What Happens During Surgery for Oral Cancer
Most people with oral cancer have some type of surgery.8,9 If you have a large tumor in your mouth, you may have other treatment before surgery.2,6 That treatment may be chemotherapy alone, or in addition to radiation therapy.6 The goal of these other treatments is to help shrink the tumor and make it easier to remove.2,9 Receiving another type of treatment before surgery is called neoadjuvant therapy.8
Types of Surgery
The type of surgery you have depends on your health condition and stage of the tumor.3,9 The doctor may remove part or all of the affected area of the oral cavity.5
Regardless of the type, on the day of your surgery, you’ll get anesthesia so that you don’t feel pain.1 Before the surgery, you can ask your surgeon questions about the anesthesia and how it will affect you.1
Your doctor will explain your surgical options.2 The list below gives you a general idea of the types of surgery you might hear about:
Primary tumor resection. This surgery involves removing the tissue in your mouth that contains the cancer, along with a little of the normal tissue surrounding the tumor.2 If your surgical team removes a large amount of tissue, they may use reconstruction techniques to rebuild the area.2,3 Doctors do this by taking normal tissue from another part of your body. 2,3
Partial mandible resection. If the cancer involves your jawbone (also called the mandible), your surgeon may remove part of the bone.2 Sometimes the jawbone is rebuilt with bone from another part of your body, or by inserting a metal plate.5,7
Maxillectomy. If the cancer involves the bone in your mouth that holds your upper teeth (called the maxilla), your surgeon may remove part of the bone.2 You may receive a prosthesis, which is a special device that fits into the roof of your mouth.2
Mohs’ micrographic surgery. If the cancer is in your lip, your surgeon might use this special technique to remove the cancer.2 Its goal is to help preserve your lip’s appearance. The surgeon shaves off layers of skin one layer at time. Each layer is examined under the microscope to identify any cancerous cells.2 When your surgeon finds no more cancerous cells, then no more layers of skin are removed. 2
Neck dissection. This surgery can be done if there is a chance the cancer has spread to lymph nodes in your neck. Your surgeon removes the lymph nodes in the neck and some surrounding tissue.2
Tracheostomy. You may have this surgery if the cancer or surgery makes breathing difficult.2 The surgeon makes a hole in your neck, into your trachea, and holds it open with a small tube, called a trach tube.5 You then breathe through this tube.2,5
Gastronomy tube. This is a feeding tube that a surgeon places in your stomach if the cancer or its treatment makes it difficult for you to eat. Your surgeon may place the tube through your nose or through your abdominal wall directly into your stomach.2 This tube may be temporary or permanent.2
Many of the surgeries for oral cancer may affect your appearance or make it difficult to use your mouth.9 You may need more surgery to rebuild your mouth.3 This is called reconstructive surgery.2,3 Your surgeon may do this right after the tumor is removed. Or it may be done as a separate surgery.3,9
1“Anesthesia.” American Association of Oral and Maxillofacial Surgeons, 2006. www.aaoms.org/anesthesia_info.php Accessed 2010.
2“Detailed Guide: Oral Cavity and Oropharyngeal Cancer.” American Cancer Society, 2007. www.cancer.org/Cancer/OralCavityandOropharyngealCancer/DetailedGuide/oral-cavity-and-oropharyngeal-cancer-treating-surgery Accessed 2010.
3“Head and Neck Cancer: Questions and Answers.” National Cancer Institute, 2005. www.cancer.gov/cancertopics/factsheet/Sites-Types/head-and-neck Accessed 2010.
4“Lip and Oral Cavity Cancer Treatment (PDQ): Patient Version.” National Cancer Institute, June 16, 2010.www.nci.nih.gov/cancertopics/pdq/treatment/lip-and-oral-cavity/patient Accessed 2010.
5 “Medical Encyclopedia: Tracheostomy.” U.S. National Library of Medicine, National Institutes of Health, 2007. www.nlm.nih.gov/medlineplus/ency/article/002955.htm Accessed 2010.
6 “Medical Encyclopedia: Oral Cancer.” U.S. National Library of Medicine, National Institutes of Health, 2008. www.nlm.nih.gov/medlineplus/ency/article/001035.htm Accessed 2010.
7 “Neoadjuvant therapy.” National Cancer Institute. www.cancer.gov/dictionary/?searchTxt=neoadjuvant Accessed 2010.
8 “Surgery.” Oral Cancer Foundation. www.oralcancerfoundation.org/facts/surgery.htm Accessed 2010.
9 “What You Need to Know About Oral Cancer.” National Cancer Institute, 2006. www.cancer.gov/cancertopics/wyntk/oral Accessed 2010.