Given the historical case of Sigmund Freud, it is important to note that medical practice in the early to mid-20th century was considerably different from what it is today. Freud’s oral cancer treatment was primarily surgical, complemented with rudimentary forms of radiotherapy.
In contemporary medical practice, the treatment options for oral cancer depend on the stage, location, and type of the tumor, as well as the patient’s overall health and preferences. Surgery remains a cornerstone treatment for many solid tumors, including oral cancers, especially if the tumor is localized and has not metastasized significantly. However, there are several non-surgical treatment modalities that can be considered either as an alternative to surgery or in combination with surgical therapy:
- Radiation Therapy: This can be used as a primary treatment, particularly for small, localized oral cancers. It can also be an adjunct therapy post-surgery to control microscopic disease or as a palliative treatment to relieve symptoms in advanced cases.
- Chemotherapy: Systemic treatment with cytotoxic drugs can be used alone in certain cases, but more often it is combined with radiation therapy (chemoradiotherapy), either as a definitive treatment or as a neoadjuvant (before surgery) or adjuvant (after surgery) therapy.
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Targeted Therapy: This involves drugs that specifically target molecular abnormalities within cancer cells. For example, cetuximab (Erbitux) is a monoclonal antibody that targets the epidermal growth factor receptor (EGFR) and is used for treating head and neck cancers.
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Immunotherapy: A newer area of cancer treatment, immunotherapy, utilizes the body’s own immune system to fight cancer. Pembrolizumab (Keytruda) and nivolumab (Opdivo) are two immunotherapy drugs approved for the treatment of head and neck squamous cell carcinoma.
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Photodynamic Therapy (PDT): This local treatment uses a photosensitizing agent, which is activated by light to destroy cancer cells. It is generally used for very early-stage cancers or pre-cancerous lesions.
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Laser Treatment: For very early-stage oral cancers, especially those located on the superficial layers of the oral mucosa, laser surgery can be an option.
It’s crucial to engage in a multidisciplinary discussion with an oncologist, a radiation oncologist, a maxillofacial surgeon, and other relevant specialists to understand the best treatment options for a specific case. Patient preference, performance status, and the quality of life considerations play a significant role in deciding the treatment plan. For any contemporary patient, these options would be discussed in detail, taking into account the latest clinical guidelines and evidence from clinical trials.
Signature:
Michael Truppe, MD
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Ordination Dr. Michael Truppe
Albertgasse 3/6 1080 Wien
Telefon 01 408 95 00 66
Email ordination@smile.wien
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