David I. Rosenthal
Last Modified: November 1, 2001
Dear OncoLink "Ask the Experts,"
My husband was told he has carcinoma of the tongue. Are there any articles on current treatment? He had chemotherapy for lg/small cell non-Hodgkin's lymphoma in 1998-1999. Will this affect any future treatment options?
David I. Rosenthal, MD, Director for Head and Neck Radiation Oncology at the Abramson Cancer Center of the University of Pennsylvania.
Treatment of tongue cancer depends on whether it involves the oral or base of tongue (BOT). The oral tongue is the part you see while the base of the tongue is at the back of the mouth and attaches in the neck. Tongue cancers can be treated with surgery, radiation therapy, or with a combined approach. Oral tongue cancers can be treated with radiation (either x-rays or a temporary radiation implant), or surgery combined with radiation. At most centers in the USA, initial surgery is preferred because of better control, and side-effect considerations. For BOT cancer, if surgery can lead to complete resection and leave adequate swallowing function, it is an option. For many patients, treatment with combined radiation therapy and chemotherapy is preferred to preserve swallowing function.
We have performed a phase II BOT cancer study (not yet published in final form), but as preliminary report last year in Am J Clin Oncol 2000 Oct; 23(5): 509-15 with excellent results for many patients. Previous cancers and treatment effects may affect a patients ability to undergo some or any of these treatments, and must be decided on a case-by-case basis by the Head & Neck cancer team. Because of complex issues involved in treating a second cancer, you may want to consider an evaluation at a cancer center that has a Head and Neck cancer evaluation center with multiple specialists involved. This would include surgeons, radiation oncologists, and medical oncologists.