Advanced medical treatment for tongue cancer

In addition to conventional surgery, radiotherapy and chemotherapy, advanced treatment for tongue cancer involves the introduction of the latest technologies and therapies, with the aim of improving treatment efficacy and reducing side effects. Particular emphasis is placed on preserving tongue function (speech and swallowing) as much as possible, and personalized treatment is being developed. Below are some of the main advanced medical techniques and approaches to tongue cancer.

1. Robot-assisted surgery (da Vinci surgery)

Abstract: Robotic-assisted surgery is a minimally invasive procedure using the da Vinci system and is applicable to tongue cancer. The precision maneuvering of the surgical-assist robot allows the tumor to be removed while protecting the surrounding tissue and nerves.
Advantages: smaller wounds, less bleeding and faster post-operative recovery. It is also easier to preserve the function of the tongue and is expected to protect speech and swallowing functions.

2. Transoral Endoscopic Surgery (TOS)

Summary: Transoral endoscopic surgery is a minimally invasive procedure in which an endoscope is inserted through the oral cavity to remove a tumor. It has cosmetic benefits as it leaves no scarring on the face or neck and is also used to remove part of the tongue.
Advantages: because it does not involve an external incision, post-operative recovery is quicker and the risk of pain and infection is reduced. It also leaves no scarring on the face and neck, making it possible to take into account function and appearance.

3. Intensity-modulated radiotherapy (IMRT)

Abstract: IMRT is a radiotherapy technique that minimizes the impact on normal tissue by concentrating radiation on the tumor. In tongue cancer, it can also irradiate the tumor with high precision, reducing damage to other tissues in the oral cavity.
Advantages: precise focusing of the radiation increases the effectiveness of the treatment and reduces side effects. Particularly effective against advanced or recurrent tongue cancer.

4. Proton beam therapy

Description: proton beam therapy uses protons to focus radiation on cancer cells, delivering high energy to the tumors with minimal damage to normal tissue.
Advantages: because the radiation reaches the cancer cells precisely, it can attack the tumor while protecting normal tissue, and is particularly useful in cases of recurrent cancer or when surgery is difficult.

5. Heavy particle radiotherapy

Description: heavy particle radiotherapy is a form of radiotherapy that uses carbon ions, which have higher energy than conventional radiotherapy and destroy cancer cells more powerfully. It is also used in the treatment of tongue cancer and is highly effective against advanced or recurrent cancers.
Advantages: can effectively treat cancer cells while protecting normal tissue, especially in cases where surgery is difficult. Fewer side effects and preserved quality of life after treatment.

6. Molecularly labelled therapies

Summary: Molecular targeted therapies are treatments that target specific molecules or genes in cancer cells to reduce the growth and spread of the cancer.Therapies that target the EGFR ( e.g. cetuximab) are also used for tongue cancer.
Advantages: works selectively against cancer cells with minimal effect on normal cells, making it highly effective and with fewer side effects. Also used against advanced or recurrent cancers.

7. Immunotherapy (immune checkpoint inhibitors)

Description: immunotherapy is a treatment that strengthens a patient’s immune system to attack cancer cells. Immune checkpoint inhibitors (such as pembrolizumab and nivolumab) prevent cancer cells from escaping the immune system, allowing immune cells to attack the cancer.
Advantages: effective against advanced cancers and recurrent cancers that do not respond to chemotherapy, with fewer side-effects and long-term therapeutic effects.

8. Cancer genomic medicine

Abstract: Cancer genomic medicine is an approach that analyses the genetic profile of cancer cells to provide the best treatment for individual patients. In tongue cancer, the most appropriate molecularly targeted drugs and immunotherapies are selected based on genetic information.
Advantages: personalised medicine based on genetic mutations is possible, increasing the likelihood of receiving more effective treatment.Fewer side-effects and improved efficacy of treatment are expected.

9. High Intensity Focused Ultrasound (HIFU) therapy

Abstract: HIFU is a non-invasive treatment in which high-intensity ultrasound waves are focused on the tumor to heat and destroy cancer cells. It may also be applied as a local treatment for tongue cancer.
Advantages: non-invasive, less invasive and less physically demanding treatment, effective for patients who are difficult to operate on and for recurrent cancers.Efficiently destroys the tumour while protecting the surrounding normal tissue.

10. nanoknife (irreversible electroporation, IRE)

Description: nano knife is a treatment that delivers electrical pulses to cancer cells, disrupting their cell membranes and killing them. It is particularly applicable to tumors in close proximity to blood vessels and nerves, treating cancer without damaging the surrounding vital tissue.
Advantages: non-invasive, causes less damage to normal tissue and can be applied to tumors in difficult surgical sites. The post-treatment recovery is quicker and less burdensome for the patient.

Summary

Advanced medical treatment for tongue cancer offers a diverse range of options, including robot-assisted surgery, molecular targeted therapy, immunotherapy and advances in radiotherapy. This is expected to enable optimal treatment according to the patient’s condition, improve treatment efficacy and reduce side effects. In particular, advances in cancer genome medicine and immunotherapy are providing new treatment options for advanced and recurrent cancers.

Successful treatment of tongue cancer depends on thorough consultation with a specialist and choosing the most appropriate treatment option.

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