Childhood Oral Cavity Cancer Treatment (PDQ®)

Last modified: 2018-03-30
Last downloaded: 2018-04-17

   

General Information About Childhood Oral Cavity Cancer

   

Oral cavity cancer is a disease in which malignant (cancer) cells form in the tissues of the mouth.

The oral cavity includes the following:

Anatomy of the oral cavity. The oral cavity includes the lips, hard palate (the bony front portion of the roof of the mouth), soft palate (the muscular back portion of the roof of the mouth), retromolar trigone (the area behind the wisdom teeth), front two-thirds of the tongue, gingiva (gums), buccal mucosa (the inner lining of the lips and cheeks), and floor of the mouth under the tongue.   

Most tumors in the oral cavity are benign (not cancer).

The most common type of oral cavity cancer in adults, squamous cell carcinoma (cancer of the thin, flat cells lining the mouth), is very rare in children. The most common types of oral cavity cancer in children are lymphomas and sarcomas.

Both benign and malignant oral cavity tumors can affect eating or speaking and need treatment.

  

Being infected with the human papillomavirus (HPV) may increase the risk of oral cavity cancer.

Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your child's doctor if you think your child may be at risk.

Risk factors for oral cavity cancer in children and adolescents include the following:

  

Signs and symptoms of oral cavity cancer include a sore that does not heal.

These and other signs and symptoms may be caused by oral cavity cancer or by other conditions.

Check with your child's doctor if your child has any of the following:

  • A sore in the mouth that does not heal.
  • A lump or thickening in the mouth.
  • A white or red patch on the gums, tongue, or lining of the mouth.
  • Bleeding, pain, or numbness in the mouth.
  

Tests that examine the mouth and throat are used to detect (find) and diagnose oral cavity cancer.

The following tests and procedures may be used:

Computed tomography (CT) scan of the head and neck. The child lies on a table that slides through the CT scanner, which takes x-ray pictures of the inside of the head and neck.

Computed tomography (CT) scan of the head and neck. The child lies on a table that slides through the CT scanner, which takes x-ray pictures of the inside of the head and neck.

  • Physical exam of oral cavity: An exam to check the oral cavity for abnormal areas. The medical doctor or dentist will feel the entire inside of the mouth with a gloved finger and examine the oral cavity with a small long-handled mirror and lights. This will include checking the insides of the cheeks and lips; the gums; the roof and floor of the mouth; and the top, bottom, and sides of the tongue. The neck will be felt for swollen lymph nodes. A history of the patient’s health habits and past illnesses and medical and dental treatments will also be taken.
  • X-ray : An x-ray is a type of energy beam that can go through the body and onto film.
  • MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas of the body, such as the head and neck. This procedure is also called nuclear magnetic resonance imaging (NMRI).
  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.Computed tomography (CT) scan of the head and neck. The child lies on a table that slides through the CT scanner, which takes x-ray pictures of the inside of the head and neck.
  • PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
  • Biopsy : The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer.

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Stages of Childhood Oral Cavity Cancer

The process used to find out if cancer has spread from the oral cavity to nearby areas or to other parts of the body is called staging. There is no standard system for staging childhood oral cavity cancer. The results of the tests and procedures done to diagnose oral cavity cancer are used to help make decisions about treatment.


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Treatment Option Overview

  

There are different types of treatment for children with oral cavity cancer.

Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.

Because cancer in children is rare, taking part in a clinical trial should be considered. Some clinical trials are open only to patients who have not started treatment.

  

Children with oral cavity cancer should have their treatment planned by a team of doctors who are experts in treating childhood cancer.

Treatment will be overseen by a pediatric oncologist, a doctor who specializes in treating children with cancer. The pediatric oncologist works with other pediatric health professionals who are experts in treating children with cancer and who specialize in certain areas of medicine. This may include the following specialists and others:

  

Three types of standard treatment are used:

Surgery 

Surgery to remove the tumor is the most common treatment for benign and malignant childhood oral cavity cancer.

Chemotherapy 

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy).

Radiation therapy 

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. External radiation therapy uses a machine outside the body to send radiation toward the cancer.

  

New types of treatment are being tested in clinical trials.

This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website.

Targeted therapy 

Targeted therapy is a type of treatment that uses drugs or other substances to attack cancer cells. Targeted therapies usually cause less harm to normal cells than chemotherapy or radiation therapy do.

Targeted therapy is being studied for the treatment of childhood oral cavity cancer that has recurred (come back).

  

Treatment for childhood oral cavity cancer may cause side effects.

For information about side effects that begin during treatment for cancer, see our Side Effects page.

  

Patients may want to think about taking part in a clinical trial.

For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.

Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.

Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.

  

Patients can enter clinical trials before, during, or after starting their cancer treatment.

Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.

Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.

  

Follow-up tests may be needed.

Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.

Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your child's condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.


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Treatment Options for Childhood Oral Cavity Cancer

For information about the treatments listed below, see the Treatment Option Overview section.

Newly Diagnosed Childhood Oral Cavity Tumors

Treatment of newly diagnosedbenignoral cavitytumors in children may include the following:

Treatment of newly diagnosed malignantoral cavity cancers in children may include the following:

Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

Recurrent Childhood Oral Cavity Cancer

Treatment of recurrentoral cavity cancers in children may include the following:

Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.


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To Learn More About Childhood Oral Cavity Cancer

For more information from the National Cancer Institute about oral cavity cancer, see the following:

For more childhood cancer information and other general cancer resources, see the following:


Back to Top Source: The National Cancer Institute's Physician Data Query (PDQ®) Cancer Information Summaries ( http://www.cancer.gov/cancertopics/pdq)