
The oral cavity includes the following:
Most lip and oral cavity cancers start in squamous cells, the thin, flat cells that line the lips and oral cavity. These are called squamous cell carcinomas. Cancer cells may spread into deeper tissue as the cancer grows. Squamous cell carcinoma usually develops in areas of leukoplakia (white patches of cells that do not rub off).
Tobacco and alcohol use can affect the risk of developing lip and oral cavity cancer.Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor. Risk factors for lip and oral cavity cancer include the following:
These and other symptoms may be caused by lip and oral cavity cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:
Lip and oral cavity cancer may not have any symptoms and is sometimes found during a regular dental exam.
Tests that examine the mouth and throat are used to detect (find), diagnose, and stage lip and oral cavity cancer.The following tests and procedures may be used:
Prognosis (chance of recovery) depends on the following:
For patients who smoke, the chance of recovery is better if they stop smoking before beginning radiation therapy.
Treatment options depend on the following:
Patients who have had lip and oral cavity cancer have an increased risk of developing a second cancer in the head or neck. Frequent and careful follow-up is important. Clinical trials are studying the use of retinoid drugs to reduce the risk of a second head and neck cancer. Information about ongoing clinical trials is available from the NCI Web site.
The process used to find out if cancer has spread within the lip and oral cavity or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The results of the tests used to diagnose lip and oral cavity cancer are also used to stage the disease. (See the General Information section.)
There are three ways that cancer spreads in the body.The three ways that cancer spreads in the body are:
When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.
The following stages are used for lip and oral cavity cancer:Stage 0 (Carcinoma in Situ)In stage 0, abnormal cells are found in the lining of the lips and oral cavity. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.
Pea, peanut, walnut, and lime show tumor sizes.
In stage I, cancer has formed and the tumor is 2 centimeters or smaller. Cancer has not spread to the lymph nodes.
Stage IIIn stage II, the tumor is larger than 2 centimeters but not larger than 4 centimeters, and cancer has not spread to the lymph nodes.
Stage IIIStage IV is divided into stages IVA, IVB, and IVC as follows:
Recurrent lip and oral cavity cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the lip or mouth or in other parts of the body.
Different types of treatment are available for patients with lip and oral cavity cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Patients with lip and oral cavity cancer should have their treatment planned by a team of doctors who are expert in treating head and neck cancer.Treatment will be overseen by a medical oncologist, a doctor who specializes in treating people with cancer. Because the lips and oral cavity are important for breathing, eating, and talking, patients may need special help adjusting to the side effects of the cancer and its treatment. The medical oncologist may refer the patient to other health professionals with special training in the treatment of patients with head and neck cancer. These include the following:
Surgery (removing the cancer in an operation) is a common treatment for all stages of lip and oral cavity cancer. Surgery may include the following:
Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
Radiation therapyRadiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
For patients who smoke, radiation therapy works better when smoking is stopped before beginning treatment. It is also important for patients to have a dental exam before radiation therapy begins, so that existing problems can be treated.
New types of treatment are being tested in clinical trials.This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI Web site.
ChemotherapyChemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Hyperfractionated radiation therapyHyperfractionated radiation therapy is radiation treatment in which the total dose of radiation is divided into small doses and the treatments are given more than once a day.
Hyperthermia therapyHyperthermia therapy is a treatment in which body tissue is heated above normal temperature to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs.
Patients may want to think about taking part in a clinical trial.For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's clinical trials database.
Follow-up tests may be needed.Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.
Treatment of stage I lip and oral cavity cancer depends on where cancer is found in the lip and oral cavity.
Lip
If cancer is in the lip, treatment may include the following:
Front of the tongue
If cancer is in the front of the tongue, treatment may include the following:
Buccal mucosa
If cancer is in the buccal mucosa (the lining of the inside of the cheeks), treatment may include the following:
Floor of the mouth
If cancer is in the floor (bottom) of the mouth, treatment may include the following:
Lower gingiva
If cancer is in the lower gingiva (gums), treatment may include the following:
Retromolar trigone
If cancer is in the retromolar trigone (the small area behind the wisdom teeth), treatment may include the following:
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 radiation therapy.
