[Meaningful possibilities of palliative therapy of incurable mouth and pharyngeal neoplasms and their recurrence].

In incurable cancer of the mouth and oropharynx, reasonable palliative therapy should render the patient's remaining life-span worth living. The following problems impair tumor patient's well-being: 1. pain, 2. ingestive and respiratory difficulties, 3. aspect, 4. odor, 5. psychic trauma resulting from 3 and 4. Pain, either caused by the tumor itself or as a reaction to irradiation or inflammatory response, is of primary importance. Impairment of ingestion, respiration, and speech diminishes the quality of life. Disfigurement of the face or a penetrating odor may sometimes cause additional psychic stress. Besides palliative radio- and chemotherapy, in certain cases palliation can be obtained by surgery, which may reduce the size of a cosmetically disturbing tumor mass or create a clean wound surface easier to care for than a necrotic surface. Furthermore, painful neuralgic nerve branches may be severed. Severe lymphedema of the face and neck may be improved by lumbo-peritoneal shunt operation. Most recently, cryosurgery has won an established place in the management of these problems, although certain restrictions must be observed. Superficial recurrences can be treated without further mutilation of the patient. Painful areas of the tumor can be eradicated. Recurrences in the hypopharynx, which are accessible with difficulty only, can be treated with a cryosonde with little harm to an already impaired patient. Multiple tumor lesions can be iced at the same time. Among the reasonable palliative methods of treatment, synchronized irradiation and chemotherapy as well as implantation of solid radioactive substances must be mentioned.