Malignant neoplasm of mandible
What is it?
Mandibular Cancer Arises from the Gums & Lower Jaw. Sometimes, these cancers start in the jaw bone itself, and sometimes they start in the gums, or in other places, such as the lips, cheek, or tongue, and grow into the bone. Excessive tobacco and alcohol use are both known to contribute to the development of this type of cancer. Cancers in this region may cause pain, numbness in the mouth or chin, or could make it difficult to open the mouth or speak.
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Signs & symptoms
Unlike other cancers of the head and neck, mandibular cancers can typically be seen or felt as an abnormality by a patient, dentist, or doctor. Symptoms to watch for include:
* Painful sores or ulcers in the mouth
* A patch in the mouth
* Recurrent bleeding from the mouth
* Bad breath
In some cases, the first sign of mandibular cancer could be a lump in the neck. This means that the tumor has spread to lymph nodes in the neck. However, in mandibular cancers, the primary cancer in the mouth is usually noticed before it reaches these lymph nodes.
Diagnosis
The diagnosis phase of mandibular cancer can be difficult and overwhelming. During this phase, further testing will be necessary to confirm a diagnosis and determine the best course of treatment. Patients can expect their doctor to have a discussion with them about the risks, benefits, and alternatives to each of the following approaches.
Imaging- Imaging scans, also known as radiologic studies, provide the doctor with an inside view of the body. Imaging of the head and neck will be required to determine the extent as well as the behavior of a growth, and is a vital step prior to treatment of any mandibular tumor.
The most common initial imaging tests used are CT and MRI scans. A more advanced imaging study called a PET/CT may also be performed to evaluate if a mandibular tumor has spread to other sites in the body, as well as to determine if lymph nodes in the neck are likely to harbor cancer cells.
Biopsy- A biopsy is the removal of a small piece of tissue to examine under a microscope to see if it is cancerous. A biopsy of a suspicious area in the mouth (or mass in the neck) is usually needed prior to treatment. There are a few different ways to perform this biopsy, but the most common and easiest approach is an incisional or punch biopsy. In some cases, a fine needle aspiration (FNA) biopsy of any suspicious lymph nodes in the neck may also be helpful.
Treatment
After determining a diagnosis of mandibular cancer and completing a full pre-treatment evaluation, doctors will recommend a course of treatment for their patients. In general, your care team can treat mandibular cancers with three different options: surgery, radiation and chemotherapy. They can administer these treatments in combination or independent of the others.
Surgery - For mandibular cancer, complete surgical removal of the tumor is almost always the first treatment, unless a doctor decides that it is not possible or safe to proceed with surgery. Mandibular cancers are often treated with a mandibulectomy and a free flap.
The surgery that a doctor recommends will depend on the location of the cancer, as well as the stage. Patients and their care teams should discuss the types of surgeries that may be required for the treatment of their cancer. In addition, reconstruction of the oral cavity following cancer removal is an important means to restore the patient’s function and appearance. A thorough discussion of this aspect of the surgical plan is vital to the patient’s understanding of what life will be like after cancer treatment.
Radiation- The most common use of radiation for the treatment of mandibular cancer is called adjuvant radiation, which is radiation given after surgery in order to decrease the chances that the tumor will come back.
☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.
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