commando surgery for oral cancer
Commando surgery, also known as mandibulotomy with neck dissection, is a type of surgery used to treat oral cancer. It involves the removal of a tumor from the mouth and surrounding tissues, which can include the tongue, jaw (mandible), soft tissue, or lymph nodes. This surgery is typically done when the cancer is locally advanced and needs a more extensive approach.
Head and neck cancer symptoms
Head and neck cancer symptoms may include a lump in the neck or a sore in the mouth or the throat that does not heal and may be painful, a sore throat that does not go away, difficulty in swallowing, and a change or hoarseness in the voice. Symptoms of cancers in specific areas of the head and neck include:
- Oral cavity – A white or red patch on the gums, the tongue, or the lining of the mouth; a growth or swelling of the jaw that causes dentures to fit poorly or become uncomfortable; and unusual bleeding or pain in the mouth.
- Throat – Pain when swallowing; pain in the neck or the throat that does not go away; pain or ringing in the ears; or trouble hearing.
You might need commando surgery if: • You have advanced oral cancer that has spread to nearby structures (e.g., the jaw, neck, or lymph nodes). • The tumor is too large to be removed using less invasive techniques. • Your doctor determines that removing a portion of the jaw or other tissues will provide the best chance of curing the cancer and preventing it from returning.
Commando surgery typically involves: • Removing the tumor from the oral cavity, which may include parts of the tongue, gums, jaw (mandible), or other affected areas. • Neck dissection: Removal of lymph nodes in the neck to check if the cancer has spread. • Reconstruction: After the tumor and tissues are removed, your surgeon will often reconstruct the area using grafts or flaps (from your skin, muscle, or bone) to restore the appearance and function of the mouth. The surgery is performed under general anaesthesia, and it can take several hours depending on the extent of the cancer.
As with any surgery, commando surgery carries certain risks, including: • Infection at the surgical site • Bleeding • Damage to nearby nerves, which could affect your ability to speak, swallow, or move parts of your mouth or tongue • Difficulty swallowing (dysphagia) or eating • Changes in appearance due to the removal of tissue (which may require reconstructive surgery) • Speech difficulties if portions of the tongue or jaw are removed • Numbness or tingling in the mouth, face, or neck due to nerve damage
The hospital stay after commando surgery can range from 5 to 10 days, depending on the complexity of the surgery and your recovery. Some patients may need additional days for monitoring, especially if econstruction was necessary.
• Immediate recovery: After surgery, you will be monitored closely in the hospital for any complications, such as infection or bleeding. • Pain management: Pain is common after commando surgery, but your healthcare team will provide medications to help manage it. • Rehabilitation: You may need speech therapy, swallowing therapy, and physical therapy if part of your tongue, jaw, or neck was affected. • Diet modifications: You might need to follow a liquid or soft food diet for several weeks while you heal. • Follow-up care: Regular check-ups are essential to monitor for signs of cancer recurrence and to evaluate your functional recovery (speaking, eating, etc.).
Reconstructive surgery is often part of the commando procedure if a significant amount of tissue (like parts of the jaw or tongue) is removed. Reconstruction can help restore your appearance and functionality, such as the ability to speak or eat. This can be done through: • Flap surgery: Using tissue from another part of your body (like the arm, leg, or abdomen) to reconstruct the mouth or jaw. • Bone grafts: To rebuild parts of the jaw if necessary. • Dental implants or prosthetics to replace lost teeth or restore mouth function.
The recovery time can vary depending on the extent of the surgery and individual healing rates. Typically: • Initial recovery: 4-6 weeks for healing of the surgical site. • Full functional recovery (ability to speak, eat, swallow normally): Several months. In some cases, full recovery may take up to a year, especially if reconstructive surgery is involved. • Speech and swallowing rehabilitation: Most patients require 3-6 months of therapy to regain normal function.
After commando surgery, you may experience temporary or permanent changes in your ability to speak or eat, especially if parts of your tongue, jaw, or throat are removed. However, many patients undergo speech therapy and swallowing therapy to help regain function. • Speaking: If part of your tongue or voice box is affected, speech therapy can help you learn new ways to communicate. • Eating: You might need to adjust to a soft food or liquid diet initially. Over time, you may be able to return to a normal diet, but some patients may require long-term adjustments depending on the extent of the surgery.
Preparation may include: • Preoperative tests such as imaging (CT scans, MRIs) or biopsies to evaluate the cancer and plan for surgery. • Dietary adjustments: You may need to start a special diet before surgery to ensure proper nutrition. • Quit smoking and avoid alcohol: These can interfere with healing and increase the risk of complications. • Support: Arrange for someone to help you at home during the early stages of recovery.
The long-term outlook after commando surgery depends on: • The stage of cancer at the time of surgery (whether it has spread to nearby lymph nodes or other parts of the body). • The success of the surgery in removing the tumor completely. • Whether you require additional treatments (e.g., radiation, chemotherapy) to prevent cancer recurrence. For many patients, commando surgery offers a high chance of survival, especially if the cancer is detected early and is localized to the mouth or neck.
The emotional impact of oral cancer and its treatment can be significant. It is normal to feel anxious, depressed, or frustrated during recovery. Consider: • Counseling or therapy to help cope with emotional and psychological challenges. • Support groups for people undergoing similar experiences. • Talk to your healthcare team: They can refer you to mental health professionals who specialize in cancer care.