Last updated date: 19-Aug-2023
Originally Written in English
Tongue cancer is a form of mouth cancer (also known as oral cancer) that typically begins in the squamous cells on the tongue surface. It has the potential to cause lesions or tumors. The tongue sore, which does not resolve, and a painful tongue are the most visible signs associated with tongue cancer.
This cancer can appear in two areas of the tongue. Oral tongue cancer occurs at the front part of the tongue, whereas oropharyngeal cancer develops behind the tongue. The kind of cells associated with cancer often determines the treatment as well as the prognosis.
Signs and Symptoms of Tongue Cancer
Squamous cell carcinoma is the most common type of tongue cancer. Squamous cells are thin, flat cells found on the skin and tongue surface. They are also present within the digestive and respiratory system linings, as well as the mouth, throat, larynx, and thyroid lining.
The most common symptoms of tongue cancer include pain in the tongue and the formation of a sore on the tongue. Other symptoms that may occur are:
- Throbbing in the jaw or throat
- Feeling as if something is caught in the throat
- Swallowing pain
- Difficulties swallowing and chewing food
- Tongue or jaw rigidity
- A white or red patch that forms on the mouth or tongue lining
- Numbness or tingling in the mouth
- A tongue ulcer that won't heal
- Indiscriminate bleeding from the tongue
- A non-resolving lump on the tongue
Tongue cancer symptoms are the same as those of other oral cancers and could be absent during the early stages of the condition. Some of the symptoms may also occur in people who do not have tongue cancer or any other form of oral cancer.
Causes of Tongue Cancer
Medical professionals still don’t know the causes of tongue cancer and are baffled as to why people acquire tongue cancer. On the other hand, certain risk factors might raise the chances of a person developing the disease.
Some of the common risk factors are:
- Excessive alcohol consumption
- Tobacco use, whether smoking or chewing
- Consuming a diet rich in red meat or the processed foods and low in vegetables and fruits.
- Having a family history of cancers of the tongue or mouth
- Having a history of cancer, mainly squamous cell cancer
- Being infected with the human papillomavirus (HPV)
In many cases, older men are the most vulnerable to tongue cancer. On the other hand, oral cancers are more common in people over the age of 50. Also, the smokers who consume a lot of alcohol are 15 times most likely to get oral cancer, unlike nonsmokers.
Other possible risk factors can include:
- Gastroesophageal reflux disease (GERD)
- Betel chewing (a popular pastime in Southeast Asia)
- Poor oral hygiene or other mouth-related factors, like jagged teeth causing irritation or dentures that don’t fit correctly
- Exposure to specific chemicals such as sulfuric acid, asbestos, formaldehyde, etc.
Stages and Grades of Tongue Cancer
The stage of tongue cancer indicates how advanced it is and if it has spread further. It enables the doctor or ENT specialist to determine the best course of treatment for you.
The stage of your tongue cancer is determined by:
- The extent to which cancer has spread into nearby tissues
- Whether or not it has spread to neighboring lymph glands
- Whether or not it has moved to other areas of the body
Doctors often use different staging systems. The staging system they use on you is determined by where your cancer begins. For instance, mouth cancer is graded as tongue cancer that begins in the front two-thirds of the tongue (oral tongue).
Tongue Cancer Diagnosis
The ENT specialist will first inquire about your medical history to make a tongue cancer diagnosis. He or she will also ask if you have a family or personal history of cancer, how much you smoke or drink, and whether you have ever been infected with the HPV virus.
After that, they can perform a physical exam of your mouth to check for any cancer signs, including ulcers that have not healed. They can also look for swelling in surrounding lymph nodes.
If the medical provider notices any indicator of tongue cancer, he or she will perform a biopsy on the suspected cancerous area. The most common type of biopsy is an incisional biopsy. Your doctor will remove a small sample of the suspected cancer during this form of biopsy. This is often conducted in the provider's office under local anesthesia.
Alternatively, the doctor may perform a brush biopsy, which is a new form of biopsy, rather than an incision biopsy. During this biopsy, a small brush will be rolled over the suspected cancerous area. This leads to minor bleeding, enabling the doctor to obtain cells for testing purposes.
The sample cells from each form of biopsy will be thoroughly analyzed in a laboratory. If the results show tongue cancer, the provider may perform a CT scan or an MRI. This is to determine how deep the tumor is and the extent it has spread.
Tongue Cancer Treatment
Tongue cancer treatment is determined by the size of the tumor and the extent to which cancer has metastasized. You may only require one treatment or a combination of treatments which includes the following;
Early-stage tongue cancer that has not spread is often treatable with minor surgery to eliminate the affected part. The doctor usually recommends a partial glossectomy for large tumors, which involves removing a portion of the tongue.
If a large portion of your tongue is removed, you may require reconstruction surgery. Your doctor will use a small piece of tissue or skin from a different body part to rebuild the tongue during this procedure. Glossectomy and reconstruction surgery aims to eliminate cancer while causing the least amount of damage to your mouth.
However, glossectomy can have serious side effects, such as changes in the way you breathe, eat, swallow, and talk. Luckily, speech therapy can assist you in learning to adapt to such changes. Talk therapy might also help you adjust and cope.
If your tongue cancer has metastasized to the lymph nodes, they will certainly be taken during surgery. Other people can have a bigger tumor in the tongue or cancer that has spread. In such cases, they will most likely require a combination of surgical operation and radiation to make sure that all cells are eliminated or destroyed. This could result in side effects like mouth dryness and changes in taste.
- Radiation therapy
Radiation therapy, which includes intensity-modulated radiation therapy, inhibits the cancerous cell division and slows tumor growth. This treatment can also shrink or get rid of tumors by destroying the tumor cells. Intensity-modulated radiation therapy involves the use of higher-effective radiation doses while causing few side effects, unlike traditional radiation approaches.
Generally, radiation therapy entails daily treatments for about five to six weeks.
This treatment, which is frequently combined with radiation therapy, employs drugs to kill the cancerous cells in the body. If the cells have spread to surrounding lymph nodes, chemotherapy might be an alternative. A number of chemotherapy medications can be combined to destroy cancer cells at different stages of growth cycles. This reduces the possibility of drug resistance.
- Targeted drug therapy
This treatment works by altering the growth of cancerous cells at the molecular level. As part of the tongue cancer treatment plan for the patient, it’s frequently combined with radiation therapy and/or chemotherapy.
Preventing Tongue Cancer
It’s almost impossible to prevent the development of tongue cancer. Nevertheless, if you develop any signs and symptoms linked to tongue cancer, you have to see your doctor right away. The sooner your provider can diagnose the problem, the earlier your treatment can commence, and the better the prognosis.
You can also reduce the risk of getting tongue cancer by changing your lifestyle habits. These are some of the changes you need to make:
- Stop smoking
- Avoid using tobacco or betel
- Limit or completely avoid alcohol consumption
- Consume a varied and healthy diet rich in fruits and vegetables
- Brush and floss on a regular basis, and ensure that you attend your routine dental appointments
- Get a full course of HPV vaccination
- Use a dental dam during oral sex and always practice safe sex
Tongue cancer is a type of cancer that begins within the tongue cells and could result in lesions or tumors on the tongue. It is a form of cancer of the head and neck. This cancer can develop on the front of the tongue (oral tongue cancer) or the base of the tongue (oropharyngeal cancer).
Tongue cancer is typically treated through surgery to eliminate cancer. Chemotherapy, radiation therapy, and targeted drug therapy might also be suggested. Advanced tongue cancer treatment can impair your ability to eat and talk. Working with a professional therapist can assist you in coping with the changes caused by tongue cancer treatment.