Stage I Lip and Oral Cavity Cancer
Stage II Lip and Oral Cavity Cancer
Stage III Lip and Oral Cavity Cancer
Stage IV Lip and Oral Cavity Cancer

Stage I Lip and Oral Cavity Cancer

Treatment of stage I lip and oral cavity cancer depends on where cancer is found in the lip and oral cavity.

Lip

If cancer is in the lip, treatment may include the following:

• Surgery (wide local excision).
• Internal radiation therapy with or without external radiation therapy.

Front of the tongue

If cancer is in the front of the tongue, treatment may include the following:

• Surgery (wide local excision).
• Internal radiation therapy with or without external radiation therapy.
• Radiation therapy to lymph nodes in the neck.

Buccal mucosa

If cancer is in the buccal mucosa (the lining of the inside of the cheeks), treatment may include the following:

• Surgery (wide local excision) for tumors smaller than 1 centimeter, with or without internal and/or external radiation therapy.
• Surgery (wide local excision with skin graft) or radiation therapy for larger tumors.

Floor of the mouth

If cancer is in the floor (bottom) of the mouth, treatment may include the following:

• Surgery (wide local excision) for tumors smaller than ½ centimeter.
• Surgery (wide local excision) or radiation therapy for larger tumors.

Lower gingiva

If cancer is in the lower gingiva (gums), treatment may include the following:

• Surgery (wide local excision, which may include removing part of the jawbone, and skin graft).
• Radiation therapy with or without surgery.

Retromolar trigone

If cancer is in the retromolar trigone (the small area behind the wisdom teeth), treatment may include the following:

• Surgery (wide local excision, which may include removing part of the jawbone.)
• Radiation therapy with or without surgery.

Upper gingiva or hard palate

If cancer is in the upper gingiva (gums) or the hard palate (the roof of the mouth), treatment is usually surgery (wide local excision) with or without radiation therapy.

Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage I lip and oral cavity cancer.

Treatment of stage II lip and oral cavity cancer depends on where cancer is found in the lip and oral cavity.

Lip

If cancer is in the lip, treatment may include the following:

• Surgery (wide local excision).
• External radiation therapy and/or internal radiation therapy.

Front of the tongue

If cancer is in the front of the tongue, treatment may include the following:

• Radiation therapy and/or surgery (wide local excision).
• Internal radiation therapy with surgery (neck dissection).

Buccal mucosa

If cancer is in the buccal mucosa (the lining of the inside of the cheeks), treatment may include the following:

• Radiation therapy for tumors that are 3 centimeters or smaller.
• Surgery (wide local excision) and/or radiation therapy for larger tumors.

Floor of the mouth

If cancer is in the floor (bottom) of the mouth, treatment may include the following:

• Surgery (wide local excision).
• Radiation therapy.
• Surgery (wide local excision) followed by external radiation therapy, with or without internal radiation therapy, for large tumors.

Lower gingiva

If cancer is in the lower gingiva (gums), treatment may include the following:

• Surgery (wide local excision, which may include removing part of the jawbone, and a skin graft).
• Radiation therapy alone or after surgery.

Retromolar trigone

If cancer is in the retromolar trigone (the small area behind the wisdom teeth), treatment may include the following:

• Surgery (wide local excision, which includes removing part of the jawbone).
• Radiation therapy with or without surgery.

Upper gingiva or hard palate

If cancer is in the upper gingiva (gums) or the hard palate (the roof of the mouth), treatment may include the following:

• Surgery (wide local excision) with or without radiation therapy.
• Radiation therapy alone.

Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage II lip and oral cavity cancer.

Treatment of stage III lip and oral cavity cancer depends on where cancer is found in the lip and oral cavity.

Lip

If cancer is in the lip, treatment may include the following:

• Surgery and external radiation therapy with or without internal radiation therapy.
• A clinical trial of chemotherapy before or after surgery.
• A clinical trial of chemotherapy and radiation therapy.
• A clinical trial of hyperfractionated radiation therapy.

Front of the tongue

If cancer is in the front of the tongue, treatment may include the following:

• External radiation therapy with or without internal radiation therapy.
• Surgery (wide local excision) followed by radiation therapy.
• A clinical trial of chemotherapy and radiation therapy.
• A clinical trial of hyperfractionated radiation therapy.

Buccal mucosa

If cancer is in the buccal mucosa (the lining of the inside of the cheeks), treatment may include the following:

• Surgery (wide local excision) with or without radiation therapy.
• Radiation therapy.
• A clinical trial of chemotherapy before or after surgery.
• A clinical trial of chemotherapy and radiation therapy.
• A clinical trial of hyperfractionated radiation therapy.

