Latest advancements in treatment of oral cancer

This article is contributed by Dr. Dushyant Mandlik, Consultant - Surgical Oncology (Head & Neck, Robotic and Reconstructive Surgery Specialist), HCG Cancer Centre, Ahmedabad.

Table of Content

• Overview
• What are the Latest Advancements in Oral Cancer Treatment?
• Minimal Access Surgery (MAARSH)
• Organ Preservation
• Advanced Reconstruction
• Improved Adjuvant Treatment
• Advanced Techniques and Technology
• Frozen Section Excision
• Laser Treatment
• Transoral Robotic Surgery (TORS)
• Nanoplatforms
• Bottom Note
• Frequently Asked Questions
• References

Overview

Oral cancer is the sixth most prominent type of cancer worldwide, with India accounting for about a third of the total burden. It is also the second country to have the largest number of oral cancer cases.

As we learn about its prevalence, it is also important for us to understand the risk factors that are associated with its incidence. Some of the main risk factors associated with oral cancers are tobacco consumption, HPV infection, bad oral hygiene, dental trauma, etc.

Thanks to the constant research that is happening in the field of head and neck oncology, we are learning something new about oral cancer and its management every day, be it how to prevent it, how to detect it in its early stages, or how to treat it in a better way.

Today, unlike before, we can dive into much deeper levels of understanding of how oral cancer occurs. This higher level of understanding plays a pivotal role in treating any oral cancer case with the right treatment, for the first time.

At HCG, patients can consult the best oral cancer specialists in Ahmedabad, who have vast experience in devising and administering value-based and patient-centric treatment and care.

What are the Latest Advancements in Oral Cancer Treatment?

Back then, oral cancer treatment was not as advanced as it is today. Preserving the structure and function during the treatment was a big challenge.

After oral cancer surgery, adjuvant treatment in the form of radiation therapy and chemotherapy came with inevitable damage to the healthy tissue, as they were not as precise as they are today. However, this is no longer the case.

We have some highly advanced treatment approaches for oral cancers that not only preserve the structure and function of the organ but also preserve the quality of life in patients.

Minimal Access Surgery (MAARSH)

Minimal access surgery was not an option for head and neck cancers until a few years ago, and traditional surgeries, which involved large excisions, came with drawbacks like visible scars, a lengthy recovery, breathing/swallowing difficulties, etc.

Minimal Access Adequate Resection Surgery for Head & Neck Cancer (MAARSH), also known as minimal access surgery, addresses these drawbacks.

Since minimal access surgeries involve smaller to no incisions, the recovery time and the risk of treatment-related complications are reduced significantly. There is minimal scarring, and patients hardly experience breathing/ swallowing difficulties. These surgeries also help patients return to their normal activities at a faster rate.

Organ Preservation

As the name says, organ preservation in oral cancer treatment refers to treating the tumor

Advanced Reconstruction

During reconstruction surgery, soft tissues, or bone from a different part of the body are used to reconstruct the mouth region. Reconstruction may also be performed through microvascular surgery, wherein surgeons cut and sew tiny blood vessels under a microscope.

Microvascular surgeries are often used to restore the oral structures that are responsible for functions such as speaking, chewing, and swallowing food. This surgery

may also be followed by dental implants in some cases.

Improved Adjuvant Treatment

Adjuvant therapies become important in oral cancer patients as they increase the chances of disease-free and metastasis-free survival. This approach involves administering oral cancer treatment without surgery.

Adjuvant therapies are administered after oral cancer surgery, and they commonly include radiation therapy and chemotherapy.

The purpose of adjuvant therapy is to ensure that there are no residual cancer cells left after oral cancer surgery.

Advanced Techniques and Technology

Apart from the ones discussed already, oncologists are using various other treatment techniques for oral cancer treatment, and they include frozen sections, LASER treatment, and robotics.

Frozen Section Excision

A frozen section, or cryosection, is a cancer treatment technique wherein the surgeon excises a portion of tumor tissue and evaluates it under the microscope for the presence of cancer cells. It ensures the complete removal of cancer on the operation table, leading to better oncological outcomes.

Laser Treatment

Laser treatment for mouth cancer is another reliable treatment option for both precancerous lesions and tumors in the mouth region. Some of the commonly used laser devices include the CO2 laser, the Nd: YAG laser, the Er: YAG laser, and the KTM laser. Laser treatment works by precisely cutting or destroying the tumor using heat.
The key advantages of oral cancer laser treatment include precise cutting, reduced blood loss, reduced post-operative pain and swelling, and an overall faster recovery.
HCG is a leading hospital for laser treatment for oral cancer in India. Our specialists excel at treating oral cancers of varying complexity through laser treatment.

Transoral Robotic Surgery (TORS)

During transoral robotic surgery, the surgeon uses a computer-enhanced system to guide the surgical tools to remove mouth and throat malignancies.
This surgical approach provides the surgeon with a better view of the tumor and surrounding tissue, which is necessary for the surgeon to remove the tumor with enhanced precision while causing minimal damage to surrounding healthy tissues.

Nanoplatforms

The use of nanoplatforms is another significant technological advancement in the field of oral cancer management. It may be used both as a part of diagnostic and treatment modalities to make disease management more precise and effective for patients.
Nanoplatforms can support the delivery of chemotherapy drugs directly into cancer cells and thereby minimize damage to healthy cells in the body. They can also carry anti-cancer drugs that can be specifically activated at the tumor site for better treatment results.
They can also be used to enhance the precision of imaging techniques and improve the quality of the diagnostics.

Bottom Note

The breakthrough solutions that we have discussed in this article have permanently changed how oral cancers are seen, treated, and managed.

Today, oral cancer can be treated with advanced surgeries, non-invasive approaches, and organ reconstruction. These treatment solutions have made it possible for oral cancer patients to get better treatment results and return to their best state of health as early as possible.

That said, the best oral cancer treatment may vary from one patient to another, depending on the individual case factors.

At HCG, we have some of the best oral cancer specialists in Ahmedabad who are skilled at successfully managing oral cancers while ensuring that the patients have a good quality of life post-treatment.

References

• Oncological outcome following 3-drug neo-adjuvant chemotherapy initiated “Triple regimen” for selected subset of cT4b bucco-alveolar carcinoma with supra-notch infratemporal fossa extension: https://www.researchgate.net/publication/371834110_Oncological_outcome_following_3-drug_neo-adjuvant_chemotherapy_initiated_Triple_regimen_for_selected_subset_of_cT4b_bucco-alveolar_carcinoma_with_supra-notch_infratemporal_fossa_extension
• The Post-treatment Impact on Quality of Life, Body Image, and Occupational Concerns among Head and Neck Cancer Patients: https://www.researchgate.net/publication/377001341_The_Post-treatment_Impact_on_Quality_of_Life_Body_Image_and_Occupational_Concerns_among_Head_and_Neck_Cancer_Patients
• Minimally invasive surgery for head and neck cancer: https://pubmed.ncbi.nlm.nih.gov/20202612/
• Locally Advanced Oral Tongue Cancer: Is Organ Preservation a Safe Option in Resource-Limited High-Volume Setting?: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7433937/
• Transoral robotic surgery for oropharyngeal cancer: patient selection and special considerations: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5916264/
• A hospital-based study of survival in oral cancer patients of Tata Memorial Hospital, Mumbai: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10911663/

Author Bio

Dr. Dushyant Mandlik

MS, FUICC (Geneva), FGOLF (MSKCC USA)

Consultant - Surgical Oncology (Head & Neck, Robotic and

Reconstructive Surgery Specialist),

HCG Cancer Centre, Ahmedabad