Tongue Cancer

A complete remission of your tongue cancer is our primary goal at UChicago Medicine Comprehensive Cancer Center. But we know that preserving as much of your ability to taste, eat, speak and swallow is also vital.

To achieve both of these goals for our patients, our internationally esteemed head and neck cancer specialists believe in a team approach to tongue cancer that considers all possible treatments (surgery, radiation, chemotherapy and novel therapies). This means that all of our experienced cancer specialists—medical oncologists, radiation oncologists, head and neck surgical oncologists, speech pathologists and others—will be involved in your case, combining their deep expertise to determine how to best treat the cancer.

UChicago Medicine has been a leader in defining alternative approaches to successfully treat tongue cancer in many of our patients, even when the cancer is advanced. (Read about our results.) When possible, we try chemotherapy and radiation first and recommend surgery when absolutely necessary if the tumor does not respond to initial treatment.

Our survival rates for tongue cancers are among the best in the world. As a result, many of our patients are able to retain all or most of their tongues, as well as maintain their ability to eat, taste, speak and swallow. When surgery is recommended, our experienced head and neck surgeons aim to only remove as much of the tongue as necessary, to ensure they get all the cancer, while maintaining or restoring critical functions.

Tongue Cancer: Symptoms and Diagnosis

Tongue cancer is a type of mouth/oral cavity cancer that starts in the front two-thirds of the tongue, or the part that you can stick out of your mouth.

Alternatively, cancer at the back of the tongue (or tongue base) is considered a type of throat or oropharyngeal cancer.

Tongue cancer may be suspected when unexplained lumps, sores or red/white patches appear on the front two-thirds of the tongue. Other symptoms include ulcers that fail to heal and unexplained bleeding from the tongue.

Various tests may be used to diagnose tongue cancer, including a biopsy or removal of a small part of tongue tissue. Using a variety of laboratory tests, our highly experienced pathologists can pinpoint any genetic mutations associated with your specific cancer, which can help us identify the best treatment for you.

Tongue Cancer Treatment

Most/many medical centers use a surgery-first approach to tongue cancer, followed by chemotherapy and radiation. The surgeon(s) typically leads the treatment.

At UChicago Medicine, we believe in a team approach to tongue cancer that considers all possible treatments (surgery, radiation and drug therapy). This means that all of our experienced cancer specialists—medical oncologists, radiation oncologists, head and neck surgical oncologists, speech pathologists and others—will be involved in your case, combining their expertise to determine how to best treat it.

A Less-Is-More Approach

As a team, we will talk with you and your loved ones about your specific diagnosis and the risks associated with various treatments. We will tell you whether we think your tongue cancer will be better suited to either a surgical- or a nonsurgical-based approach.

With a nonsurgical approach, refined here at UChicago Medicine, this treatment involves first using a combination of systemic therapy—such as chemotherapy, immunotherapy or targeted therapies—in strategic combination with state-of-the-art radiation therapy. This approach often makes surgery unnecessary or reduces the amount of tongue tissue that needs to be removed.

When surgery is recommended, our experienced head and neck surgeons aim to only remove as much of the tongue as necessary to ensure they remove all the cancer. When beneficial, our expert reconstructive surgeons can reconstruct your tongue, to restore speech and swallowing function.

What Matters to You

We listen to what matters most to you. For instance, some patients may want to elect the surgery-first approach, while others may want to do everything possible to prevent the surgical removal of part or all of their tongue.

While we are experts in how to treat cancer, you are the expert of your own body and life.

Novel Treatments

At UChicago Medicine, we offer more clinical trials of new treatments for head and neck cancer than any other hospital in the Chicago area. At any one time, we often have 10 or more clinical trials recruiting patients at all stages and settings to test promising treatments and new treatment combinations.

Among the novel treatments available for tongue cancer are immunotherapies that help the body’s immune system attack cancer, and targeted drug therapies that block specific proteins that drive cancer growth. Advanced laboratory molecular testing of your tumor can sometimes help identify a targeted personalized therapy for your tumor.

Clinical trials can offer access to emerging and promising cancer therapies and combinations specifically for patients with head and neck cancer. These treatments may be especially helpful in patients who cannot tolerate or don’t respond well to chemotherapy, as well as to treat cancers with specific genetic markers.