Floor of the mouth

If cancer is in the floor (bottom) of the mouth, treatment may include the following:

• Surgery (wide local excision, which may include removing part of the jawbone, with or without neck dissection).
• External radiation therapy with or without internal radiation therapy.
• A clinical trial of chemotherapy before or after surgery.
• A clinical trial of chemotherapy and radiation therapy.
• A clinical trial of hyperfractionated radiation therapy.

Lower gingiva

If cancer is in the lower gingiva (gums), treatment may include the following:

• Surgery (wide local excision) with or without radiation therapy. Radiation may be given before or after surgery.
• A clinical trial of chemotherapy and radiation therapy.
• A clinical trial of hyperfractionated radiation therapy.

Retromolar trigone

If cancer is in the retromolar trigone (the small area behind the wisdom teeth), treatment may include the following:

• Surgery to remove the tumor, lymph nodes, and part of the jawbone, with or without radiation therapy.
• A clinical trial of chemotherapy before or after surgery.
• A clinical trial of chemotherapy and radiation therapy.
• A clinical trial of hyperfractionated radiation therapy.

Upper gingiva

If cancer is in the upper gingiva (gums), treatment may include the following:

• Radiation therapy.
• Surgery (wide local excision) and radiation therapy.
• A clinical trial of chemotherapy and radiation therapy.
• A clinical trial of hyperfractionated radiation therapy.

Hard palate

If cancer is in the hard palate (the roof of the mouth), treatment may include the following:

• Radiation therapy.
• Surgery (wide local excision) with or without radiation therapy.
• A clinical trial of chemotherapy and radiation therapy.
• A clinical trial of hyperfractionated radiation therapy.

Lymph nodes

For cancer that may have spread to lymph nodes, treatment may include the following:

• Radiation therapy and/or surgery (neck dissection).
• A clinical trial of chemotherapy and radiation therapy.
• A clinical trial of hyperfractionated radiation therapy.

This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.

Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III lip and oral cavity cancer.

Treatment of stage IV lip and oral cavity cancer depends on where cancer is found in the lip and oral cavity.

Lip

If cancer is in the lip, treatment may include the following:

• Surgery and external radiation therapy with or without internal radiation therapy.
• A clinical trial of chemotherapy and radiation therapy.
• A clinical trial of chemotherapy before or after surgery.
• A clinical trial of hyperfractionated radiation therapy.

Front of the tongue

If cancer is in the front of the tongue, treatment may include the following:

• Surgery to remove the tongue and sometimes the larynx (voice box) with or without radiation therapy.
• Radiation therapy as palliative therapy to relieve symptoms and improve quality of life.
• A clinical trial of chemotherapy and radiation therapy.
• A clinical trial of chemotherapy before or after surgery.
• A clinical trial of hyperfractionated radiation therapy.

Buccal mucosa

If cancer is in the buccal mucosa (the lining of the inside of the cheeks), treatment may include the following:

• Surgery (wide local excision) and/or radiation therapy.
• A clinical trial of chemotherapy and radiation therapy.
• A clinical trial of chemotherapy before or after surgery.
• A clinical trial of hyperfractionated radiation therapy.

Floor of the mouth

If cancer is in the floor (bottom) of the mouth, treatment may include the following:

• Surgery before or after radiation therapy.
• A clinical trial of chemotherapy and radiation therapy.
• A clinical trial of chemotherapy before or after surgery.
• A clinical trial of hyperfractionated radiation therapy.

Lower gingiva

If cancer is in the lower gingiva (gums), treatment may include the following:

• Surgery and/or radiation therapy.
• A clinical trial of chemotherapy and radiation therapy.
• A clinical trial of chemotherapy before or after surgery.
• A clinical trial of hyperfractionated radiation therapy.

Retromolar trigone

If cancer is in the retromolar trigone (the small area behind the wisdom teeth), treatment may include the following:

• Surgery to remove the tumor, lymph nodes, and part of the jawbone, followed by radiation therapy.
• A clinical trial of chemotherapy and radiation therapy.
• A clinical trial of chemotherapy before or after surgery.
• A clinical trial of hyperfractionated radiation therapy.

Upper gingiva or hard palate

If cancer is in the upper gingiva (gums) or hard palate (the roof of the mouth), treatment may include the following:

• Surgery with radiation therapy.
• A clinical trial of chemotherapy and radiation therapy.
• A clinical trial of chemotherapy before or after surgery.
• A clinical trial of hyperfractionated radiation therapy.

Lymph nodes

For cancer that may have spread to lymph nodes, treatment may include the following:

• Radiation therapy and/or surgery (neck dissection).
• A clinical trial of chemotherapy and radiation therapy.
• A clinical trial of chemotherapy before or after surgery.
• A clinical trial of hyperfractionated radiation therapy.

This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.

Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage IV lip and oral cavity cancer.

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