Tongue Cancer-Pictures, Symptoms, Treatment, Causes
What is tongue cancer?
Tongue cancer is a widespread and a severe type of head and neck cancer. The cancer develops in most cases as spots on the tongue, or ulcers or a lump on the outer layer of the tongue. The cells that are affected are squamous cells
Tongue cancer statistics
Oral cancer is more common in men compared to women and they tend to appear after the age of 40. Every year, about 37,500 people in the United States alone are affected with oral cancer and 10,000 people with tongue cancer specifically. The cancer kills one person every hour and has resulted in 8000 deaths in US itself. In nearly 77 percent of the cases, tobacco use and smoking are blamed. India has the largest incidence of tongue cancer, with oral cancers comprising 40 percent of all cancers.
Symptoms of Tongue Cancer
Tongue cancer symptoms include:
1. White spots on tongue, skin lesions, ulcers and lumps on the exterior layer of tongue that does not fade away in 14 days.
2. Spots on the tongue may be pale or discolored
3. The skin lesions or lumps are painless in the beginning. As the tumor advances, there can be pain
4. The early signs of tongue cancer are white patch or red patch on the soft tissues of the oral cavity
Later symptoms of Tongue Cancer
1. Difficulty while swallowing
2. Sores in the mouth
3. Tongue related problems
4. Pain, pricking, tingling and numbness in the tongue area at the later stages of tongue cancer
Tongue Cancer Causes
1. Consuming betel, areca and paan. In India, eating these are common, which is why it has the highest percentage of tongue cancer and oral cancer, by nation
2. Consuming Tobacco- 75 percent of oral cancer and tongue cancer is related to tobacco, nicotine and smoking. Smoking cigarettes and other nicotine products can cause the heat and smoke to inflame and deteriorate the mucous membranes of the mouth. Since tobacco has more than 60 carcinogens or cancer causing compounds, it is obvious that direct contact with the mouth can cause tongue and oral cancer.
3. Alcohol- Alcohol addiction is also a cause of tongue cancer. But the risk greatly increases if the person is a heavy smoker along with drinking alcohol heavily.
4. Oral submucous fibrosis-This cause of oral cancer is also noticeably higher in India given most people eat spicy food. This condition is caused by burning sensation on eating spicy food, giving rise to a growing lesion in which the opening of the mouth becomes restricted, limiting normal eating in later stages.
Diagnosis of tongue cancer
Diagnosis of tongue cancer starts with a systematic medical history checkup and physical examination. Your doctor may perform a biopsy, wherein he may remove a small tissue sample and send it for lab analysis. The pathologist identifies cancer cells by examining the tissue under microscope.
Further diagnosis of tongue cancer can be done in the form of imaging tests like MRI scan, CT and X-rays to find out to what extent the tongue cancer has spread.
Tongue Cancer Treatment
The treatment for tongue cancer depends on the stage of the cancer and the overall health of the person. The methodology for treatment is surgery usually accompanied by radiation therapy. Tongue base cancer can be treated with chemoradiation, a combination of chemotherapy and radiation therapy, which may or may not be followed by surgery. In advance case of tongue cancer, there can be risks with surgery where the speech and swallowing of the person may be compromised because at this time, the cancer will have moved towards the deeper regions of the tongue. In that case, the doctors may contemplate radiation therapy or chemoradiation
Tongue Cancer Surgery
A laser or cautery surgical instrument can remove the tumor directly through the mouth, if the cancer of the tongue is in its early stage. But if the tumor has moved to the intermediate or later stage the surgeon may have to remove the lymph nodes in the neck. Doctors are working on the latest tumor removal techniques that can reduce loss of functions for the tongue and adjoining areas.
The tumor removal surgery for tongue cancer, traditionally speaking, is done by cutting the jawbone and getting to the tumor through an incision done in the neck. The surgery may alter the shape of the face, may harm the surrounding organs, affect speech and swallowing functions. The recovery also stretches for long and the rehabilitation period is lengthy.
The modern tongue surgery techniques include ‘through the mouth’ (transoral) surgery in which the tumor is removed without harm any other surrounding organs or healthy tissues. This reduces the recovery time considerably. There is another form of modern surgery called the transoral robotic surgery, that is minimally invasive technique to exactly locate tongue base tumors and remove them through the mouth, without causing any damage to the face or facial bones. The advantages of modern surgery for tongue cancer treatment over the traditional one is that it preserves the shape and functioning of other organs and does not cause problems with speech or swallowing The person has to be in hospital just for three or four days. The treatment is complete with radiation therapy.
Radiation Therapy for Tongue Cancer
Radidation therapy makes use of high powered X-rays, with radioactive chemicals and electronic beams to neutralize cancer cells. The radiation oncologists (doctor who specializes in the treatment of cancer patients) closely keep a track of every treatment session because they have to ensure that the adjoining non-cancerous tissue are not affected. There are more advanced techniques in radiation therapy as well known as IMRT or intensity modulated radiation therapy and IGRT or image-guided radiation therapy which ensure that there is no loss of function for the tongue as well as surrounding tissues; while doing so in record time; just 5-7 minutes instead of the usual 20 minutes.
Medical oncologists perform chemotherapy to kill cancer cells. Chemotherapy can make radiation therapy quite effective especially when oral or base of tongue cancer has moved to the lymph nodes or other organs in the body.
Reconstructive Surgery for oral cancer
In case, there has been a disfigurement of the face or loss of function to the tongue and surrounding organs, a reconstructive surgery may be needed. This is done by specialist surgeons like maxillofacial surgeons, head and neck surgeons; who are adept at this form of surgery.
Rehabilitation for oral tongue cancer
After surgery or radiation therapy, doctors may help you with rehabilation where you are helped with speech, diet management, swallowing ec. Loss of speech and swallowing may be regained with the help of physical and occupational therapists.
Alternative treatment for tongue cancer
Alternative therapies may be given along with traditional treatments; and can be used for faster recovery and better management of the disease. These include Yoga, massage therapy and acupuncture. . The alternative therapies cannot substitute the traditional treatment of surgery, radiation and chemotherapy for tongue cancer.