Oral Cancer: Risks, Recurrence, and Survival Rates

Oral cancer issues?

Hello Doctor, my sister has had a mucosal tear in her left cheek since the beginning of this year that hasn't healed.
By July, it formed a protruding hard lump that continued to grow towards her lip.
In August, she visited an oral surgeon for a biopsy, which confirmed it was malignant.
After a series of tests, a CT scan showed no lymph node metastasis, and she underwent surgery to remove the lump.
The pathology report confirmed it was a stage II malignant tumor of the left buccal mucosa.

My question is, after surgical removal, is there a chance of recurrence? If it does recur, would it still be classified as stage II? I read that the 5-year survival rate for stage II is 5 years; does this mean surviving beyond 5 years? If she takes good care of herself, can she live longer? My sister has rheumatoid arthritis, diabetes, and periodontal disease, and she does not smoke, drink alcohol, or chew betel nut.
Thank you, Doctor.

Niming, 40~49 year old female. Ask Date: 2022/09/12

Dr. Chen Sirong reply Oncology

Anonymous / 45 years old / Female
1.
Will there be a recurrence after the doctor performs surgery?
A: Yes, there is a possibility of recurrence.
The likelihood of recurrence is related to whether the surgeon was able to achieve clear margins and the safety distance.
If the excision is too extensive, it may not be aesthetically pleasing; if it is too limited, it may not be thorough enough.
A safety margin of 1mm or 2mm might be too close.
Assuming the surgery is performed appropriately, there is about a 20% chance of recurrence.
2.
If there is a recurrence, will it still be classified as stage II?
A: Not necessarily; it will need to be re-evaluated.
Therefore, long-term follow-up is recommended.
3.
I read that the 5-year survival rate for stage II is over 5 years.

A: The chance of surviving beyond 5 years means that, specifically for head and neck cancer, the likelihood of recurrence after 5 years is usually less than 3%.
Therefore, those who survive for 5 years are likely to have long-term survival.
4.
If I take good care of myself, can I live longer?
A: It can be said that maintaining a healthy lifestyle, such as not smoking or drinking, may help, but it is difficult to specify how to best care for oneself.
Wishing you the best as you face life with a healed mindset.
Taoyuan Hospital, Chen Si-Rong

Reply Date: 2022/09/12

More Info

Understanding oral cancer, particularly in the context of your sister's diagnosis and treatment, involves several critical aspects, including the risks of recurrence, survival rates, and the importance of ongoing care.

Firstly, regarding the risk of recurrence after surgery for stage II oral cancer, it is indeed a possibility. The likelihood of recurrence can depend on various factors, including the completeness of the surgical resection, the margins of healthy tissue around the tumor, and the tumor's characteristics. In general, if the tumor is removed with clear margins (meaning no cancer cells are found at the edges of the removed tissue), the risk of recurrence is lower. However, even with successful surgery, studies suggest that there is still about a 20% chance of recurrence for stage II oral cancers. If a recurrence does occur, it may not necessarily be classified as stage II again; the staging would need to be reassessed based on the new findings.

As for survival rates, the five-year survival rate for stage II oral cancer is indeed a common statistic used in oncology. This rate indicates the percentage of patients who are alive five years after their diagnosis. A five-year survival rate of around 60-70% for stage II oral cancer means that a significant number of patients live beyond five years, and many may continue to live long, healthy lives after that point. It is important to note that survival rates are statistical averages and can vary widely based on individual circumstances, including overall health, response to treatment, and lifestyle factors.

In your sister's case, her existing health conditions, such as rheumatoid arthritis and diabetes, can complicate her overall health but do not necessarily preclude her from achieving a good outcome. Maintaining a healthy lifestyle, which includes a balanced diet, regular check-ups, and managing her existing health conditions, can contribute positively to her prognosis. While there is no guaranteed way to prevent recurrence, good health practices can support her immune system and overall well-being.

Regular follow-up appointments with her healthcare team are crucial. These visits allow for monitoring any changes in her condition and addressing any concerns promptly. If any new symptoms arise, such as changes in the oral cavity or difficulty swallowing, it is essential to report these to her doctor immediately.

In summary, while there is a risk of recurrence after surgery for stage II oral cancer, many patients do well with appropriate follow-up care and lifestyle management. The five-year survival rate provides a hopeful outlook, but individual experiences can vary. Encouraging your sister to focus on her health and maintain regular communication with her healthcare providers will be vital in her journey toward recovery.

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