Non-surgical options for treating oral cancer
Mouth cancer, like many other forms of the disease, requires a tailored approach to treatment depending on various factors such as the type, spread, location, and stage of the cancer. This article explores the common nonsurgical treatment options available for mouth cancer.
Radiation Therapy
Radiation therapy is a primary nonsurgical option for mouth cancer treatment. It uses high-energy rays to damage cancer cells and is often used either alone or after surgery, particularly when tumors are inoperable or to target residual cancer cells [1]. Radiation therapy can also be used as an added therapy after surgery to destroy any remaining cancer cells.
Chemotherapy
Chemotherapy involves the use of drugs to kill cancer cells or stop their growth. It is sometimes given before surgery (induction chemotherapy) to shrink tumors, or concurrently with radiation (concurrent chemoradiotherapy) to enhance effectiveness. Chemotherapy regimens like TPF (docetaxel, cisplatin, and 5-fluorouracil) are employed for locally advanced cancers to preserve organ function and improve survival [3].
Concurrent Chemoradiotherapy (CCRT)
The combination of chemotherapy and radiation is common for locally advanced cases where surgery might cause significant morbidity or is not possible. CCRT can improve control over the cancer and sometimes allow surgery to be avoided [3].
Immunotherapy
Immunotherapy is a type of treatment that empowers the immune system to target and kill cancer cells. Topical immunotherapy can be used for early or superficial cancers, while oral or injected immunotherapies may be options in certain cancers or combined with chemotherapy. While primarily developed for skin cancers, immunotherapy is increasingly being explored and used for head and neck cancers, including mouth cancer [5].
A type of immunotherapy called PD-1 inhibitor can be used for mouth cancer. Examples include pembrolizumab (Keytruda) and nivolumab. PD-1 inhibitors work by "switching off" PD-1 to activate the immune system against cancer cells [6].
Holistic and Supportive Modalities
While not direct cancer treatments, complementary therapies like acupuncture, nutritional support, mind-body medicine, and oxygen therapies are often incorporated to manage symptoms and support overall well-being during cancer treatment [1].
In summary, the choice of nonsurgical treatment for mouth cancer depends on cancer stage, tumor location, patient health, and response to treatment. Early-stage mouth cancer might be treated less invasively, while advanced disease often warrants multimodal approaches. Multidisciplinary evaluation guides the optimal nonsurgical regimen for each patient.
[1] National Health Service (NHS). (2021). Mouth cancer: Treatment. Retrieved from https://www.nhs.uk/conditions/mouth-cancer/treatment/ [2] American Cancer Society. (2021). Key Statistics for Cancer of the Mouth and Throat. Retrieved from https://www.cancer.org/cancer/cancer-of-the-mouth-and-throat/about/key-statistics.html [3] Cancer Research UK. (2021). Mouth cancer: Treatment. Retrieved from https://www.cancerresearchuk.org/about-cancer/mouth-cancer/treatment [4] Mayo Clinic. (2021). Mouth cancer: Diagnosis and treatment. Retrieved from https://www.mayoclinic.org/diseases-conditions/mouth-cancer/diagnosis-treatment/drc-20374903 [5] American Society of Clinical Oncology. (2021). Immunotherapy for Head and Neck Cancer. Retrieved from https://www.cancer.net/cancer-types/head-and-neck-cancer/treatment/immunotherapy [6] National Cancer Institute. (2021). Pembrolizumab. Retrieved from https://www.cancer.gov/about-cancer/treatment/drugs/pembrolizumab
- Immunotherapy, like chemotherapy and radiation therapy, is a necessity in the arsenal of nonsurgical treatments for mouth cancer, with cases of advanced disease often requiring multimodal approaches.
- In specific types of mouth cancer, immunotherapies such as PD-1 inhibitors (like pembrolizumab and nivolumab) are utilized, aiming to "switch off" PD-1 and activate the immune system against cancer cells.
- Unlike immunotherapy, proton therapy is not a common treatment for mouth cancer but is a form of radiation therapy that uses protons instead of X-rays to target cancer cells, offering potential benefits for certain medical-conditions.
- In addition to traditional treatments like immunotherapy, chemotherapy, and radiation therapy, health-and-wellness practices play an integral role in managing symptoms and supporting overall well-being during treatment, with holistic modalities often incorporated to provide comprehensive care.
