[Music]

I'm Andrew Sykes, I'm a clinical oncologist. I work at The Christie Hospital in Manchester

and I specialise in treating head and neck cancers.

Oral cancers consist of a number of tumour sites, from the lips, the gums,

the inside surfaces of the cheeks, the hard palate, the tongue and an area behind the molars.

When oral cancer is diagnosed there are a number of treatment options that will be considered in any individual case.

And these could be surgery, or radiotherapy or drug treatment, which could be chemotherapy or various other drugs.

Chemotherapy is the use of drug treatment to treat cancers.

It's not usually given on its own, but most frequently in combination with surgery or radiotherapy.

There are a number of different chemotherapy drugs that we use,

mostly given by injection directly into the vein, but occasionally as tablets.

There is also a class of drugs called monoclonal antibodies

and these are new drugs that are targeted specifically against parts of the cancer cell

that are responsible for regulating growth of the cell.

Using these drugs we can disrupt that, and that causes the cell to die off.

Radiotherapy is also often used for oral cancers, either as a treatment in its own right,

or in combination with surgery after an operation, where there may be concerns about the completeness of the operation

Most radiotherapy is given by shining x-rays at the patient externally

but in some cases radioactive implants are actually put directly into small cancers

and this allows a very localised treatment directly to the cancer with a very high dose of radiotherapy.

Early detection of oral cancer is very important because small cancers can often be removed with simple laser treatment.

As cancers grow and become more advanced, removing the cancer may be quite straightforward

but it often leaves a hole that has to be repaired

The maxillofacial surgeons who will do this surgery will often take skin grafts from the forearm or from the leg,

to fill in the hole after the operation. And this is a very complicated surgery

that can often take six or twelve hours in some cases.

The problem with these grafts is that they fill the gap very nicely but they have no function of their own.

And particularly in the oral cancer setting it can be a difficult issue

when treatments might involve surgery on the tongue, the palate, the gums

that can affect functions such as speech and swallowing.

There are a number of services that all hospitals will offer to help with the after effects of surgery, the disfigurement,

the difficulty with function and these include speech therapists, dietitians, Macmillan nurses, and various support groups.

For people who are worried about disfigurement, for most cases it's not as big an issue as they would expect.

Certainly, this is something that surgeons are very aware of, they try to minimise the disfigurement

and it's something that they would be more than happy to discuss before any operation.

I think it's important to remember that for many people, if not most people who have had cancer, oral cancer,

after treatment they can get back to a normal, certainly very near normal life.

For information, help, or if you just want a chat,

call the Macmillan Support Line on 0808 808 00 00 or visit macmillan.org.uk