As many as 50,000 Americans will be diagnosed this year with oral cancer. If you are one of them, you will likely have at least one of these three treatments: surgery, chemotherapy or radiation. You may also have combinations of these treatments, as well as reconstructive surgery. Newer, experimental treatments such as immunotherapy are also offering new options for oral cancer patients. While a mouth cancer diagnosis is difficult, these oral cancer treatment options can be effective in removing the cancer and restoring any lost tissue. Mouth Cancer Surgery Surgery is the most common oral cancer treatment, though this will depend on the size, stage and location of your tumors. Doctors can perform several kinds of oral cancer surgery: Wide local excision: The primary cancer is removed as well as some healthy tissue surrounding it, to ensure all the cancer cells are removed. This can take place through the mouth, neck or jawbone. Glossectomy: This is a partial or full removal of the tongue, done when cancer is found in the tongue. Mandibulectomy: Partial or complete removal of the jawbone (mandible) may be needed to treat tumors found there. Maxillectomy: Partial or complete removal of the roof of the mouth (hard palate) may be required as part of mouth cancer treatment. Neck dissection: When cancer has spread from the lips or mouth to the lymph nodes of the neck, all or part of these nodes and other neck tissue may need to be removed. Transoral robotic surgery (TORS) and transoral laser microsurgery (TLM): These procedures use endoscopes, robotic instruments, and, in the case of TLM, lasers to remove oral cancers through the mouth. Restorative surgery: Plastic surgery or other procedures may be necessary to rebuild structures, such as your jaw, that may have been removed along with the cancer. Sometimes, surgeons place dental implants or skin grafts to restore function and appearance. Radiation Therapies for Oral Cancer Sometimes doctors use radiation to treat mouth cancer without surgery. This can be done with certain small tumors, where surgery isn’t necessary, or in cases where a patient can’t have surgery. Radiation also is commonly used after surgery to ensure any remaining cancer cells are destroyed. Types of radiation therapy include: External-beam radiation: This is the most common type of radiation used in oral cancer treatment. The radiation beams come from outside the patient and are directed at the cancer site. Usually the beams are X-rays but sometimes proton beams are used instead. Intensity modulated radiation therapy (IMRT): This type of external radiation uses numerous low doses aimed at the cancer, in an effort to better protect surrounding healthy tissue from damage. Internal radiation therapy: This is also called brachytherapy, and refers to radiation delivered from within the body, such as via pellets or rods implanted at or near the site of the cancer. Hyperfractionated radiation therapy: This divides radiation treatment into small doses that are delivered more than once per day. Chemotherapy for Mouth Cancer Chemotherapy is medication designed to kill rapidly-producing cells, which can include both cancer cells and healthy cells. Sometimes doctors use chemo before surgery or radiation to help shrink a tumor; other times, patients start chemotherapy after one of these procedures. It can be used on its own or in combination with radiation therapy. Systemic chemotherapy: This process delivers the chemotherapy drugs to your system via the bloodstream. It is given through an IV, injection, or by pills. Regional chemotherapy: Chemo can also be targeted to a specific region of the body. For example, to treat mouth cancer, the drugs can be infused through an artery in the neck or head. Newer Therapies for Oral or Mouth Cancer New therapies have emerged in recent years, and researchers are still studying many others. Some are only available in clinical trials. Talk to your medical care team about whether these treatments might be an option for you. Immunotherapy: Also called biologic therapy, this treatment uses either your body’s own cells or those made in a lab to boost your immune system to fight off your oral cancer. The U.S. Food & Drug Administration (FDA) has approved two immunotherapy drugs (Keytruda and Opdivo) for patients with recurrent or metastatic head and neck squamous cell cancer that hasn’t responded to traditional platinum-based chemotherapy. Targeted therapy (brachytherapy): Doctors evaluate your specific tumor type and target specific gene mutations, proteins, or cancer cell metabolism, with the goal of blocking its growth and spread. So far, the only targeted therapy for oral cancer approved by the FDA is cetuximab. Radiofrequency thermal ablation (RFA): This minimally invasive approach destroys cancer cells through heat. It can be effective for tumors that can’t be removed surgically. Managing Oral Cancer Treatment Side Effects and Symptoms Mouth cancer treatment can carry significant side effects, and symptoms of the disease itself also may require coping strategies. Acupuncture may help cut pain, fatigue and nausea caused by chemotherapy or radiation. You may need speech or physical therapy after surgery, and it will take time to adjust to any changes in appearance and function. You may benefit from counseling along with your physical therapy to cope with these challenges. An oral or mouth cancer diagnosis is challenging, but you do have treatment options. Consult with your healthcare team to see which treatments might be best to address your cancer and help you maintain a good quality of life during oral cancer treatment.