The front two-thirds of the tongue that you can "stick-out" is called the oral tongue. It extends backwards and forms a V-shape as it meets the base of the tongue.

The base is the back one-third of the tongue that extends down towards the throat.

Surgical removal of the primary tumor might be the only treatment needed for small oral tongue cancers. If the tumor is large, it may have spread to lymph nodes in the neck. When this occurs the surgeon may recommend removal of the affected lymph nodes in the neck (called a neck dissection).

Most small cancers of the oral tongue leave little cosmetic or functional changes after they are removed.

Larger tumors can spread and cause swallowing difficulties. Surgery for large tumors also affects speech and swallowing. With the latest reconstuctive techniques, our doctors are able to restore most speech and swallowing problems.

Tumors on the base of the tongue are usually larger when diagnosed because in the early stages the tumor is difficult to see. The only early symptom is ear pain. Voice changes and difficult swallowing occur later.

Because it is diagnosed later, the cancer may have already spread to the neck. A neck dissection is frequently needed to remove the affected lymph nodes.

Treatment options include surgery and radiation. Some lesions may be treated with a combination of surgery, radiation and chemotherapy.

Radiation therapy may be prescribed before surgery, after surgery, or sometimes as the only treatment. Radiation uses high-energy X-rays, electron beams, or radioactive isotopes to destroy cancer cells.

IMRT uses a computer to help calculate the precise dose of radiation needed for the tumor. This minimizes radiation exposure to the surrounding normal tissue. IMRT uses a more effective radiation dose with fewer side effects than conventional radiotherapy techniques.

Radiation therapy, including IMRT, stops cancer cells from dividing. The dose of radiation is calculated to damage only the rapidly dividing cancer cells. It causes only minimal damage to the normal tissues in the path of the radiation beam.

Radiation therapy involves 5-6 weeks of daily treatments.

Although chemotherapy alone will not cure this type of cancer, it helps control growth of the tumor when used in combination with surgery or radiation therapy.

Chemotherapy is prescribed in different ways:

• Together with radiation as an alternative to surgery (called chemoradiation).
• After surgery to decrease the risk of the cancer returning.
• To slow the growth of a tumor and control symptoms if the cancer cannot be cured (palliative treatment).