Squamous Cell Cancer of the base of tongue
Like the oral tongue, the base of tongue (or posterior 1/3) can also grow several types of cancers, but again, squamous cell carcinoma is the most common and we will direct our comments with that in mind.Unlike oral tongue cancers, base of tongue squamous cell cancer is usually larger when diagnosed because in the early stages it can not be seen and it creates few, if any, symptoms. Later however, base of tongue cancer may create pain, a sense of fullness, changes in what the voice sounds like, and perhaps even some difficulty in swallowing. Also, because the diagnosis often comes a bit later, a greater number of patients with this disease will already have neck metastasis, that is, cancer cells in the lymph nodes of the neck, by the time they are seen by the Head and Neck Surgeon.
While it may technically feasible to surgically remove some base of tongue cancers, it is our opinion that most can and should be treated by radiotherapy. These tumors are arguably more sensitive to radiation treatment than some other cancers. Certainly, there are exceptions to this. Radiation therapy can also be used to control the cancer in the neck nodes as long as it is not too advanced. Interestingly, in those cases, we will sometimes remove massive neck node disease before starting radiation therapy when we know that x-ray therapy alone would not be successful in controlling the neck disease.
The prognosis after treatment of base of tongue cancer will vary from patient to patient as with any type of malignant disease. It has been our experience that the cure rate is good, but not quite as good as for early detected oral tongue cancer. The fact that base of tongue cancers are usually larger at the time of diagnosis probably is a significant contributing factor to this disparity. Very large base of tongue cancer may require a combination of surgery and radiation
