Tongue Cancer

Treatment

Tongue cancer treatment at Mayo Clinic depends on the patient's overall health, and type and stage of tongue cancer. Oral tongue cancer is typically treated with surgery, often followed by radiation therapy. Tongue base cancer is usually treated with a combination of chemotherapy and radiation therapy (chemoradiation), sometimes followed by surgery.

For late stage tongue cancer and cancer that originates deeper in the tongue, the risks of traditional surgery may outweigh the benefits. If surgical tumor removal will significantly compromise speech and swallowing, radiation therapy or chemoradiation may be recommended. Specialists from several medical areas work together to develop the most appropriate treatment plan for each patient.

Robotic surgery unit

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Surgery

Early stage cancers of the tongue can often be removed directly through the mouth using a laser or cautery surgical instrument. If the tumor extends deeply into the underlying muscle, the surgeon may remove the nearby lymph nodes in the neck. For larger tumors, Mayo Clinic surgeons use the latest tumor removal techniques to minimize the loss of function of the tongue and surrounding structures.

Traditional tongue cancer tumor removal surgery involves splitting the jawbone and accessing the tumor via an incision in the neck (neck dissection). The surgery can disfigure the face, damage surrounding organs, and disrupt speech and swallowing function. It also involves a lengthy recovery and rehabilitation period.

Mayo surgeons in Arizona, Florida and Minnesota typically use transoral (through the mouth) surgery whenever possible to remove oral tongue and base of tongue tumors. Accessing tumors this way greatly reduces injury to surrounding healthy tissue and shortens recovery time.

Mayo Clinic in Minnesota and Arizona offer transoral robotic surgery, a minimally invasive surgical technique to precisely extract tongue base tumors through the mouth while leaving facial bones intact. Mayo's head and neck surgeons modified the da Vinci Robotic Surgery System, previously used for other surgeries, to create a better treatment option for tongue cancer patients. Mayo Clinic is one of the few medical centers in the United States with extensive experience in using minimally invasive robotic surgery to treat tongue cancer.

A Mayo Clinic study found that robotic surgery for transoral tumor removal was a safe and effective treatment option for tongue base cancer. Advantages over traditional surgery include preserving normal organ structure and anatomy, a more rapid return of swallowing function and a shorter hospital stay, typically three to four days.

Radiation Therapy

Radiation therapy uses high-energy X-rays, electron beams or radioactive compounds to kill cancer cells. Radiation oncologists tailor each treatment session to protect nearby noncancerous tissue. Patients at Mayo Clinic have access to the most advanced systems for radiation treatment planning and delivery, including intensity-modulated radiation therapy (IMRT). IMRT helps minimize loss of function of the tongue and surrounding structures such as the salivary glands.

Chemotherapy

Medical oncologists administer chemotherapy to destroy cancer cells when tongue cancer has spread to lymph nodes or other organs in the body.

Reconstructive Surgery

When reconstructive surgery is necessary, experienced Mayo Clinic plastic and reconstructive surgeons, head and neck surgeons, and oral and maxillofacial surgeons work together to restore physical appearance and function to the tongue and surrounding organs.

Rehabilitation

After extensive surgery or radiation therapy, experienced Mayo specialists in dietetics, and speech, swallowing, physical and occupational therapists help patients regain speech and swallowing function. The Nicotine Dependence Center at Mayo Clinic in Florida and Minnesota helps patients who wish to stop using tobacco. Research has shown that individuals with a history of nicotine dependence are more likely to have tongue cancer.