9. Quality of life

Oral cancer and its management are associated with tremendous physical, emotional and psychosocial disruption, as discussed in Article 8. This affects patients' ‘quality of life’ (QoL) and impacts not only on them but also their family, carers and others. Thus, while the aims of cancer treatment must ideally be to remove or destroy the tumour entirely, the outcome is a balance between positive results (eg survival; freedom from tumour) and adverse effects (eg psychological sequelae; treatment side-effects) (Figure 1). Survival rates are improving so more patients are having to live with the adverse effects of having cancer and its treatment.

Cure means there is no evidence of cancer following treatment, but since in some cases cancer recurs later, ‘remission’ is a more appropriate term. In some cases, treatment aims rather to control the cancer so that it progresses less rapidly. In other cases, where the cancer is far advanced or the patient has such co-morbidities that treatment is limited, it may be palliative, aiming to ease symptoms only – for example, reducing tumour size (debulking) to ease pain or difficulty swallowing.