Treatments for tongue cancer and oral cancer vary depending on the stage of the disease at the time of diagnosis. Surgery, chemotherapy, and radiation therapy are all used to treat mouth cancers.

Mouth and tongue cancers are staged according to the TNM system, which measures tumor size (T), lymph node involvement (N), and metastasis (M). The higher the stage of oral cancer, the worse the prognosis. Localized oral cancer has a five-year survival rate of 82 percent. If mouth or tongue cancer spreads within the oral region, survival rates drop to 46 percent. Once oral cancer metastasizes to distant organs, survival drops to 21 percent.

Stage I: (T1N0M0). The oral tumor is smaller than two centimeters.

Stage II: (T2N0M0). The mouth tumor or tongue tumor is larger than two centimeters, but smaller than four.

Stage III: (T3N0M0, T1N1M0, T2N1M0, or T3N1M0). Oral tumors are at least two centimeters in size. Those labeled T3 are greater than 4 centimeters in size. Some lymph node involvement may be present (NO or N1).

Stage IVA: (T4N0M0, T4N1M0, or any T with N2M0). Any size mouth or tongue tumor. T4 denotes invasion of nearby organs. Multiple lymph node involvement, or a single large lymph node (three to six centimeters).

Stage IVB: (Any T with N3M0). Any size oral tumor, with lymph nodes reaching over six centimeters in size.

Stage IVC: (Any T, any N, M1). Oral cancer has spread to distant organs.

Surgical removal of a mouth tumor or tongue tumor is the most common oral cancer treatment. When possible, the entire tumor is removed. Should the mass prove too large, or if tumor removal will damage too much of the surrounding area, the surgeon removes as much of the tumor as possible. Surgical treatment of mouth and tongue cancer aims to conserve the maximum amount of the oral cavity.

Radiation therapy is often used in combination with oral cancer surgery. Radiation can be used prior to surgery to shrink tumors to surgically manageable sizes. Radiation can also be used after surgery to kill remaining mouth cancer cells.

External radiation directs radiation through the skin to target the cancer. Brachytherapy, or internal radiation, surgically implants radiation "seeds" next to the tumor. The seeds deliver radiation directly to the mouth or tongue cancer and limit exposure to non-cancerous tissue.

Chemotherapy is also used to treat oral cancer. Chemotherapy drugs are systemic: they affect the entire body. Chemotherapy drugs destroy metastastic cancer cells and reduce symptoms. Chemotherapy is used as a follow-up to surgery, or as palliative care for oral cancer.

Chemotherapy also kills healthy cells, causing a number of unwanted side effects. However, the benefits of chemotherapy often outweigh potential complications.

Surgical changes to the oral cavity may cause difficulty speaking or swallowing. If the salivary glands are damaged, dry mouth can occur. Speech pathologists treat speaking or swallowing problems, and reconstructive surgery may help in some cases.

A dietician can recommend easy-to-swallow foods for dry mouth. If dry mouth is severe, doctors may prescribe a saliva substitute. Learn more about dry mouth treatments.

Resources

 

American Cancer Society. (nd).What happens after treatment? Speech and swallowing therapy. Retrieved September 12, 2003, from
www.cancer.org/docroot/CRI/content/CRI_2_4_5X_What_

happens_ after_treatment_60.asp?sitearea=&level=.

Neville, B., Day, T. (2002). Oral cancer and precancerous lesions. CA: A Cancer Journal for Clinicians 52, 195-215.