Jaw cancer

Diagnósticos

Diagnosis usually starts with an exam. Your healthcare professional may examine your mouth and jaw and feel your neck for enlarged lymph nodes. Imaging tests and a biopsy help find out whether a growth is cancer. If it is cancer, these same tests can help find out what type it is.

Imaging tests

CT scans and MRI scans can show a tumor's size, where it is and whether it has grown into nearby areas. They also can help show whether cancer may have spread to lymph nodes in the neck.

If jaw sarcoma is suspected, CT scans and MRI scans of the head and neck can show the tumor and nearby areas. A chest CT can check whether cancer has spread to the lungs. A whole-body scan, such as a PET-CT scan, may be used to look for cancer that has spread to other parts of the body.

For squamous cell carcinoma in the mouth, CT scans or MRI scans may be used to look at the tumor and nearby areas. These tests also can help your care team check lymph nodes and look for signs that the cancer has spread.

Imaging tests also can help show how a jaw tumor affects bone. But imaging tests, including X-ray, CT or MRI, cannot alone determine what type of tumor it is. A biopsy is always required to confirm the diagnosis of cancer.

Biopsy

A biopsy is a procedure to remove a sample of tissue for testing in a lab. A pathologist is a doctor who examines tissue for signs of disease. The pathologist checks the sample to find out whether it is cancer and, if so, what type.

The type and location of the tumor help determine how the biopsy is done. A surgical team may help plan the biopsy. The way the biopsy is done can affect later surgery.

Options for biopsy can include:

• Surgical biopsy. A surgeon makes an incision to reach the suspicious area and remove a tissue sample for testing.
• Image-guided needle biopsy. A healthcare professional uses imaging, such as a CT scan or MRI scan, to guide a thin needle into the suspicious area and collect a sample.
• Core biopsy. This is a type of needle biopsy. A healthcare professional uses a hollow needle to remove a small column of tissue for testing.

The type of biopsy used depends on the tumor and where it's located. Your surgical team will recommend the approach that's right for you.

Tratamientos

Treatment depends on the type of cancer affecting the jaw, where it started, how far it has spread and whether surgery can remove it completely.

Your healthcare team may include:

• Head and neck surgeons, such as oral and maxillofacial surgeons or ear, nose and throat surgeons.
• Medical oncologists, who use medicines to treat cancer.
• Radiation oncologists, who treat cancer with radiation therapy.
• Reconstructive surgeons, who rebuild areas affected by cancer surgery.

Your care team also considers how treatment may affect eating, speaking, swallowing and your appearance.

Surgery is an important treatment for both squamous cell carcinoma that involves the jaw and jaw sarcomas that affect the jawbone. Surgery may be combined with radiation therapy or chemotherapy depending on the stage of the cancer and the type of the cancer. Some people may receive other treatment as well.

Chemotherapy

Chemotherapy treats cancer with strong medicines. It may be part of treatment for some jaw cancers. Some advanced jaw cancers may be treated with both surgery and chemotherapy.

Radiation therapy

Radiation therapy treats cancer with powerful energy beams. It may be used after surgery for some jaw cancers that have a higher risk of coming back.

Radiation therapy isn't usually the main treatment for jaw cancers that can be completely removed by surgery. Radiation may be considered when surgery isn't possible. It also may be used when cancer cells are found at the edge of the tissue removed during surgery.

Surgery

The goal of surgery is to remove the cancer along with a small amount of cancer-free tissue around it. If no cancer cells are found at the edges of the removed tissue, this is called a clear margin. It also is called a negative margin. The amount of jawbone that needs to be removed depends on where the cancer is and how deeply it has grown into the bone.

Surgery in the lower jaw may include:

Marginal mandibulectomy. A marginal mandibulectomy may be used when cancer is close to the lower jaw but hasn't grown deeply into the bone itself. In this procedure, the surgeon removes part of the upper edge of the lower jawbone while keeping the jawbone connected. This allows the jaw to remain connected. Only a portion of the upper half of the lower jaw is removed.

Segmental mandibulectomy. The surgeon removes a section of the lower jaw from top to bottom. This may be needed when cancer has grown more deeply into the bone. Often that part of the jaw needs to be rebuilt.

To rebuild the jaw, the surgeon may use bone, soft tissue and blood vessels from another part of the body. The tissue is shaped to replace the part of the jaw that was removed. The blood vessels in the tissue are connected to blood vessels in the neck. This is called a free-flap or microvascular reconstruction.

Maxillectomy. This surgery removes part or all of the upper jawbone. Reconstruction is often needed afterward. Depending on how much tissue was removed, the surgeon may rebuild the area using tissue from another part of the body, implants or both.

If jaw cancer has spread to lymph nodes in the neck, surgery may include removing the lymph nodes. This is called a neck dissection.

Immunotherapy

Immunotherapy helps the immune system recognize and attack cancer. One type of immunotherapy uses medicines called checkpoint inhibitors. They may be considered as part of the treatment for mouth and jaw cancers.

Estudios clínicos

Explora los estudios de Mayo Clinic que ensayan nuevos tratamientos, intervenciones y pruebas para prevenir, detectar, tratar o controlar esta afección.