Tongue Cancer is one of the most common sites of head and neck malignancy. The major risk factors of tongue cancer are Smoking, Consuming Alcohol, and Human Papilloma Virus infection.
Tongue Cancer is a type of Oral Cancer and is rare and represents only about 3% of all cancers. If detected early it is curable, otherwise, it is life-threatening. As time lapses and is not treated it can spread to the other parts of the mouth, head, and neck region and to the other parts of the body.
Cancer on the tongue first appears as a pinkish red lump or a sore on the sides of the tongue’s margin that looks like an ulcer.
Tongue Cancer is oral cancer that develops in the cells of the mouth or tongue. Squamous Cell Carcinoma is the most common type of tongue cancer. Squamous cells are flat, skin-like cells that cover the lining of the mouth, larynx, thyroid, and throat. The two types of tongue cancer are:
1. SQUAMOUS CELL CANCER AT THE FRONT OF THE TONGUE: The front two-thirds of the tongue is affected and it usually sticks out.
2. SQUAMOUS CELL CANCER OF THE BACK OF THE TONGUE: The back one-third of the tongue gets affected and extends down the throat.
SYMPTOMS OF TONGUE CANCER:
- A patch or lump on the margins of the tongue.
- If bitten or touched they may bleed.
- They may not heal quickly.
- The tongue area might become thick.
- Pain in the tongue, difficulty in swallowing.
- A feeling of a lump in the neck or throat, so the voice changes.
- Ear begins to pain.
- Always better to inform the doctor.
RISK OF DEVELOPING TONGUE CANCER:
The factors that increase the chances of getting Tongue Cancer are:
- Tobacco-smoking cigarettes, cigars, chewing tobacco, and inhaling snuff.
- When the lip is exposed to ultraviolet light (UV) such as sun and tanning bed.
- Consuming excessive alcohol.
- When the base of the tongue develops a human papillomavirus infection.
CAUSES OF TONGUE CANCER:
- Smoking or chewing tobacco,
- Consuming alcohol in excess,
- Consuming red meat or processed food more than needed and eating less of fruit and vegetables.
- Having Human Papillomavirus infection.
- Family history of tongue and mouth cancers.
- Having squamous cell cancer previously.
- Oral cancers are common in those aged 50 and above.
- Poor oral hygiene, dentures if they do not fit properly.
HOW IS TONGUE CANCER DIAGNOSED?
If anyone suspects he has tongue cancer consult a doctor immediately. The doctor may ask a few questions, like:
- Medical history, family history.
- Examines the tongue and mouth.
- examines the lymph nodes.
- Then the doctor can perform a biopsy, after that a CT scan or MRI scan is taken to see if the cancer has spread.
- If diagnosed early, it can be cured.
- If it has not spread to the other parts.
- 78% of survival, if it has not spread.
METHODS TO PREVENT TONGUE CANCER:
Changes in lifestyle, like:
- Quit smoking, chewing of tobacco,
- Limit the consumption of alcohol or avoid it completely.
- Eating fruits and vegetables.
- Oral hygiene by brushing, regular dental checkups.
- Receive the full course of HPV vaccine.
- Practice safe sex for oral sex.
STAGES OF TONGUE CANCER:
STAGE I AND II: A lower stage that indicates a smaller cancer and that is confined to one area and has not spread to the lymph nodes.
STAGE III: The cancer measures 4cms. May have spread to only one lymph node.
STAGE IV: In this stage, the tumor is larger or it means cancer has spread to other areas of the head or neck or to the other parts of the body.
TREATMENT OF TONGUE CANCER:
SURGERY: In stage one, cancer in the mouth is 2cms or lesser and has not spread to the lymph nodes and can be treated. The dentist finds the cancer in its early stages as the mouth and lip are easy to examine.
It can be easily cured through surgery that is in the mouth. In the throat of the tongue, it is diagnosed at an advanced stage and the cancer has spread to the lymph nodes. Hence takes a longer time for treatment. Surgery is done to remove the smaller primary tumors. For larger tumors a portion of the tongue may be removed.
CHEMOTHERAPHY: (Ch T): Anti cancer drugs to destroy cancer cells throughout the body. This treatment will stop the growth of the tumor, if it cannot be cured. Ch T may treat the advanced tongue cancer that has spread to the nearby lymph nodes.
Combination of ChT with RT ( Chemoradiation ) is a better treatment. Ch T is combined with surgery and RT to slow the tumor growth. If it is not cured RT is the best to reduce cancer recurrence.
TARGETED THERAPY: This treatment targets cancerous cells or tumors. This treatment is also combined with Ch T and/or RT.
INTENSITY –MODULATED RT (IMRT): RT is used to destroy cancer cells with high –energy x-rays, electron beams or radioactive isotopes. IMRT is a more effective radiation treatment. If required IMRT is done before or after surgery.
DIET FOR A TONGUE CANCER PATIENT:
A normal diet and it’s very important to maintain weight. Food like mashed food, liquid food can be taken. A calorie-rich diet is recommended.
Nutritional counseling and dietary support must be there to maintain the patients’ strength and should not lose weight during the recovery period.
They can act on the well being of the patients and can provide educational seminars for the local physicians, nurses, pharmacy staff and patients for the patient’s good health. Topics on harmful effects of long-term usage of tobacco can be highlighted.
AWARENESS OF TONGUE CANCER:
Oral cancer is the most common cancer in India and tongue is commonly affected, many people are not aware of this. So more awareness campaigns health education programs must be held from school going children, college students and elders both men and women must be informed about the dangers of tongue cancer and its early detection and treatment.