Surgery is often used for smaller cancers that haven't spread. Minimally invasive approaches may be suitable for many oral and oropharyngeal cancer patients, but they aren't right for everyone. Our skilled head and neck surgeons perform complex operations that might not be possible elsewhere.
Surgical treatment options may include:
Before your surgery, you will likely have an appointment at the Roberta and Stephen R. Weiner Center for Preoperative Evaluation to get necessary information and tests. Your care team will provide specific instructions on how to prepare for your surgery, including guidelines for the night before. Don't hesitate to ask your doctor any questions you have about the surgery.
It's essential to plan ahead, including arranging for someone to drive you to and from the procedure. Ensure you have enough food and supplies at home for after the surgery and have someone ready to help with chores like grocery shopping, cleaning, and laundry.
On the day of your surgery, a team of surgeons, anesthesiologists, and nurses who specialize in oral cavity and oropharyngeal cancer surgery will take care of you. After the procedure, you will be moved to the post-surgical care unit for recovery, where our experienced staff will monitor you closely. The length of your hospital stay will vary depending on the type of surgery you have undergone.
Recovery times can differ from person to person. You may feel tired or weak initially and experience pain for the first few days. Your care team will help manage your pain with both narcotic and non-narcotic medications. Your care team will encourage you to start eating, getting out of bed and walking the same day as your surgery. If you have any questions about what to expect before, during or after your surgery, talk to your healthcare team. They can provide detailed information about your hospital stay and what to expect when you return home.
After removing the tumor or cancerous cells, reconstructive surgery may be needed to rebuild your mouth, helping you regain the ability to talk and eat. Large areas of tissue removed might be replaced with grafts of skin, muscle or bone from other parts of your body. Dental implants can also replace natural teeth.
Surgery carries risks such as bleeding and infection, and it often affects your appearance and ability to speak, eat and swallow. You might need a feeding tube, either temporarily through your nose or longer-term through your skin into your stomach, to help you eat, drink and take medicine.
These are a few surgical procedures to aid nutrition and breathing:
Oral and oropharyngeal cancers can make swallowing difficult, leading to poor nutrition and weakness, which can hinder treatment. Sometimes, the treatment itself can make eating challenging.
To address this, during your hospital stay, doctors might use a gastrostomy tube (G-tube), inserted through the abdomen directly into the stomach. This procedure can be done surgically or, more commonly, through endoscopy. During endoscopy, while the patient is sedated, a doctor uses a camera-equipped tube to guide the feeding tube into place. This method is called a percutaneous endoscopic gastrostomy (PEG) tube. Once inserted, the tube allows liquid nutrition to be delivered directly to the stomach, and patients can still eat normally if they are able to swallow. PEG tubes can be used temporarily or for a longer period, depending on the patient’s needs.
Another short-term option is a nasogastric (NG) tube, which is inserted through the nose and into the stomach. However, some patients find the NG tube uncomfortable and prefer a PEG tube. Both types of tubes come with instructions for use, and our nurses are equipped to provide additional support and guidance for you and your family.
A tracheostomy is a temporary opening created in the neck to assist with breathing, especially if the cancer blocks the throat or causes significant swelling after treatment. This procedure is rare for oral and oropharyngeal cancers, but it may be necessary for very large tumors. The tracheostomy helps air move directly into the windpipe and lungs. Your surgeon will explain if this is needed and how long it will be in place. This decision depends on the size and location of the cancer and the presence of any post-treatment swelling.
The best treatment for oral cavity and oropharyngeal cancer depends on factors like age, health, disease extent, tumor size, stage, and HPV status. At Dana-Farber Brigham Cancer Center, experts use a collaborative approach to create personalized treatment plans. These often include advanced surgical techniques combined with radiation and chemotherapy to maximize effectiveness.
Learn more about non-surgical treatment options for oral cavity and oropharyngeal cancer.
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