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Treating tongue cancer

The main treatments for tongue cancer are surgery, radiotherapy and chemotherapy, either combined or on their own. Your treatment depends on how far your cancer has grown and whether it has spread (the stage). It also depends on which part of the tongue is affected.

Treating the oral tongue

The front two thirds of the tongue (oral tongue) are treated like a mouth cancer.

Early stage

Early cancer means your cancer is smaller than 4cm and is contained within the tongue.

The most common treatment is surgery to remove the affected area. You might also have surgery to remove lymph nodes in your neck.

Advanced stage

Advanced cancer means your cancer is larger than 4cm. Or it has grown outside the tongue, invading other tissues or lymph nodes. You are most likely to have a combination of all of these treatments:

  • surgery to remove the cancer from your tongue and the lymph nodes in your neck
  • reconstructive surgery
  • radiotherapy after surgery – this might be combined with chemotherapy (chemoradiotherapy)

You might have chemotherapy if your cancer has come back. Or if your cancer has spread into surrounding tissues or to other parts of the body.

Treating the back of the tongue

The back third of the tongue (base of the tongue) is treated like oropharyngeal cancer. Oropharyngeal cancer starts in the part of the throat just behind the mouth.

Early cancer

Early cancer means your cancer is smaller than 4cm and is contained within the tongue.

You might have either:

  • surgery to remove the cancer and some of the lymph nodes in your neck
  • radiotherapy to the throat and neck

You might need radiotherapy or chemoradiotherapy after surgery if your doctor thinks there is a high risk that your cancer will come back. Chemoradiotherapy means you have chemotherapy and radiotherapy together.

Advanced cancer

Advanced cancer means your cancer is larger than 4cm. Or it has grown outside the tongue, invading other tissues or lymph nodes.

You might have one of the following:

  • chemotherapy and radiotherapy together (chemoradiotherapy) to your throat and neck
  • surgery to remove part of the throat (including all or part of the tongue) and some of the lymph nodes in your neck, followed by radiotherapy or chemoradiotherapy
  • radiotherapy on its own

You might have radiotherapy, chemotherapy or surgery to control symptoms of advanced cancer.

Surgery

Your surgeon removes the cancer and an area (margin) of normal tissue around it. This helps to make sure that they have removed all the cancer. The operation is called a primary tumour resection. 

There are different types of primary tumour resection. It depends on the location of your cancer.  

You might only need a simple operation if the cancer is very small. This can be done using local anaesthetic or with laser surgery, and you don't need to stay overnight in hospital. 

For larger cancers, you might need a more complicated operation and stay in hospital for a while.  You might have an operation to remove part or all of your tongue (a glossectomy). This is quite a big operation. Your surgeon rebuilds (reconstructs) your tongue.

The surgeon usually removes the lymph nodes from one or both sides of your neck. This operation is called a neck dissection. It lowers the risk of your cancer coming back in the future.

Radiotherapy

Radiotherapy uses high energy waves similar to x-rays to kill cancer cells. You might have radiotherapy:

  • on its own as your main treatment or after surgery
  • combined with chemotherapy (chemoradiotherapy) as your main treatment or after surgery
  • to help relieve the symptoms of advanced tongue cancer

You have radiotherapy to the part of the tongue affected by cancer. And the doctor might also treat the lymph nodes in your neck.

You usually have radiotherapy treatment once a day for a few weeks.

Chemotherapy

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer.

You might have chemotherapy combined with radiotherapy (chemoradiotherapy). The chemotherapy helps the radiotherapy work better. You might have this:

  • after surgery if there is a high risk of your cancer coming back
  • as your main treatment

You usually have a PET-CT scan a few months after chemoradiotherapy. This is to check if your lymph nodes contain cancer. If there are signs of cancer, you usually have surgery to remove the lymph nodes.

Some people have chemotherapy to shrink the cancer before the main treatment, although this isn’t very common. This is called neo adjuvant treatment.

The most commonly used drug is cisplatin. You might have this with fluoracil (5FU). Some people have carboplatin instead of cispatin.

Targeted cancer drugs

Cetuximab ( Erbitux) is a type of targeted cancer drug called a monoclonal antibody. You might have cetuximab together with radiotherapy if you can't have chemotherapy for any reason. 

Nivolumab is a type of immunotherapy. This type of treatment stimulates the body’s immune system to fight cancer cells. You might be able to have nivolumab if your cancer has started to grow again within 6 months of stopping chemotherapy. To be able to have this, your doctor needs to make an individual application to a special fund called Cancer Drugs Fund.

Treatment side effects

All treatments have side effects. Some are temporary but some might be permanent.

Surgery to the tongue can cause problems with your speech, and changes in eating and drinking. These could be permanent changes for some people.

This can be very hard to cope with and you're likely to need a lot of support and help following your operation. Talk to your doctor or specialist nurse before your operation. You can ask them about how it will affect you. 

Radiotherapy to the head and neck area can cause several side effects including a dry, sore mouth and taste changes. 

Common chemotherapy side effects include:

  • feeling sick
  • loss of appetite
  • losing weight
  • feeling very tired
  • a lower resistance to infections
  • bleeding and bruising easily
Contact the doctor or nurse immediately if you have any signs of infection such as a temperature higher than 38C or generally feeling unwell. Infections can make you very unwell very quickly.

Finding other people with tongue cancer

Lots of people say it helps to talk to others who know what they're going through. If you're seeing a specialist in head and neck cancer, ask them if they can put you in touch with any other patients. That way, they might be nearby.

With rare cancers, it's hard to find people with the same condition. The Mouth Cancer Foundation website has an online support group that offers practical advice and support for people affected by cancers of the head and neck. Their website also provides information about tongue cancer.

Last reviewed: 
18 Jul 2018
  •  

    Head and Neck Cancer: United Kingdom National Multidisciplinary Guidelines
    The Journal of Laryngology & Otology, 2016

  • Cancer: Principles and Practice of Oncology (10th edition)
    VT DeVita, TS Lawrence, SA Rosenberg
    Lippincott, Williams and Wilkins, 2015

  • Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy
    Furness S (and others)
    Cochrane Database Systematic Review, 2011, Volume 4

  • Oropharyngeal cancer: United Kingdom National Multidisciplinary Guidelines
    H. Mehanna and others
    Journal of Larynology and Otology (2016) 130 S290 – 96

  • Oral cavity and lip cancer: United Kingdom National Multidisciplinary Guidelines
    C Kerawala and others
    Journal of Larynology and Otology (2016) 130 S83-89

  • Surgery in head and neck cancer management: United Kingdom National Multidisciplinary Guidelines
    JJ Homer
    Journal of Larynology and Otology (2016) 130 S68-70

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