Oral Cancer Surgery

What surgeries can be used to treat oral cancer?

Your Mercy Health doctor will determine the most appropriate surgery for your case. Based on the type and severity of your case, your doctor may choose one of the following surgeries:

Tumor resection

A tumor resection is an oral surgery that removes the entire tumor along with some normal tissue surrounding the tumor. If the tumor is small, it can be removed through the mouth, while larger or hard to reach tumors may be removed through the neck or jawbone.

Mohs micrographic surgery

Mohs micrographic surgery is often recommended for cancers on the lip. During this procedure, your surgeon will remove a cancerous tumor in very thin slices. The surgeon will evaluate each slice under a microscope for the presence of cancer cells. He or she will continue taking layers until no cancer cells can be seen in the sample. This approach allows your doctor to remove the tumor while sparing healthy tissue around the tumor.

Full or partial mandible resection (mandibulectomy)

If you have a tumor in your jawbone, a mandibular resection may be necessary. During this procedure, your surgeon will remove all or part of your jawbone.

Glossectomy

A glossectomy is a type of cancer surgery to treat cancer of the tongue. During a glossectomy, your surgeon will remove part of your tongue or the entire tongue if you have a larger tumor.

Maxillectomy

A maxillectomy is a procedure to treat oral cancer. During the procedure, your doctor will remove part or all the hard palate that lives in the front of the roof of your mouth. After the procedure, you will be fitted with a prosthesis — a device that will cover the hole in the roof of the mouth after surgery.

Tracheostomy

A tracheostomy is a surgical procedure that is performed when your oral cancer or surgery makes breathing more challenging. During the procedure, your surgeon will make a hole in the neck, which is held open by a tracheostomy tube so that you can breathe normally. This could be a permanent or temporary treatment for breathing issues related to oral cancer.

Laryngectomy

A laryngectomy is an oral cancer treatment that involves removing the primary tumor and the voice box. This procedure may be an option for patients who have a large tumor on the tongue or oropharynx removed. When these organs are removed, the risk of pneumonia increases as food may be able to enter the lung through the trachea. During the procedure, your doctor will attach the windpipe to a hole in the neck for breathing.

Neck dissection

A neck dissection is an oral cancer treatment that involves removing the lymph nodes in the neck to remove cancer in that area. This procedure can be performed as a standalone procedure or at the same time the primary tumor is removed.

The procedure can be performed as a:

• Partial or selective neck dissection — a procedure used to remove a few lymph nodes
• Modified radical neck dissection — surgery to remove lymph nodes, muscle and nerve tissue between the jawbone and collarbone
• Radical neck dissection — a surgery that involves removing all the lymph nodes on one side as well as muscle and nerves.

Who is a candidate for oral cancer surgery?

Your Mercy Health surgical team will evaluate your case, looking at factors such as those listed below to determine if you are a candidate for oral cancer surgery.

• Type of cancer
• Size of cancer
• Location
• Grade/stage of tumor
• Your age and physical health
• Your medical co-morbidities

Patients who have early stage oral cancer that has not spread to other organs are the ideal candidates for oral cancer surgery.

Patients who have a later stage oral cancer may also be treated with oral surgery. Your Mercy Health oncology team will determine the most appropriate treatment plan for you. In many cases, surgery is combined with radiation, chemotherapy or other treatments.

What are the risks associated with oral cancer surgery?

Oral cancer surgery is a major surgery that can lead to severe complications such as blood clots, infection and pneumonia.

The most common side effect in patients who undergo uncomplicated surgeries is mild to moderate pain that can be treated with pain medication.

In more complex cases, where the tumors are harder to reach or surrounded by vital organs, side effects may include:

• Infection
• Eating problems
• Difficulty breathing or speaking
• Facial disfiguration
• Speech challenges or trouble swallowing if part of your tongue has been removed. Inability to speak or swallow when the entire tongue is removed.
• Inability to speak if your voice box has been removed in a laryngectomy

What to expect during oral cancer surgery

What you can expect from your oral cancer surgery will depend on the procedure you are having. Most procedures will be performed under local or general anesthesia and many require a hospital stay. Your doctor will outline exactly what you can expect before your procedure.

Recovery from an oral cancer surgery

Many patients are concerned that surgery can cause disfigurement. In many cases, your doctor can perform reconstructive surgery after the tumor removal to restore your appearance with very few signs you had surgery.