Laser Ablation Surgery in Late Stage Buccal Cancer

Abstract

Oral cancer is a major health problem in India. The use of tobacco in various forms has escalated the problem to be the leading cause of cancer in males in India. Many patients postpone surgery for fear of facial mutilation and therefore present with Late stage Buccal Cancer. The management of Late stage buccal cancer has very few options. Conventional surgery, chemotherapy and radiation give very little relief to patients. The occurrence of inevitable recurrence after surgery due to Field cancerisation makes the surgery a futile exercise in controlling the spread of the tumor. The treatment in unresectable tumors which is given as palliation is often limited to pain control and bypassing of oral functions by inserting a nasogastric tube. The mortality rate has remained changed over last 10 years. Therefore Quality of life in these patients has become a discussion matter in most cancer forums. The main cause of the suffering of the patient is the bulk of the tumour. Intralesional Laser ablation offers an alternative way to destroy the bulk of the tumor. The reduction in tumor volume allows good restitution of oral function and pain. There were 49 patients observed in this study. Many patients went into remission after laser ablation and Chemotherapy. The ensuing results were analyzed taking into account Quality and Quantity of life and the resulting Quality index was applied on the patients. Most patients had a good Quality Index post-procedure. All patients were highly satisfied with the procedure. There was an enhanced benefit noted in the quality of life and the expected overall survival time of the patients. Conclusion: Laser Ablation offers an alternative treatment in late-stage Oral Cancer for palliation as well as remission.