Minimally Invasive Oral Cancer Treatment

Minimally invasive sentinel lymph node biopsy for oral cancer.

At Henry Ford, we understand the concerns that patients have when they receive a diagnosis for head or neck cancer, and they are faced with treatment options. It can be difficult to know which treatment will be best for you personally and the type of oral cancer you are fighting.

For that reason, we are grateful to have the expertise and technology that enables us to offer our patients an individualized treatment called a sentinel lymph node biopsy. Henry Ford is one of the few — if not the first — medical centers in the State of Michigan to adopt this innovative and minimally invasive procedure. As a leader in the field, our surgeons, oncologists, pathologists, and radiologists are specially trained to use the procedure to detect the spread of oral cavity squamous cell cancer.

The sentinel lymph node biopsy can eliminate the need for extensive neck surgery. Patients experience less discomfort with a small incision, and they have fewer side effects. Also, their ability to cope with oral cancer is improved.

When patients are first diagnosed with oral cancer, about 15-25 percent of them have hidden microscopic cancer cells in the lymph nodes of the neck. The sentinel lymph node biopsy will help your doctors find any concealed cancer and determine the best treatment plan for you.

Depending on the patient, cancer cells can travel from the tumor site to lymph nodes following different paths and in different patterns. It will be important for your doctor to know which path any cancer cells have followed.

The sentinel lymph node biopsy procedure involves injecting into the tumor site a weak radioactive substance that marks white blood cells. The substance will act as a tracer, and it will be picked up by the lymph vessels. The tracer will travel along the path most likely used by any cancer cells draining from the mouth to lymph nodes in the neck. The first lymph node that the substance goes to is the sentinel lymph node, which acts as a guard. A scan will be done to find it and any other nodes containing the tracer.

In the operating room, your surgeon will remove the suspected lymph nodes and the oral cancer. Then your pathologist will immediately examine the cells under a microscope and determine if cancer is present in the nodes. If it is present, your surgeon will perform a standard surgical procedure — known as a full neck dissection — to remove the diseased lymph nodes.

There are several important benefits to having the sentinel lymph node biopsy. Compared to extensive surgery, removing only a few lymph nodes lowers the risk of lymphedema. This condition is a side effect that sometimes occurs when many lymph nodes have been removed. It causes fluid to buildup and may produce long-term swelling in the arms or legs.

Additionally, the biopsy can find any diseased lymph nodes in the lower neck and opposite side of the neck. Lymph nodes in these areas are not typically examined during traditional, extensive neck surgery. For patients who have cancer in the middle area of the head or neck, the sentinel lymph node biopsy can eliminate the need for surgery on both sides of the neck.

By using this personalized approach, your doctors at Henry Ford can improve the outcome of your cancer treatment and shorten your recovery time.