Squamous Cell Cancer (SCC) of the Oral Cavity
Squamous cell cancer (SCC) of the oral cavity is a potentially deadly disease that is usually treated surgically, with or without radiation therapy (XRT). When caught early, these cancers can be treated with surgery alone and enjoy a better survival rate. While adding XRT might improve survival statistics for high-stage lesions of the oral cavity, it should be avoided if possible. XRT comes with side effects that are lifelong. Among these are permanent dry mouth and difficulty eating, muscle tightness, loss of the sense of taste, and potential for bone loss due to loss of blood supply to the jaw and face. Short-term complications include skin burns, mouth burns, and inability to eat. Once XRT has been employed, it cannot be used safely in the same region again. Patients who survive oral cavity cancer are prone to develop second cancers about 20% of the time because whatever caused the first cancer (smoking, drinking, tobacco/paan chewing) has already condemned the entire lining of the mouth. A patient with an SCC has a higher risk of developing another cancer than a patient who has never had oral cavity cancer. If a second cancer develops, XRT would not be a viable treatment option because tissue cannot be reradiated; instead, a larger operation would be necessary. Therefore, avoiding XRT is preferred, if possible.
Surgical treatment of oral cavity cancer depends on the size of the cancer, the depth of invasion (including bone involvement), the location of the cancer, and the general health of the patient. More extensive operations are not tolerated well by older persons; they add time, possible blood transfusions, and increased risks of complications.
Squamous cell cancer of the head and neck spreads by local invasion and also spreads to lymph nodes surrounding the area of the cancer. What is not linear is the rate of growth of a cancer. There are factors such as a patient’s immune response to their cancer that cannot be measured. Cancer that is 1 centimeter in one patient may grow rapidly compared to the exact same size cancer in another patient. What is absolute is that untreated cancers of the mouth will grow, involve lymph nodes, and metastasize.