Most people with oral cancer have surgery to remove the tumor. You have to be healthy enough to have surgery for it to be a good option for you. If you have heart disease, your surgeon may ask your heart doctor for advice before your surgery. Most tumors in the oral cavity can be removed with surgery. Some types of tumors are not operable, meaning they can’t be removed by surgery.
You’ll meet with your surgeon beforehand to talk about the procedure. The surgeon will find out if you are taking any medications and will go over your medical records. This is done to make sure your surgery will not be affected by any medications you’re taking or any other health problems you have. You can ask any questions and address any concerns you may have. Here are some questions to consider asking your surgeon:
What are the risks of having this surgery?
How do I go about getting a second opinion?
Are there any other ways to treat the cancer?
How often do you perform this surgery?
What are the possible side effects of the surgery?
Will the surgery change my appearance?
Will the surgery change how I use my mouth to eat, breathe, or talk?
What can I do to make it easier to return to my normal activities after surgery?
After you have discussed all the details with your surgeon, and all your questions have been addressed to your satisfaction, you will sign a consent form that says that the doctor can perform the surgery.
After surgery, you may have to stay in the hospital for a few days. How long you stay in the hospital depends on how much of your oral cavity was removed. Once you've left the hospital, you'll probably still need some special care as you recover from surgery.
Here's an overview of how you might feel after surgery:
For the first few days after surgery, you are likely to have pain from the cut called the incision. The tubes that you have draining your wound may aggravate the healing process. Your pain can be controlled with medicine. Talk with your doctor or nurse about your options for pain relief. Some people are hesitant to take pain medication, but doing so can actually help your healing.
You may feel tired or weak for a while. The amount of time it takes to recover from an operation is different for each person.
You may have a tracheostomy. This is a hole in your neck with a tube in it, called a trach tube, that goes into your windpipe. You breathe through the tube. A physical or respiratory therapist can teach you exercises to make breathing easier. He or she will also show you and your caregivers how to care for the tracheostomy.
You may have trouble eating because your ability to swallow is limited. A nurse or therapist will help you learn how to swallow so you can eat after surgery.
If you had trouble swallowing before surgery, you may have a gastrostomy tube placed in your stomach. The tube allows you to receive nutrients directly to your stomach, bypassing your mouth and throat. A nurse or therapist will show you and your caregivers how to use the tube for feeding yourself. You may have the gastrostomy tube for a while, until you can swallow well enough to eat again. If your treatment prevents you from swallowing well again, you may always use a gastrostomy tube to feed yourself.
You may have diarrhea from tube feeding stress, or an infection. Talk with a dietitian about what you can eat to reduce the chances of getting diarrhea.
You may have constipation from using opioid painkillers, from not moving much, or from not eating much. Talk with your doctor or nurse about getting more fiber in your diet.
You may have facial swelling or bloating.
You may have had to have teeth removed as part of your surgery. Many people have dental problems addressed by their dentist or oral surgeon after they have healed from their cancer treatment. There are many options for restoring dental structures after surgery.
After surgery, you may have either radiation or radiation plus chemotherapy to reduce the chance that any cancerous cells that remain will spread. Having another type of treatment after surgery is called adjuvant therapy.