Base of Tongue Cancer

UT Southwestern Medical Center’s head and neck cancer experts have the experience and training to treat complex cancers such as those affecting the base of the tongue. We offer exceptional care and supportive services to guide patients and their families from diagnosis through the treatment journey.

As the only National Cancer Institute (NCI)-designated comprehensive cancer center in North Texas, we deliver the best cancer care available today and make it our mission to discover new treatments. NCI designation means we offer patients the ability to participate in the broadest possible range of clinical trials, with access to potential therapies not available at other facilities.

Advanced Care for Base of Tongue Cancer

The back third of the tongue, which starts in the throat, is known as the base of the tongue. It is part of the oropharynx, which also includes the tonsils, the walls of the throat, and the soft palate (back part of the roof of the mouth). Cancer that develops in the base of the tongue is a type of head and neck cancer.

Almost all cancers in the base of the tongue are squamous cell carcinomas, which form in the thin, flat cells that line the larynx. Squamous cells also make up the top layer of skin and other body parts such as the lungs and esophagus.

 Our highly trained surgeons, doctors, nurses, and other providers at the Harold C. Simmons Comprehensive Cancer Center specialize in treating cancers of the head and neck. Our team for base of the tongue cancer includes otolaryngologists (ear, nose, and throat specialists), radiation and medical oncologists, oral and reconstructive surgeons, physical and occupational therapists, and speech pathologists.

Causes and Risk Factors of Base of Tongue Cancer

The exact causes of cancers affecting the base of the tongue are not fully known. However, not everyone with risk factors will develop this type of cancer, and people who don’t have risk factors can develop the disease. Risk factors include:

• Infection with human papillomavirus, a sexually transmitted virus
  
• Tobacco use
  
• Heavy alcohol use
  
• Use of betel nuts, which are commonly chewed as a stimulant by people in Asia

Patients can help prevent some types of cancer by avoiding certain risk factors. Learn more about head and neck cancer awareness and prevention.

Symptoms of Base of Tongue Cancer

Some symptoms can occur with other conditions, and some people do not experience any symptoms. Patients should see their doctors if they experience any of these symptoms and they don’t go away:

• Difficulty moving the tongue
• Ear pain
• Difficulty swallowing
• Sore throat that does not go away
• White or red patches on the tongue or lining of the mouth
• Lump in the back of the mouth, throat, or neck
• Pain or sores in the mouth that don’t go away
• Changes in the voice, such as hoarseness
• Sensation of fullness in the throat

Diagnosis of Base of Tongue Cancer

At UT Southwestern, our cancer experts conduct a thorough evaluation, which includes a:

• Physical exam
• Discussion of personal and family medical history
• Discussion of symptoms and risk factors

 To confirm a diagnosis, our doctors might recommend one or more tests, such as:

• Laryngoscopy: We sometimes use a laryngoscope (a thin, flexible tube with a lighted camera), which is inserted through the nose or mouth for a closer look into the throat at the base of the tongue. During the same procedure, we can use the scope to take tissue samples from any suspicious areas, if needed.
  
• Barium swallow: The patient swallows liquid barium, a substance that shows up on X-rays, and then X-rays are taken. Barium swallows can show abnormalities in the throat and evaluate swallowing.
  
• Computed tomography (CT) scan: CT uses specialized X-rays with or without a contrast agent to produce cross-sectional, 3D images of the mouth and throat.
  
• Magnetic resonance imaging (MRI) scan: MRI uses radio waves and a strong magnet, with or without a contrast agent, to produce detailed images of the mouth and throat. MRI can also show whether cancer has spread to lymph nodes in the neck.
  
• Positron emission tomography (PET) scan: Using small amounts of radioactive materials and a special camera, PET scans produce highly detailed images that can detect cancerous cells.
  
• Biopsy: Our doctors take a small tissue sample using a needle or a small brush to collect cells from a suspicious area. A pathologist analyzes the cells under a microscope to check for HPV infection and signs of cancer.
  

Treatment for Base of Tongue Cancer

Treatment options vary based on the stage of cancer, which includes its size, location, and whether it has spread. Whenever possible, we develop a plan that preserves the patient’s ability to breathe, talk, and eat normally. The most common treatments for cancer of the base of the tongue are surgery and radiation therapy.

Our treatment options for this type of cancer include the following, sometimes in combination:

Surgery: Depending on the extent of the cancer, we can often remove tumors through the mouth (transoral), while other tumors require open surgery (using an incision). Surgical options include:

• Glossectomy to remove part or all of the tongue, which then requires reconstructive surgery and rehabilitation to regain the ability to speak and swallow
  
• Laryngectomy to remove the larynx (voice box) if cancer has spread to it, which also involves surgery to create a stoma (hole) for breathing
  
• Neck dissection to remove one or more lymph nodes or other tissues in the neck, if cancer has spread there
  

Radiation therapy: Our doctors often use radiation, treatment with high-energy waves such as X-rays, to destroy cancer cells left after surgery. Radiation therapy can also treat inoperable tumors.

• Chemotherapy: Anticancer medications work to destroy cancer cells and prevent them from spreading. We sometimes use chemotherapy before or during radiation therapy and/or surgery to destroy as many cancer cells as possible.
  
• Chemoradiation: Chemotherapy given at the same time as radiation therapy is known as chemoradiation.
  

Reconstructive surgery: Patients with advanced cancer might need reconstruction after cancer surgery to rebuild the tongue. Our plastic surgery and ENT experts work together to restore swallowing, speaking, and other oral functions for a more natural appearance of the throat and neck.

For patients who are having radiation therapy for cancer in the base of the tongue, we recommend having any necessary dental work done before treatment. Radiation treatment slows healing and can cause other side effects. Learn more about cancer and transplant dental care.

At UT Southwestern’s Harold C. Simmons Comprehensive Cancer Center, patients have access to every available treatment option, delivered by the most experienced head and neck cancer specialists in Dallas. Find out more about all the options we offer for head and neck cancer treatment.

Support Services

We offer a variety of head and neck cancer support services for patients and their families, such as:

• Oncology rehabilitation
• Integrative therapies
• Nutrition counseling
• Support groups

Clinical Trials

As a medical research institution, UT Southwestern frequently conducts head and neck cancer clinical trials, giving our patients access to the newest treatments. Patients should speak with their doctors about the availability of clinical trials.