Oral cancer or mouth cancer is a subtype of head and neck cancer, is any cancerous tissue growth located in the oral cavity.
Laser Oncosurgery is a field which has advanced rapidly in the last couple of years. From being a fringe player in this field it is now the treatment of choice in many cancers like basal cell carcinoma. Squamous cell carcinoma of skin. There is now a separate field in MRI guided laser ablation of Brain Tumours.
Liver carcinoma is being increasingly handled by laser over surgery in specialized centres. Breast carcinoma is being handled by many centres internationally by ablation rather than open surgery. The world over application of lasers in General Surgery has been slow but steady. Surgeons are adapting to this new tool all over the world. Today lasers can be used in 70% of Non laparoscopic General Surgery though the expertise is extremely limited at present.
Laser Surgery is different from routine scalpel surgery. It has the advantage of being fast, bloodless and practically no pain post op.
Technical aspect of Tumour handling in late stages
Late stage cancer has always been an enigma in handling for Oncosurgeons. Late stage is defined as any tumour in stage 3 or 4. For sake of arguments I shall restrict myself to oral cancer stage 4.
In this stage any surgery to remove the tumour has a very high chance of recurrence within 2 to 3 months. It has a near 90% chance in next 6 months for recurrence.
Tumour handling in late stages is not intended for cure but for palliation. i.e. relief of symptoms. There are various ways in which that can be achieved but essentially it follows the principle of Cyto-reduction or ablation or debulking as some surgeons would like to call it. Cyto-reduction is a simple concept that decrease in the size of advanced tumour makes Radiotherapy and chemotherapy more effective in treatment of advanced cancer.
The various ways one can do it are as follows
With last 7 years of our experience in dealing with advanced Cancer of Mouth by laser, We have come to the firm conclusion that
Routine mutilating Surgery is not required in Late cases of Cancer of Mouth (In fact it should be avoided)
The results as far as Quantity Of Life is concerned -It is same if not more after laser surgery
The Quality Of Life is far superior compared to near total destruction of Quality of Life After Normal surgery