (wide local excision).
  • Internal radiation therapy with or without external radiation.
  • Radiation therapy to lymph nodes in the neck.
Buccal mucosa: If cancer is in the buccal mucosa (the lining of the inside of the cheeks), treatment may include the following:
  • Surgery (wide local excision) for tumours smaller than 1 centimetre, with or without internal and/or external radiation.
  • Surgery (wide local excision with skin graft) or radiation for larger tumours.
Floor of the mouth: If cancer is diagnosed in the floor (bottom) of the mouth, treatment may include the following:
  • Surgery (wide local excision) for tumours smaller than ½ centimetre.
  • Surgery (wide local excision) or radiation therapy for larger tumours.
Lower gingiva: If cancer is in the lower gingiva (gums), treatment may include the following:
  • Surgery (wide local excision, which may include removing part of the jawbone and skin graft).
  • Radiation with or without surgery.
Upper gingiva or hard palate: If cancer is in the upper gingiva (gums) or the hard palate (the roof of the mouth), treatment is usually surgery (wide local excision) with or without radiatiotherapy.
Stage II Lip and Oral Cavity Cancer
Treatment of stage II lip and oral cavity cancer depends on where cancer is located in the lip and oral cavity.
Lip: If cancer is detected in the lip, treatment may include the following:
  • Surgery (wide local excision).
  • External radiation and/or internal radiation therapy.
Front of the tongue: If cancer is diagnosed in the anterior part (front) of the tongue, treatment may include the following:
  • Radiotherapy and/or surgery (wide local excision).
  • Internal radiation with surgery (neck dissection).
Buccal mucosa: If cancer is in the buccal mucosa (the lining of the inside of the cheeks), treatment may include the following:
  • Radiation for tumours that are 3 centimeters or smaller.
  • Surgery (wide local excision) and/or radiation or larger tumours.
Floor of the mouth: If cancer is diagnosed in the floor (bottom) of the mouth, treatment may include the following:
  • Surgery (wide local excision).
  • Radiation.
  • Surgery (wide local excision) followed by external radiation, with or without internal radiation for large tumours.
Lower gingiva: If cancer is detected in the lower gingiva (gums), treatment may include the following:
  • Surgery (wide local excision, which may include removing part of the jawbone and a skin graft).
  • Radiation alone or after surgery.
Retromolar trigone: If cancer is located in the retromolar trigone (the small area behind the wisdom teeth), treatment may include the following:
  • Surgery (wide local excision, which includes removing part of the jawbone).
  • Radiation with or without surgery.
Upper gingiva or hard palate: If cancer is diagnosed in the upper gingiva (gums) or the hard palate (the roof of the mouth), treatment may include the following:
  • Surgery (wide local excision) with or without radiation therapy.
  • Radiation alone.
Stage III Lip and Oral Cavity Cancer
Treatment of stage III lip and oral cavity cancer depends on where cancer is located in the lip and oral cavity.
Lip: If cancer is diagnosed in the lip, treatment may include the following:
  • Surgery and external radiation with or without internal radiation.
Front of the tongue: If cancer is in the front of the tongue, treatment may include the following:
  • External radiation with or without internal radiation.
  • Surgery (wide local excision) followed by radiation.
Buccal mucosa: If cancer is detected in the buccal mucosa (the lining of the inside of the cheeks), treatment may include the following:
  • Surgery (wide local excision) with or without radiation.
  • Radiation.
Floor of the mouth: If cancer is diagnosed in the floor (bottom) of the mouth, treatment may include the following:
  • Surgery (wide local excision, which may include removing part of the jawbone, with or without neck dissection).
  • External radiation with or without internal radiation.
Lower gingiva: If cancer is located in the lower gingiva (gums), treatment may include the following:
  • Surgery (wide local excision) with or without radiation. Radiation may be given before or after surgery.
Retromolar trigone: If cancer is diagnosed in the retromolar trigone (the small area behind the wisdom teeth), treatment may include the following:
  • Surgery to remove the tumour, lymph nodes and part of the jawbone, with or without radiation.
Upper gingiva: If cancer is located in the upper gingiva (gums), treatment may include the following:
  • Radiation.
  • Surgery (wide local excision) and radiation.
Hard palate: If cancer is in the hard palate (the roof of the mouth), treatment may include the following:
  • Radiation.
  • Surgery (wide local excision) with or without radiation.
Lymph nodes: For cancer that may have spread to lymph nodes, treatment may include the following:
  • Radiation and/or surgery (neck dissection).
Stage IV Lip and Oral Cavity Cancer
Treatment of stage IV lip and oral cavity cancer depends on where cancer is found in the lip and oral cavity.
Lip: If cancer is diagnosed in the lip, treatment may include the following:
  • Surgery and external radiation with or without internal radiation.
Front of the tongue: If cancer is detected in the front of the tongue, treatment may include the following:
  • Surgery to remove the tongue and sometimes the larynx (voice box) with or without radiation.
  • Radiation as palliative therapy to relieve symptoms and improve quality of life.
Buccal mucosa: If cancer is located in the buccal mucosa (the lining of the inside of the cheeks), treatment may include the following:
  • Surgery (wide local excision) and/or radiation.
Floor of the mouth: If cancer is located in the floor (bottom) of the mouth, treatment may include the following:
  • Surgery before or after radiation.
Lower gingiva: If cancer detected is in the lower gingiva (gums), treatment may include the following:
  • Surgery and/or radiation.
Retromolar trigone: If cancer is diagnosed in the retromolar trigone (the small area behind the wisdom teeth), treatment may include the following:
  • Surgery to remove the tumour, lymph nodes and part of the jawbone, followed by radiation.
Upper gingiva or hard palate: If cancer is detected in the upper gingiva (gums) or hard palate (the roof of the mouth), treatment may include the following:
  • Surgery with radiation.
  • Chemotherapy and radiation.
Lymph nodes: For cancer that may have spread to lymph nodes, treatment may include the following:
  • Radiation and/or surgery (neck dissection).
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