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Lip and Oral Cavity (Mouth) Cancer

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Most lip and oral cavity cancers occur in squamous cells. These cells are thin, flat cells that line the lips and oral cavity. These cancers are called squamous cell carcinomas. They can grow in the mouth, the jaw, the front of the tongue and the lips. Your doctor may notice white patches on your gums, or inside your cheeks, the bottom of your mouth and, sometimes, your tongue. These are called leukoplakia.

You are at higher risk for lip and mouth cancer if you use tobacco or drink heavily.

Why Choose Sylvester Comprehensive Cancer Center?

Sylvester is an NCI-designated cancer center. The National Cancer Institute has recognized Sylvester for its outstanding work conducting research in its laboratories, treating patients in its clinics and hospitals, and reaching out to medically underserved communities with innovative prevention strategies.

The Department of Otolaryngology ranks No. 9 in the nation according to U.S. News & World Report. The team has one of the largest academic head-neck cancer groups in the country at South Florida’s only NCI-designated cancer center, Sylvester Comprehensive Cancer Center. Surgeons lead a well-established multidisciplinary oncology team, incorporating innovative techniques such as oral cancer screening, robotic technology, microvascular reconstruction, sentinel node identification, and a specialized postoperative care unit for these complex procedures.

More board-certified head and neck surgical specialists than any other South Florida provider. We have experts who work together to treat every aspect of your head and neck care. In the majority of cases requiring reconstruction, you have just one operation for cancer removal and any reconstructive surgery. Sylvester is one of the best places in the country for simultaneous head and neck cancer surgery and microvascular reconstruction.

Clinical trials that focus on robotic surgery, chemotherapy, reducing radiation toxicity and immunotherapy are often available for head and neck cancer patients. You can get new treatments that aren’t available elsewhere. Your access to trials that match your specific cancer gives you the best chance for the best treatment outcomes.

Advanced radiation oncology tools. Sylvester is one of only five medical centers in the country with ViewRay — MRI-guided radiation therapy. And, our RapidArc® radiotherapy system delivers intensity modulated external radiation therapy (IMRT). This leads to more efficient and effective treatments, shorter treatment times, pinpoint accuracy in tumor targeting, and less damage to surrounding healthy tissue.

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Treatments

At Sylvester Comprehensive Cancer Center, each cancer has a wide range of treatments that can be used alone or in combination to give the best outcome for your specific cancer, including standard therapies and novel therapies only available in clinical trials. That’s why careful diagnosis is so important.

Your exact diagnosis, side effects expected, how the treatment might affect your physical appearance or your speech and ability to eat, and your personal preferences help decide your treatment plan.

  • Surgery 

    Your surgeon will remove the tumor from the head and neck region and remove lymph nodes if cancer is present. Smaller tumors have a lower chance of negatively impacting your ability to speak, swallow and live life to the fullest.  

    Surgery is the primary choice for cancer of the lips, the floor of the mouth, the tongue, inside the cheek, the gums, and of the roof of the mouth. For small tumors, radiation may work without surgery. Lymph nodes in the neck may be removed (lymph node dissection) to check for cancer spread.

    • Reconstructive Surgery: Sometimes, head and neck surgeries can cause substantial cosmetic changes. Your Sylvester head and neck experts will plan before any treatment starts for both the cancer removal and any bone or tissue reconstruction.
      • Often these reconstructive procedures can utilize small pieces of tissue, skin or bone from your own body for a more natural look and feel — such as from your lower leg, shoulder blade, chest, forearm and other areas.
      • Another option is to develop a prosthesis (an artificial replacement). Sylvester's head and neck cancer team works with our prosthodontist, a dentist who specializes in making replacements for teeth and other facial structures.

    Radiation Therapy 

    Radiation is a primary treatment for small head and neck cancers of the oral cavity. Cancer cells remaining are removed by a surgeon.

