Dr. Amit Chakraborty

Dr. Amit Chakraborty

Head & Neck Cancer Specialist
 MS, MCh – Surgical Oncology

Blogs | 20 February 2023

Is Removal of The Tongue Necessary For Tongue Cancer?

Tongue cancer is a type of oral cancer, in which any part of the tongue gets affected.

On the tongue, cancer may grow to involve its different parts Tongue cancer affects the anterior part of the tongue, while oropharyngeal cancer affects the rear of the tongue.

This Blog is about Is removal of the tongue necessary for tongue cancer?<br />

Your prognosis and therapy are influenced by the sort of part of tongue involved by  cancer. Depending on the part of tongue involved; it’s excision is guided by it.

Only 5 to 10% of the tongue is necessary to be removed in early-stage tongue cancer, 20 to 30 percent of the tongue may be removed in stage two if needed  & in late stages near complete removal of the tongue.

Stages of tongue cancer

Most cancer types are divided into stages based on  how much portion of tongue is affected and if it has spread  to other places of the body or metastasized.

Letters and numbers are used in the categorization system. The sign T denotes a tumor size, whereas the letter N represents number of lymph nodes in the neck. These letters are graded on 1–4 or 0–3.

People with a T1 tumor have the early stage, while those with a T4 tumor have the advanced stage.

The N0 categorization means that the tongue cancer hasn’t progressed to any lymph nodes in the neck. An N3 classification is given to tongue cancer that has progressed to many lymph nodes.

Tongue cancer may also be graded using the following methods:

  • Low grade
  • Moderate
  • High grade


This classification indicates how quickly cancer progresses and how probable it is to spread to other places of the body.

What is the treatment for tongue cancer?

Tongue cancer generally needs surgery to remove the malignant tissue. Smaller lesions require surgery of the tongue with neck dissection without a plastic reconstructive procedure.

If a significant proportion of the tongue is involved then extended hemi to near total glossectomy with free flap reconstructive procedure.

A glossectomy is a procedure that includes removing part or all of the tongue. Although specialists will make every effort to minimize the procedure’s impact on the mouth, specific side effects are unavoidable.

The effects of a glossectomy include:

  • Breathing
  • Eating
  • Speaking
  • Swallowing

Some patients may need radiation or chemotherapy and surgery to remove any malignant cells that remain.

Artificial Tongue Reconstruction

Tongue Reconstruction procedures may now be used to repair a tongue thanks to advances in medical technology. Reconstruction of the tongue is often a component of the treatment approach.

Plastic surgeons use cutting-edge procedures to maintain and restore the residual piece of the tongue, resulting in the greatest possible function.

They usually conduct a technique known as a radial artery-based forearm flap, which involves removing skin from the forearm and the soft tissues underneath it to reconstruct the tongue.

They link the small blood vessels in the forearm tissue to those in the neck using microsurgical procedures. Because of this reconstruction patients can have good-quality speech & swallowing function.

This reconstructed tongue functions similarly to a natural tongue, except that it cannot detect taste sensations. However, it will enhance the patient’s quality of life.


Surgery is the gold standard treatment for tongue cancer. Early diagnosis has better outcomes as compared to late ones.

The tongue may be affected by various cancers, but tongue cancer is most often caused by the thin, flat squamous cells that line the tongue’s surface. Those with cancer that hasn’t spread have a better chance of surviving.