Tongue cancer treatment

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Most tongue cancers are squamous cell carcinomas. A squamous cell is a kind of cell found on the inside and outside surfaces of the body, such as the tissue that makes up the skin's surface, the lining of the respiratory and digestive tracts, and the lining of hollow organs. A carcinoma simply refers to a cancer that begins in surface-tissue cells such as those described above.

Tongue cancers are also divided into two major types according to the two major anatomical parts of the tongue. The first is the oral tongue, the front part of the tongue, the part you can stick out, which amounts to about two-thirds of the tongue. These qualify as oral cavity cancers. The second is the base tongue, the other third, which begins further back in the mouth, past the tongue's taste buds. These quality as throat cancers.

Treatment for tongue cancer is dictated according to whether the cancer affects the oral tongue or the base tongue.

Oral tongue cancer treatment

Treatment for these tumors is generally an outpatient surgery to remove the primary tumor, performed by a head and neck surgeon. Radiation therapy is also sometimes used, but since surgery is quick it is often the preferred first-line treatment, since radiation therapy requires several weeks and is dose-limiting over time. In some cases, radiation or chemotherapy (generally using cisplatin and 5-Fluorouracil) may be used as adjuvant therapy prior to or following surgical resection of the primary tumor. In many cases, either surgery or radiation can be curative (although many additional factors influence this).

Base tongue cancer treatment

Because these tumors are not visible and tend not to cause any symptoms in early stages, they do not tend to be diagnosed until they have moved into advanced stages, creating the possibility that the tumor has metastasized, most likely into the lymph nodes in the neck. Radiation therapy is often the preferred first-line treatment of these tumors, in part because they are diagnosed at later stages and tend to be larger, making surgical resection more difficult.

Surgery: Techniques and risks

In both cases, surgery to remove these tumors comes with significant risks, namely that it can lead to facial disfigurement, or the impairment of either speech or one's ability to swallow or both. In base tongue cancers, a procedure called a neck dissection may be necessary, which involves an incision in the neck. A radical neck dissection includes the removal of the adjacent lymph nodes in the neck.

In the cases of large tongue tumors, a glossectomy is sometimes necessary. In this procedure, the tongue is removed. This is an extreme form of treatment, and generally considered to be the last line of defense against a tongue tumor because of the rather devastating after-effects of the procedure.

Sources

Mayo Clinic, Tongue cancer treatment
Cancer Research UK, Tongue cancer treatment

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