ABSTRACT
Treatment of oral cavity and oropharyngeal cancers can be broadly divided into therapies with curative or p alliative intent. Traditionally, the two categories have been considered distinct entities (Figure 8.1a); however, it is preferable to integrate these treatment objectives at all cancer stages. With progression of disease, the likelihood of success and cost-effectiveness of curative therapy diminishes and palliation and quality of life issues become increasingly important (Figure 8.1b). Palliative treatment options are discussed in detail in Chapter 18. Integration of the totality of treatment intentions is a concept that has not been paid attention to in the past. With advancing stage of the disease at presentation or with recurrent disease, the probability of cure diminishes and the need for addressing the issues pertaining to quality of life and symptomatic palliation becomes increasingly important. Thus, covering all bases at the outset allows smooth transition from curative, invasive and expensive therapies into cost-effective symptomatic care with control of pain, nutrition and overall optimization of quality of life and eventually quality of death. This approach allows delivery of value-based care, with optimal utilization of available resources.
