Radiation therapy is often a key part of treatment for oral cancer. The side effects can be uncomfortable but are usually temporary.

Tongue cancer is a type of oral cancer. Often, the best course of treatment includes radiation therapy (RT).

Sometimes, it’s recommended as a sole solution or as part of a multi-part treatment with options like chemotherapy, surgery, or a drug regimen to boost success rates.

Radiation treatments can also be effective for recurrent cancers or control symptoms associated with advanced-stage cancer like pain, bleeding, difficulty swallowing, or when cancer spreads.

Keep reading to learn what to expect if your oncologist recommends radiation, including the length and cost of treatments, potential side effects, success rates, and recovery timelines.

RT is a noninvasive treatment that exposes a person to high doses of X-rays or radiation particles to kill cancer cells or significantly slow their growth. The high doses permanently damage the cancer cell’s DNA to prevent spreading. However, treatments can take time to yield results — sometimes weeks.

The most common RT oncologists will use for oral cancer is external-beam radiation therapy (EBRT).

It’s very similar to getting a regular X-ray, except the dosages used are much higher, and the exposure is for shorter periods of time — usually just a few minutes. While receiving treatments, patients will usually have a mesh head and a neck mask to maintain an aligned position.

There are three common types of EBRT:

  • Protein beam radiation therapy: This relies on protons instead of X-rays to help minimize radiation exposure to other parts of the body.
  • Three-dimensional conformal radiation therapy (3D-CRT): In this procedure, the radiation leverages computer mapping for more precise application to the tumor while minimizing damage to healthy cells.
  • Intensity-modulated radiation therapy (IMRT): This is a different type of 3D-CRT that uses a rotating X-ray machine to adjust radiation intensity as it moves to further minimize damaging healthy cells.

Alternatively, some people undergo brachytherapy, a type of radiation that relies on implants that are inserted for up to 8 days while releasing a high dose of radiation. This is often a solution for recurrent cancer.

Treatment schedules for radiation

Most EBRT treatments for oral cancer require multiple doses across several days over an extended calendar. Usually, this will be 5 days per week for roughly 7 weeks, but individual experiences will vary. Other schedules can include:

  • Hyperfractionation: using a slightly lower radiation dose multiple times a day
  • Accelerated hyperfractionation: using the standard dosage but every day of the week over a shorter time frame (i.e., 5 to 6 weeks instead of 7)
  • Hypofractionation: using a slightly higher dosage every day to reduce the total number of treatments

Unlike with chemotherapy, side effects from radiation are usually localized to the treatment area. This means that for tongue cancer symptoms will be in the head and neck region. This is because radiation treatments can also damage healthy cells along with carcinogenic ones.

The most common symptoms reported are fatigue during the actual treatment. Other common side effects include:

RT success rates for any cancer always depend on when treatments began after detection and the stage when the therapy began.

Although oral cancer is the eighth most common type of cancer worldwide, radiation therapy usually isn’t the sole treatment used. As a result, figures outlining success or survival rates often include reviews of patients who used multi-pronged approaches to fight the disease.

For example, a 2021 review of radiotherapy for oral cancer found that while those who relied on RT alone for oral cancer had a 15% 5-year survival rate, the rate increased to 66.9% when combined with chemotherapy, even for people with stage 3 or 4.

Understandably, RT costs vary widely depending on location, the service provider, and the patient’s insurance — if applicable. The average cost for total treatment durations can be very different depending on whether a patient is undergoing RT only or with other treatments.

For example, for RT-only, the average cost from a 2021 review of patients diagnosed with and treating oral cancer between 2015 and 2018 was $635. When paired with other treatments like chemotherapy, that figure rose significantly to a range of $1,452 to $1,626.

Insured patients will usually only pay for doctor’s visits, prescription drug copays, or a coinsurance payment for any surgeries that can range from 10–50% of the total procedure cost. In most cases, RT is covered by most major insurers.

However, always check with your individual provider, as some of the more specialized RT methods are often labeled experimental and aren’t always covered.

Individual recovery times will vary between patients. However, on average, people can expect to fully recover within 2 to 3 months after treatment ends.

Yet, some people may never fully regain their ability to taste, may always experience dry mouth, or continue to experience dental complications after treatment ends.

As with any other form of cancer, early detection and prioritizing treatment are critical to boost success odds with oral cancer. Radiation therapy is just one method that might be employed to control cancerous cells and prevent them from spreading.

While side effects are common during treatments, many people will fully recover normal tongue or mouth function once treatments are complete.