Managing Advanced Oral Cancer: Concerns About Treatment and Progression

Terminal stage of oral cancer?

Recently, my father was diagnosed with terminal oral cancer, with cancer cells located in the left gum and eroding into the left mandible.
Surgery is scheduled for the 15th, but prior to that, the doctor has not prescribed any medication for him aside from examinations.
Shouldn't there be concerns about the cancer cells spreading to other areas? Or is there no need to suppress the growth of the cancer cells?

a a, 10~19 year old female. Ask Date: 2019/08/06

Dr. Chen Sirong reply Oncology

Ah, 19 years old, female.

1.
The surgery date is already scheduled for the 15th.

a: That's great! It's coming up quickly.

2.
The doctor has not prescribed any medication for my father.
Shouldn't we be concerned about the cancer cells spreading to other areas? Or about not inhibiting the growth of the cancer cells?
a: There will be no medication before the surgery, but postoperatively, he will receive chemotherapy and radiation therapy.
It's important to focus on nutrition before the surgery and try to gain some weight.
Wishing for a speedy recovery.
Taoyuan Hospital, Dr.
Chen Sih-Rong.

Reply Date: 2019/08/06

More Info

Managing advanced oral cancer, particularly in the context of your father's condition, requires a comprehensive understanding of the disease, its treatment options, and the potential for disease progression. Given that your father has been diagnosed with advanced oral cancer, specifically affecting the left gingiva and invading the left mandible, it is crucial to address your concerns regarding treatment and the risk of cancer spread.

Firstly, it is important to recognize that advanced oral cancer can indeed pose significant risks, including local progression and potential metastasis to distant sites. The absence of immediate pharmacological intervention prior to surgery may seem concerning, especially when considering the aggressive nature of cancer. However, the decision to delay systemic treatment (such as chemotherapy or targeted therapy) until after surgical intervention is not uncommon in cases where surgical resection is deemed the primary treatment modality. The rationale behind this approach is that surgery aims to remove the bulk of the tumor, which can significantly reduce the tumor burden and potentially improve the effectiveness of any subsequent therapies.

In your father's case, the surgical procedure scheduled for the 15th is likely intended to excise the cancerous tissue and any affected surrounding structures. This is a critical step in managing the disease, as it can provide immediate relief from symptoms and reduce the risk of further local invasion. Following surgery, the pathology results will guide the next steps in treatment, which may include adjuvant therapies such as radiation therapy or chemotherapy, depending on the final staging and margins of the resected tissue.

Regarding your concern about the potential for cancer cells to spread during this waiting period, it is essential to understand that while there is always a risk of progression in cancer, the timeline for significant changes can vary widely among individuals. Factors such as the aggressiveness of the tumor, the patient's overall health, and the presence of any systemic symptoms will influence this risk. It is also worth noting that some cancers can be slow-growing, and immediate intervention may not always be necessary.

In the interim, it is advisable to maintain open communication with your father's healthcare team. They can provide insights into the expected timeline for surgery and any necessary pre-operative assessments. If there are specific symptoms or concerns about pain management or quality of life, discussing these with the physician can lead to supportive care options that may alleviate discomfort and improve overall well-being.

Additionally, exploring nutritional support is vital, especially if your father is experiencing difficulties with eating or maintaining weight due to the cancer. Nutritional interventions can help bolster his strength and resilience as he prepares for surgery.

In summary, while the absence of immediate pharmacological treatment may raise concerns, the surgical approach is a critical component of managing advanced oral cancer. Following surgery, a tailored treatment plan can be developed based on the pathology results. It is crucial to stay engaged with the healthcare team, address any symptoms proactively, and consider supportive measures to enhance your father's quality of life during this challenging time.

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