Oral Cavity Cancer Timeline: Chemoradiation

When an advanced oral cavity cancer cannot be removed safely, or when a person's health does not allow a major operation, treatment is usually radiation combined with chemotherapy, over about 7 weeks.

This page is one of the treatment-track timelines for advanced oral cavity cancer. The steps before treatment, how a track is chosen and the long-term follow-up schedule are covered on the oral cavity cancer treatment timelines page.

Who follows this track

For most advanced mouth cancers, surgery comes first. This track is for the less common situations when the tumor has grown into structures that cannot be removed safely, or when other health conditions make a long operation too risky. Mouth cancers generally respond less well to radiation than throat cancers do, which is one reason surgery is favored whenever it is possible.

Before treatment (weeks 0 to 4)

The biopsy, scans and appointments are the same as on every track (see the overview page). The dental check is especially important, since teeth in poor condition are treated or removed at least 2 weeks before radiation starts. A baseline hearing test is done before cisplatin, and a feeding tube is sometimes placed before treatment begins.

Chemoradiation (about weeks 4 to 11)

• Radiation is given 5 days a week for about 7 weeks.

• Cisplatin chemotherapy is given during radiation. When cisplatin is not a good fit, other drugs are available.

• Side effects build and are worst in the last week or two and for a couple of weeks afterward: sore mouth and throat (mucositis), dry mouth, taste changes, swallowing trouble, tiredness and weight loss. Cisplatin can also affect hearing, the kidneys and blood counts.

Recovery (months 3 to 12)

• Swallowing and taste improve over 6 to 12 months.

• A PET-CT scan about 12 weeks after treatment checks how the cancer responded.

• Most feeding tubes are removed within about 6 months.

Quality of life on this track

Published average scores on the questionnaires used on these timelines have not been found for people with mouth cancer treated with chemoradiation alone, so the quality-of-life row on this timeline is left blank. Swallowing and taste usually dip during treatment and improve over the following 6 to 12 months. The questionnaires are described on the quality-of-life questionnaires page.

Check-ups and long-term care

• Check-ups follow the usual schedule counted from the end of treatment: every 1 to 3 months in the first year, every 2 to 6 months in the second, every 4 to 8 months in years 3 to 5, then yearly.

• Dental visits and possible fluoride treatments continue for life.

• A thyroid blood test (TSH) every 6 to 12 months for the first 3 years checks for an underactive thyroid.

• Jaw stretching, swallowing exercises and lymphedema care continue as needed.