If the biopsy shows that cancer is present, your doctor needs to know the
stage (extent) of your disease to plan the best treatment. The stage is based on
the size of the tumor, whether the cancer has spread and, if so, to what parts
of the body.
Staging may require lab tests. It also may involve
endoscopy. The doctor uses
a thin, lighted tube (endoscope) to check
your throat, windpipe, and lungs. The doctor inserts the endoscope through your
nose or mouth. Local anesthesia is used to ease your discomfort and prevent you
from gagging. Some people also may have a mild sedative. Sometimes the doctor
uses general anesthesia to put a person to sleep. This exam may be done in a
doctor's office, an outpatient clinic, or a hospital.
The doctor may order one or more imaging tests to learn whether the cancer
has spread:
Dental x-rays: An x-ray
of your entire mouth can show whether cancer has spread to the jaw.
Chest x-rays: Images of
your chest and lungs can show whether cancer has spread to these areas.
CT scan: An x-ray machine
linked to a computer takes a series of detailed pictures of your body. You may
receive an injection of dye. Tumors in the mouth, throat, neck, or elsewhere
in the body show up on the CT
scan.
MRI: A powerful magnet
linked to a computer is used to make detailed pictures of your body. The
doctor can view these pictures on a monitor and can print them on film. An MRI
can show whether oral cancer has spread.
Treatment
Many people with oral cancer want
to take an active part in making decisions about their medical care. It is
natural to want to learn all you can about your disease and your treatment
choices. However, shock and stress after the diagnosis can make it hard to think
of everything you want to ask the doctor. It often helps to make a list of
questions before an appointment. To help remember what the doctor says, you may
take notes or ask whether you may use a tape recorder. You may also want to have
a family member or friend with you when you
talk to the doctor -- to take part in the discussion, to take notes, or just to
listen.
Your doctor may refer you to a specialist, or you may
ask for a referral. Specialists who treat oral cancer include oral and
maxillofacial surgeons, otolaryngologists (ear, nose, and throat doctors),
medical oncologists, radiation oncologists, and plastic surgeons. You may be
referred to a team that includes specialists in surgery, radiation therapy, or
chemotherapy. Other health care professionals who may work with the specialists
as a team include a dentist, speech pathologist, nutritionist, and mental health counselor.
Getting a second opinion
Before starting treatment, you might want a second opinion about the
diagnosis and the treatment plan. Some insurance companies require a second
opinion; others may cover a second opinion if you or your doctor requests it.
There are a number of ways to find a doctor for a second opinion:
Your doctor may refer you to one or more specialists.
At cancer centers, several specialists often work together as a team.
The Cancer Information Service, at 1-800-4-CANCER,
can tell you about nearby treatment centers.
A local or state medical or dental society, a nearby
hospital, or a medical or dental school can usually provide the names of
specialists in your area.
The American Board of Medical Specialties (ABMS) has
a list of doctors who have had training and exams in their specialty. You can
find this list in the Official ABMS Directory of Board Certified Medical Specialists. The directory is available in
most public libraries. Or you can look up doctors at http://www.abms.org. (Click on Who's Certified.)
The American Dental Association (ADA) Web site provides a
list of dentists by specialty and location. The ADA Member Directory is
available on the Internet at http://www.ada.org.
The NCI provides a helpful fact sheet on how to find a doctor called "How To Find a
Doctor or Treatment Facility If You Have Cancer." It is available on the
Internet at http://cancer.gov/publications.
You may want to ask the doctor these questions before treatment begins:
What is the stage of the disease? Has the
cancer spread? If so, where?
What are my treatment choices? Which do you
recommend for me? Will I have more than one kind of treatment?
What are the expected benefits of each kind of
treatment?
What are the risks and possible side effects of
each treatment? How will treatment affect my normal activities? Will I
be given anything to control side effects?
How long will treatment last?
Will I have to stay in the hospital?
What is the treatment likely to cost? Is this
treatment covered by my insurance plan?
Would a clinical trial
(research study) be appropriate for me? (See "The Promise of Cancer
Research" for more information about clinical trials.)
Should I try to
quit smoking?
Preparing for treatment
The choice of treatment depends mainly on your general health, where in your
mouth or oropharynx the cancer began, the size of the tumor, and whether the
cancer has spread. Your doctor can describe your treatment choices and the
expected results. You will want to consider how treatment may affect normal
activities such as swallowing and talking, and whether it will change the way
you look. You and your doctor can work together to develop a treatment plan that
meets your needs and personal values.
You do not need to ask all your questions or understand all the answers at
once. You will have other chances to ask your doctor to explain things that are
not clear and to ask for more information.
There are a variety of diseases and conditions that can cause tongue problems, discoloration, and soreness. Though most tongue problems are not serious. Conditions such as leukoplakia, oral thrush, and oral lichen planus may cause a white tongue while Kawasaki syndrome, scarlet fever, and geographic tongue may cause the tongue to appear red. A black hairy tongue may be caused by overgrown papillae on the tongue. Canker sores, smoking, and trauma may cause soreness of the tongue.
Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law.
Toothache usually refers to pain around the teeth or jaws. In most instances, toothaches are caused by tooth or jaw problems, such as a dental cavity, a cracked tooth, an exposed tooth root, gum disease, disease of the jaw joint (TMJ), or spasms of the muscles used for chewing. A toothache can also be caused by a problem that does not originate from a tooth or the jaw, like diseases of the heart (angina or heart attack), ear infections, and sinus infections. A thorough oral examination, which includes dental X-rays, can help determine the cause.
Human papillomavirus (HPV) infection is the most common sexually transmitted infection in the U.S. HPV is primarily transmitted by sexual contact. While some people develop warts in the genital region after infection, others experience no symptoms. Though genital warts can be removed, there is no cure for HPV infection. There is a vaccine to prevent infection from four common HPV types.
Cancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
Smoking is an addiction. More than 430,000 deaths occur each year in the U.S. from smoking related illnesses. Secondhand smoke or "passive smoke" also harm family members, coworkers, and others around smokers. There are a number of techniques available to assist people who want to quit smoking.
The HPV virus (genital warts) in men can cause health problems. Genital warts are confined primarily to the moist skin of the genitals or around the anus. Genital warts are caused by the human papillomaviruses (HPVs), which are transmitted through sexual contact.
Head and neck cancer is cancer of the oral cavity, salivary glands, paranasal sinuses and nasal cavity, pharynx, larynx, or lymph nodes in the upper part of the neck. These cancers account for 3% to 5% of cancers in the U.S. Tobacco and alcohol use are important risk factors. Treatment may involve surgery, radiation therapy, and/or chemotherapy.
Leukoplakia is a white or gray patch that develops on the tongue or inside the cheek. Causes of Leukoplakia may include irritation from rough teeth fillings or crowns, chronic smoking, sun exposure to the lips, or HIV or AIDS.
Though it's difficult to say why some people develop cancer while others don't, research shows that certain risk factors increase a person's odds of developing cancer. These risk factors include growing older, family history of cancer, diet, alcohol and tobacco use, and exposure to sunlight, ionizing radiation, certain chemicals, and some viruses and bacteria.
Smokeless tobacco can have negative health effects such as cancers, poor oral health (gum disease and tooth decay), infertility, pregnancy complications, and nicotine addiction.
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