Tongue Base Cancer

Treatment

Treatment for tongue base cancer at Mayo Clinic depends on the patient's overall health and the extent of the disease. Most commonly the cancer develops from squamous cells on the surface of the tongue. Infrequently, pathologists determine the condition to arise from the minor salivary glands or lymph tissue.

For many stages of squamous cell carcinoma, or other forms of tongue base cancer that originate deeper in the tongue, the risks of surgery may outweigh the benefits. In these cases radiation therapy or chemoradiation therapy may be considered. The exception is if the cancer can be treated with transoral laser microsurgery.

Surgery

Early cancers of the tongue base can often be removed using a laser or cautery instrument working directly through the mouth. The hospitalization is short and function of the tongue is excellent. For most larger tongue base cancers, new surgical approaches to the tongue base permit removal of any involved lymph nodes and the tongue cancer through a single neck incision. For very large tumors for which surgical removal would significantly compromise speech and swallowing, radiation and chemotherapy are used. In most cases of obvious spread to the neck lymph nodes after chemoradiation, surgical removal of the involved lymph nodes is still necessary. This procedure is called a neck dissection. Surgeons at Mayo Clinic use the latest surgical techniques to preserve appearance and function of the neck and shoulder.

Radiation Therapy

Radiation therapy uses high-energy X-rays, electron beams or radioactive isotopes to kill cancer cells. Radiation oncologists tailor each treatment to protect nearby normal tissue. At Mayo Clinic, patients have access to the most advanced systems for treatment planning and delivery including intensity modulated radiation therapy (IMRT).

IMRT uses digital diagnostic imaging, computers and specialized software to conform hundreds of small radiation beams to the shape of the tumor. This produces precise dosage distributions that protect nearby normal tissue. IMRT helps to minimize the loss of function of the tongue and normal surrounding structures such as the salivary glands.

Patients with tongue base cancer can also receive brachytherapy. Brachytherapy is a form of radiotherapy in which specialists place the source of irradiation close to the tumor. In the case of tongue base cancer, radioactive material may be placed directly into body tissue using hollow needles (interstitial). Brachytherapy may be used in addition to external beam radiation therapy.

Chemotherapy

In the case of tongue base cancer, oncologists administer chemotherapy for large cancers and/or when the cancer has spread to many lymph nodes or other organs in the body. Chemotherapy uses drugs to destroy cancer cells. Medical oncologists administer chemotherapy orally or through the patient's veins. For tongue base cancer, physicians typically use chemotherapy in conjunction with radiation therapy. If the cancer has metastasized (spread) to distant parts of the body, chemotherapy alone might be thought to help control the cancer.

Rehabilitation

Care providers specializing in speech therapy, swallowing therapy, dietetics, physical therapy and occupational therapy help patients with any rehabilitation needed after radiation therapy. The Nicotine Dependence Center at Mayo Clinic can help patients who want to discontinue tobacco use.