Surgery, not chemo, better for tongue cancer

New York – Surgery, and not chemotherapy sessions, works better for those suffering from tongue or oral cavity cancer.

In a pathbreaking study, a team of scientists at the University of Michigan’s Comprehensive Cancer Center concluded that patients with tongue cancer who started their treatment with chemotherapy fared significantly worse than patients who received surgery first.

“To a young person with tongue cancer, chemotherapy may sound like a better option than surgery with extensive reconstruction. But patients with oral cavity cancer can’t tolerate induction chemotherapy as well as they can handle surgery with follow-up radiation,” said study author Douglas Chepeha, professor of otolaryngology.

“Our techniques of reconstruction are advanced and offer patients better survival and functional outcomes,” Chepeha added. The study was published in the Nature magazine.

According to researchers, the immune system is critical in oral cavity cancer, and chemotherapy suppresses the immune system. If a person is already debilitated, they don’t do well with chemotherapy.

“Despite the proven success of this strategy in laryngeal cancer, induction chemotherapy should not be an option for oral cavity cancer, and in fact it results in worse treatment-related complications compared to surgery,” they added.

The study enrolled 19 patients with advanced oral cavity cancer. Patients received an initial dose of chemotherapy, called induction chemotherapy.

Those whose cancer shrunk by half went on to receive additional chemotherapy combined with radiation treatment. Those whose cancer did not respond well had surgery followed by radiation.

The researchers then looked at a comparable group of patients who had surgery and sophisticated reconstruction followed by radiation therapy and found significantly better survival rates and functional outcomes.