Rehabilitation and Support Services for Tongue Cancer

At UChicago Medicine, our speech pathologists, nutritionists and other rehabilitation team members get involved in your care from the very beginning. This can help reduce treatment side effects. For instance, by evaluation of swallowing at the time of diagnosis, the speech pathologists take a proactive role to maintain the highest level of function and safety with individualized care plans. Early evaluation allows the speech pathologists to identify any potential speech and swallowing problems that you may develop during or after treatment, and provide ways to prevent or lessen these issues with the focus on function and quality of life.

In addition, our dedicated supportive oncology program provides a range of supportive care services to patients and their families, including mental health counseling, social work services and more.

If you smoke, it is important that you stop smoking during and after treatment for mouth cancer. UChicago Medicine’s No Smoker Left Behind program can provide you with the support you need to stop the habit.

For more on how UChicago Medicine treats tongue cancer, see mouth (oral cavity) cancers.

Chef Triumphs Over Tongue Cancer

Cancer specialists across the country told top chef Grant Achatz that his only option for treating a stage 4 tumor was to remove most of his tongue. The head and neck cancer team at UChicago Medicine offered him a different approach, one that saved his tongue and his life.

Video Transcript

[SOFT MUSIC PLAYING] I noticed a small, white dot on the side of my tongue. And they said, oh, you're young. You just had your first child. You're working 16 hours a day in a high stress environment. Eating and swallowing was very difficult. And it became very clear that there was something more sinister going on than just stress.

And in the beginning, I was met with a very antiquated approach. There was nothing creative going on. It seemed incredibly barbaric to me.

[MUSIC CONTINUES]

[MUSIC PLAYING]

I got a call from the team there and talked to them briefly on the phone, found the clinical trial, read about it, and said, this is exactly what I was looking for. And Grant said, no, I'm done. Like, we made that decision. It was a very difficult decision. And I'm done. And I said, like, one more.

And we sat in a room with Dr. Vokes and Dr. Haraf, Dr. Blair. And first of all, I was surprised because I had been to about four major institutions prior to going to the University of Chicago. And I only met with one doctor each time. And here we were in this room with a team, with three doctors-- each in their own specialty, but clearly working together.

I still don't understand how surgeons say, the only anything we can do is cut your tongue out. We have to cut your tongue out. First step, cut your tongue out. And I go, why should that be the first step? Why should you sacrifice that important organ-- not only for Grant, who was a chef and needs it for his culinary abilities, but for an average guy that wants to talk or kiss his wife.

And so at no point here do we rule out surgery. We have brilliant surgeons. But it is not what we want to do first. And so what we already had experience with at the time was to start out with chemotherapy to try and tame this tumor-- to take the inflammation down, to take the size down-- and then go in with chemotherapy and radiation.

And so we were concerned at the time that even though we gave the patient chemo and radiation therapy, if it came back in a lymph node, or maybe it was like 90% gone in the lymph node, if it regrew, it would be much harder to treat.

[MUSIC CONTINUES]

[VOCALIZING]

Years and years and years later, it really helped me become a better chef, engendering the spirit of teamwork, allowing us to grow, take wonderful ideas from other members of the team and implement them into our programs. So really, that individualistic approach-- it never gets you far. You have to work as a team in order to succeed. And, again, it's the same in the restaurant. I feel strongly it's the same in the medical profession.

Oh, I think the reentry into normalcy takes a long time. It's a very mentally challenging experience to go through. But I mean, he's got tons of advocates. And it's been great.

[VOCALIZING]

There was a lot of, obviously, anxiety about, not only was I going to live or die, but was I going to be able to continue my life's passion? And now all of that's dispelled. I've been doing what I love to do for 12 years since treatment. And I think the restaurant, me as a person, me as a chef, are better than ever.

Inspired by a famous chef's treatment journey, woman seeks care for advanced tongue cancer at UChicago Medicine

When another hospital told Pat Sirvinskas she'd have to lose her tongue to cancer, she got a second opinion at the University of Chicago Medicine Comprehensive Cancer Center. Our head and neck cancer team treated her complex case and saved her tongue.

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Surgeon Nishant Agrawal, MD, and medical oncologist, Everett Vokes, MD

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UChicago Medicine head & neck cancer experts are actively conducting clinical trials of new and promising treatments.

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Supportive oncology team, including Chris Daugherty, MD

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