Tongue cancer is a type of head and neck cancer. Cancers affecting the head and neck are not common. People with this type of cancer are usually treated in specialist centres by a team of healthcare professionals.
Your treatment depends on the stage of the cancer and whether the front or back of the tongue is affected. Treatment also depends on your general health. Your specialist doctor or nurse will explain the best treatment for you and the likely side effects.
The aim is to treat the cancer, while doing as little damage as possible to the tongue and throat. Your doctors also try not to change your appearance if possible.
You may have one or a combination of treatments. If you have a small, early-stage cancer, you may be treated with surgery or radiotherapy alone.
If the cancer is bigger or has spread to the lymph nodes, you may have a combination of surgery and radiotherapy. You may also have chemotherapy. Some people have chemotherapy and radiotherapy given together. This is called chemoradiation.
Surgery may be used to remove early-stage tongue cancer. Sometimes laser surgery might be used on small cancers. This type of surgery uses a laser light to destroy the cancer. Depending on where the cancer is on the tongue, surgery may also be used to treat more advanced cancers.
If the cancer is large and started on the front part of the tongue, you may need an operation to remove part or all of the tongue. This is called a partial glossectomy or total glossectomy.
You may also need reconstructive surgery. This is when the surgeon uses tissue, skin or bone from somewhere else in the body to rebuild parts they have removed. This can be very difficult to cope with, but you will have support before and after your operation.
The surgeon may also remove some lymph nodes from the neck. They do this through a cut in the neck. This is called a neck dissection. There are different types of neck dissection. If you need to have this, your doctor will explain what they will do in your situation.
Radiotherapy uses high-energy rays to destroy the cancer cells, while doing as little harm as possible to normal cells. Radiotherapy may be the only treatment used for some tongue cancers. It may also be used to reduce the chance of the cancer coming back after surgery.
You may have radiotherapy or radiotherapy with chemotherapy (chemoradiation) if the cancer started on the back or base of the tongue (oropharynx).
Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. You may have chemotherapy with radiotherapy (chemoradiation) instead of surgery. Chemotherapy is also sometimes given after surgery to reduce the risk of the cancer coming back. Or you may have chemotherapy if the cancer has spread to other parts of the body or the cancer has come back in the head or neck.
You may have a single chemotherapy drug or a combination of different ones.
Chemoradiation is when you have chemotherapy and radiotherapy together. Chemotherapy can make the cancer cells more sensitive to radiotherapy treatment. Cisplatin is the most common chemotherapy drug that is used with radiotherapy. It is given into a vein (intravenously).
Chemoradiation may be used
- to reduce the chance of tongue cancer coming back after surgery.
- instead of surgery
- if the cancer started on the back or base of the tongue (oropharynx).
Having chemoradiation is more effective than having chemotherapy or radiotherapy alone, but it can cause more severe side effects. It is important that you are well enough to cope with the side effects of having both treatments together.
We have more information about side effects of radiotherapy for head and neck cancer.
Targeted therapy drugs work by targeting something in or around the cancer cell that is helping it grow and survive. They may only be available in some situations to treat tongue cancer. Some people may be given them as part of a clinical trial.
If a drug is not available on the NHS, there may be different ways you are still able to have it. Your cancer doctor can give you advice.