Cancer of the Base of Tongue

base of tongueThe most common type of cancer of the tongue is called Squamous Cell Carcinoma. There are other types of cancers of the tongue but they are statistically less common.

The tongue is actually divided into 2 separate anatomical areas, the oral tongue is the part you can “stick out” at somebody and extends backward to a V-shaped group of lumps on the back of the tongue which are actually specialized taste buds. The base of tongue is behind these. The oral tongue and the base of the tongue comprise the whole tongue but it is important to know that they develop from different embryonic tissue and really are somewhat dissimilar. Most importantly, this explains why the treatment for squamous cell carcinoma for the oral tongue is usually quite different from the treatment for squamous cell carcinoma of the base of tongue.

The tumor for this kind of cancer is often difficult to see in the early stages, so it is usually diagnosed when it is larger and the cancer has progressed. There are few symptoms in the early stages. But in the later stages, the cancer may cause pain, a sense of fullness/thickness in the throat, difficulty swallowing, the feeling of a lump in the neck or throat, and ear pain or voice changes. The treatment options for Base of Tongue cancer can include surgery, chemotherapy, hyperthermia and radiation therapy. Research has shown that patients can benefit by adding hyperthermia to radiation therapy and/or chemotherapy for the treatment of base of tongue cancer. One randomized clinical study has shown that the combination of hyperthermia and radiation therapy improves complete response rate by 42% over radiation therapy alone.(3)

Hyperthermia, or Thermal Therapy, is a local, non-invasive gentle treatment, raising tumor temperature to approximately 108 degrees Fahrenheit, a temperature similar to high fever. The heat itself kills many cancer cells since many of them are stressed cells for reasons such as poorly structured blood vessels. Without proper blood flow, oxygen and nutrients to the tumor are restricted. Heat also helps to expose the tumor antigens (a substance that induces an immune response) so an effective immune response can be mounted by the immune system of the body. Research has shown that patients can benefit by adding hyperthermia to radiation therapy and/or chemotherapy for the treatment of base of tongue cancer.

During local hyperthermia treatments, a device, called a surface applicator, is applied to the region of the tumor. The area is heated to a temperature of 43 degrees C, or 109 degrees F, for about an hour. Hyperthermia is performed within an hour of radiation therapy or chemotherapy.

Comparison of the results of Radiotherapy(RT) versus radiotherapy plus hyperthermia (HT+RT) in randomized trials from Western Research Groups.

(3) Int J Radiat Oncol Biol Phys 15, 959-972, 1988.

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