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage I lip and oral cavity cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Treatment of stage II lip and oral cavity cancer depends on where cancer is found in the lip and oral cavity.
Lip
If cancer is in the lip, treatment may include the following:
Front of the tongue
If cancer is in the front of the tongue, treatment may include the following:
Buccal mucosa
If cancer is in the buccal mucosa (the lining of the inside of the cheeks), treatment may include the following:
Floor of the mouth
If cancer is in the floor (bottom) of the mouth, treatment may include the following:
Lower gingiva
If cancer is in the lower gingiva (gums), treatment may include the following:
Retromolar trigone
If cancer is in the retromolar trigone (the small area behind the wisdom teeth), treatment may include the following:
Upper gingiva or hard palate
If cancer is in the upper gingiva (gums) or the hard palate (the roof of the mouth), treatment may include the following:
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage II lip and oral cavity cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Treatment of stage III lip and oral cavity cancer depends on where cancer is found in the lip and oral cavity.
Lip
If cancer is in the lip, treatment may include the following:
Front of the tongue
If cancer is in the front of the tongue, treatment may include the following:
Buccal mucosa
If cancer is in the buccal mucosa (the lining of the inside of the cheeks), treatment may include the following:
Floor of the mouth
If cancer is in the floor (bottom) of the mouth, treatment may include the following:
Lower gingiva
If cancer is in the lower gingiva (gums), treatment may include the following:
Retromolar trigone
If cancer is in the retromolar trigone (the small area behind the wisdom teeth), treatment may include the following:
Upper gingiva
If cancer is in the upper gingiva (gums), treatment may include the following:
Hard palate
If cancer is in the hard palate (the roof of the mouth), treatment may include the following:
Lymph nodes
For cancer that may have spread to lymph nodes, treatment may include the following:
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III lip and oral cavity cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
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 in the lip, treatment may include the following:
Front of the tongue
If cancer is in the front of the tongue, treatment may include the following:
Buccal mucosa
If cancer is in the buccal mucosa (the lining of the inside of the cheeks), treatment may include the following:
Floor of the mouth
If cancer is in the floor (bottom) of the mouth, treatment may include the following:
Lower gingiva
If cancer is in the lower gingiva (gums), treatment may include the following:
Retromolar trigone
If cancer is in the retromolar trigone (the small area behind the wisdom teeth), treatment may include the following:
Upper gingiva or hard palate
If cancer is in the upper gingiva (gums) or hard palate (the roof of the mouth), treatment may include the following:
Lymph nodes
For cancer that may have spread to lymph nodes, treatment may include the following:
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage IV lip and oral cavity cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Treatment of recurrent lip and oral cavity cancer may include the following:
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent lip and oral cavity cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
For more information from the National Cancer Institute about lip and oral cavity cancer, see the following:
For general cancer information and other resources from the National Cancer Institute, see the following:
Call 1-800-4-CANCER
For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 9:00 a.m. to 4:30 p.m. A trained Cancer Information Specialist is available to answer your questions.
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For more information from the NCI, please write to this address:
Search the NCI Web site
The NCI Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families. For a quick search, use the search box in the upper right corner of each Web page. The results for a wide range of search terms will include a list of "Best Bets," editorially chosen Web pages that are most closely related to the search term entered.
There are also many other places to get materials and information about cancer treatment and services. Hospitals in your area may have information about local and regional agencies that have information on finances, getting to and from treatment, receiving care at home, and dealing with problems related to cancer treatment.
Find Publications
The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237).
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Editorial changes were made to this summary.
PDQ is a comprehensive cancer database available on NCI's Web site.
PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.
PDQ contains cancer information summaries.
The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.
The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.
Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.
PDQ also contains information on clinical trials.
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Listings of clinical trials are included in PDQ and are available online at NCI's Web site. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).
Physicians version: CDR0000062930
Date last modified: 2009-08-19
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