    Sylvester has one of the largest, most experienced and most sophisticated head/neck cancer radiation teams in the nation. Radiation therapy uses highly targeted radiation beams to kill cancer cells and to shrink tumors. This is sometimes the only type of treatment needed. More often it is used together with chemotherapy or targeted therapy. Our techniques include:

    • Oral health evaluation: A thorough oral evaluation by a knowledgeable dentist before radiation treatment spots any potential infection, fractured teeth or restorations, or periodontal disease. These issues could contribute to oral complications when cancer therapy begins.  

    • IMRT (Intensity modulated radiation therapy): Sylvester offers national-leading experience in the use of IMRT for head and neck cancers. IMRT is an external beam radiation therapy. Radiation specialists shape the radiation doses to the exact 3D shape of your tumor. This precise control helps minimize or decrease radiation to surrounding healthy tissue. 

    • Radiosensitizing treatment: In some cases, such as in cancers of the larynx (voice box) and oropharynx (middle of the throat), we may use chemotherapy and radiation therapy together to kill all the cancer cells. This combination also can help reduce the need for surgery and preserve your voice box and throat structures. 

  • Chemotherapy (Systemic Medical Therapy)

    The high level of experience of Sylvester’s medical oncology team allows our physicians to choose and deliver the most advanced chemotherapy approaches. You might receive chemotherapy drugs before or after surgery. They can also be used with radiation therapy to help some patients avoid surgery. Chemotherapy drugs for head and neck patients do not usually cause you to lose your hair. 

    • Intravenous (infusion) chemotherapy is available at the Comprehensive Treatment Unit (CTU) of Sylvester's Miami location, a 12,000-square-foot unit that includes 33 recliners and 11 private rooms. If you prefer, you may have your infusion treatments at the Deerfield Beach, Plantation, Hollywood, Coral Springs, Coral Gables, and Kendall locations.

  • Targeted Therapy 

    This treatment uses medicines that target specific parts of cancer cells. For example, a protein called EGFR may accelerate the growth of head and neck cancer cells. The most commonly used medicine that targets these cells is called cetuximab. It blocks EGFR, so the cancer cell growth often slows or stops.


Tests

In addition to a complete medical history and physical examination, procedures for diagnosing head and neck cancers may include the following:

  • Endoscopic Ultrasound

    This exam uses a long, thin, flexible tube called an endoscope with a light at the end. It is put in through the nose so the doctor can get a close look at the inside of your nasal cavity, the back of your nose, and your throat and voice box. A special tool on the endoscope may be used to remove samples of suspicious tissue.

  • Exfoliative Cytology

    Li p, throat or other oral cavity cells are gently scraped out as samples and looked at under a microscope.  Our pathologists (cell experts) will see if they are abnormal             . 

  • CT  (Computed Tomography or CAT) Scan 

    The 3D images captured on this scan offer us detailed pictures to see where cancer may be growing. CT scans can check the head and neck, chest and other areas of the body. 

  • MRI (Magnetic Resonance Imaging) 

    Images are created by a machine that uses magnets and radio waves. Your doctor will look for cancer in the image details. 

  • Biopsy

    A biopsy (a sample of the suspicious tissue) is the only sure way to know if you have cancer. The sample is checked by a pathologist who looks at the tissue under a microscope to check for cancer cells. The tissue is removed from the primary tumor site in the head/neck area. If the suspicious area is a lump or lymph node on your neck, your doctor uses a process called fine needle aspiration to check for cancerous cells in your lymph nodes. 

  • Chest X-ray or Chest CT Scan

    An X-ray to determine if cancerous cells have spread to your lungs.

  • PET (Positron Emission Tomography) Scan

    This test measures metabolic activity in your body tissue. Radioactive material in small amounts is injected into a vein. The radioactive material is seen in the images as highlighted places where cancer cells could be growing.

  • Staging Head and Neck Cancers

    Staging is the word used to describe how early or advanced a cancer is, and how fast it is growing. Stages range from I (low) to IV (advanced). Staging helps us to decide what treatment might be best for your cancer. 

Accepted Insurances

Note: Health plans that are currently contracted with UHealth are listed below. However, please check with your insurance provider to verify that UHealth is part of your provider network.