Oral cancer

Surgery

There are a number of different operations that can be used to remove oral cancer. The type of operation used will depend on the size of the cancer and where it is.

How can I prepare for the surgery?

Your doctor will explain details of the surgery, general risks and side effects of surgery. Ask your doctor if you have questions. They may recommend:

  • stopping blood thinners (e.g. aspirin) before surgery to reduce the risk of bleeding

  • special stockings to reduce the risk of blood clots

  • early mobilisation (i.e. not staying in bed) to reduce the risk of blood clots and chest infection

  • antibiotics to lower the risk of wound infection.

If you smoke, it is important that you consider stopping smoking before starting treatment to help reduce the risk of infection and help you recover after your treatment.

Surgical procedures 

The different options for oral cancer include: 

GLOSSECTOMY

This involves removing part of, or all of the tongue. It is used if the cancer is growing in the tissue of the tongue.
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MANDIBULECTOMY

This involves removing part of the lower jaw (mandible). It is used if the cancer has spread into the bone of the jaw or is next to the jaw.
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MAXILLECTOMY

This involves removing part of the upper jaw (maxilla), in the roof of the mouth. It is used when the cancer is affecting the roof of the mouth or upper gums.
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MANDIBULOTOMY

This involves cutting the jaw bone to allow better access to the cancer in the mouth. This may be needed if the cancer is further back and difficult to reach through the mouth. The jaw is put back together at the end of the operation with titanium plates.
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NECK DISSECTION

This involves removing lymph nodes from the neck. It is used when oral cancer has spread to the lymph nodes in the neck or there is a risk of cancer in the lymph nodes of the neck.
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RECONSTRUCTIVE SURGERY (Soft tissue Free flap & Bone free flap

This may be considered if a large area of tissue is removed. This may involve taking tissue from another part of the body called a free flap repair. If your jaw has been removed, bone from another part of the body may be used to replace your jaw bone. This operation is carried out by a surgeon who specialises in reconstructive surgery, your head and neck surgeon or another surgeon.
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TRACHEOSTOMY

A tracheostomy is used to create an opening in the trachea (windpipe) in the lower neck, where a tube is inserted to allow air to flow in and out, when you breathe. This is used as swelling after major head and neck surgery may affect your ability to breathe. The tracheostomy tube is usually removed within a week of surgery once normal breathing is possible.
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Feeding tubes

  • A gastrostomy tube (called a PEG tube) goes through the skin and the muscles of your abdominal wall into the stomach. Gastrostomy is recommended if feeding is needed for a medium to longer time (months or years).
  • A nasogastric tube goes through the nose down into the stomach. Nasogastric feeding is used for short time (days or weeks).
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Side effects of surgery

Treatment for oral cancer may lead to a number of side effects . You may not experience all of the side effects. Speak with your doctor if you have any questions or concerns about treatment side effects.