This form of cancer may originate in the part of the throat at the back of
the mouth, or in the oral cavity . The oropharynx includes
the back one-third of the tongue, the soft palate, the tonsils, and the back of
the throat. Salivary glands throughout the oral cavity make saliva, which
keeps the mouth moist and helps digest food.
When the cancer spreads, it travels through the lymphatic system.
The cancerous cells that enter the lymphatic system are carried along by lymph, an
almost colorless fluid containing cells that help fight
infection and disease. Along the lymphatic channels are groups of small
organs called lymph nodes. Oral
cancer that spreads usually travels to the lymph nodes in the neck.
It is important to diagnose oral cancer as early as possible because the treatment
work best if the disease is caught in its infancy. The National Cancer Institute
encourages people to perform a monthly self-examination.
Regular dental checkups that include an examination for the mouth are
also very important in the early detection of precancerous
Oral cancer usually occurs in people over the age of 40 but can develop at
any age. These are some warning signs to watch for:
If an abnormal area has been found in the mouth, your doctor should have
you get a biopsy on the abnormality, since a biopsy is the only
way to know if it is cancerous. Usually, the patient is referred to an
oral surgeon or an ear, nose, and throat surgeon, who removes part or all of the
lump or abnormal-looking area. A pathologist examines the tissue under a
microscope to check for cancer cells.
Almost all oral cancers are scaly cell tumors. Scaly cells
line the oral cavity. If the pathologist finds oral cancer, the patient's
doctor needs to know the stage that the cancer is in, so they know which plan
would be the
best treatment. These tests help the doctor find out whether the cancer
has spread and what parts of the body have been affected.
These tests generally will include dental x-rays and x-rays of the head and chest.
The doctor may also want the patient to have a CT Scan. A CT scan
is a series of x-rays put together by a computer to form detailed pictures of
areas inside the body. Ultrasonography is another way to produce pictures
of areas in the body. High frequency sound waves (ultrasound), which
cannot be heard by humans, are bounced off organs and tissue. The pattern
of echoes produced by these waves creates a picture called a sonogram.
Sometimes the doctor asks for MRI, a procedure in
which pictures are created using a magnet linked to a computer. The
doctor also feels the lymph nodes in the neck to check for swelling or other
changes. In most cases, the patient will have a complete physical
examination before treatment begins.
Before starting treatment, the patient might want a specialist who treats
lymphomas to review the diagnosis and treatment plan. Treatment planning
takes into account the type of lymphoma, the stage of disease, whether it is
likely to grow slowly or rapidly, and the general health and age of the patient.
For low-grade lymphomas that usually grow very slowly and cause few symptoms,
the doctor may decide to wait until the disease shows signs of spreading before
Treatment for intermediate or high-grade lymphomas usually involves
chemotherapy, with or without radiation therapy. In addition, surgery may
be needed to remove a large tumor. Often, patients are referred to medical
centers that specialize in treating lymphomas.
Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy for
non-Hodgkin's lymphomas usually is a combination of several drugs. Some
drugs are given by mouth; others are injected into a blood vessel or muscle.
The drugs travel through the bloodstream to almost every part of the body.
Chemotherapy is usually given in cycles, a treatment period followed by a rest
period, then another treatment period, and so on.
Radiation therapy (also called x-ray therapy, radiotherapy, or irradiation),
uses high-energy rays to damage cancer cells and stop their growth.
Radiation therapy is generally given in the outpatient department of a hospital
or clinic. Most often, patients receive radiation therapy five days a week
for five to six weeks.
Side Effects of Treatment
The methods used to treat lymphomas are very powerful. That's why
treatment often causes side effects. Fortunately, most side effects are
The side effects of chemotherapy depend on the drugs given and the individual
response of the patient. Chemotherapy commonly affects rapidly growing
cells, such as blood-forming cells and cells that line the digestive tract.
As a result, patients may have side effects, such as lowered resistance to
infection, loss of appetite, nausea and vomiting, and mouth sores. They
may also lose their hair. These side effects usually end after
chemotherapy is finished.
During radiation therapy, patients may notice a number of side effects.
They may become unusually tired as the treatment continues. Resting as much
as possible is important. Skin reaction (redness or dryness) in the area
being treated are also common. Patients should be gentle with the treated
area of skin. Lotions and creams should not be used without the doctor's
advice. When the chest and neck area is treated, patients may have a dry,
sore throat, and may have some trouble swallowing. Sometimes, they have
shortness of breath or a dry cough. Radiation therapy to the abdomen may
cause nausea, vomiting, or diarrhea. Some patients may have tingling or
numbness in their arms, legs, and lower back. These side effects gradually
disappear when treatment is over. To help withstand the side effects of
treatment, it is important that patients maintain good nutrition practices.
Source: Margolis, Simeon, The Johns Hopkins Medical Book, 2000