What is tongue cancer?

Tongue cancer is a serious type of oral cavity cancer that poses a threat to life. The tongue is the second most commonly affected area by oral cavity cancers after the lips.

What are the symptoms of tongue cancer?

The symptoms of tongue cancer are similar to those of other types of oral cancers. Depending on the stage of development, the most common symptom of tongue cancer is a non-healing sore in the oral cavity. Some symptoms of oral or tongue cancer can also be attributed to other medical conditions. Therefore, if relevant symptoms persist for more than two weeks, it is necessary to undergo a comprehensive clinical examination, laboratory tests, and consult a doctor to obtain a definitive diagnosis.

The symptoms of tongue cancer are generally painless and not specific to the disease. Due to the presence of nonspecific and usually painless symptoms, tongue cancer and other types of oral cancers are often not detected in the early stages. Compared to hypopharyngeal tongue cancer, which has a higher likelihood of being seen and felt, the symptoms of oral tongue cancer include:

• A grayish-pink lump or sore on the lateral surface of the tongue

• Tongue pain

• Throat pain

• Difficulty in swallowing or chewing

• Difficulty in moving the tongue

Cancers that develop at the base of the tongue are usually in an advanced stage when diagnosed, with larger tumors that have spread to the lymph nodes in the neck.

Symptoms caused by cancer at the base of the tongue include:

• Throat pain

• Difficulty in swallowing

• Feeling of a lump in the throat

• Changes in voice

• Ear pain

Individuals experiencing any of these symptoms should be evaluated by an ear, nose, and throat (ENT) specialist. Early diagnosis is crucial for the success of tongue cancer treatment, as is the case with most cancer types.

What are the risk factors of tongue cancer?

The most important two risk factors for the development of tongue cancer are tobacco use and alcohol consumption. The likelihood of men developing tongue cancer is twice that of women. While tongue cancer is rarely seen in young individuals, the probability of occurrence increases in individuals aged 40 and above.

The risk factors for tongue cancer can be summarized as follows:

• Smoking or using other forms of tobacco (chewing, etc.).

• Alcohol consumption

• HPV-16 and 18: Human Papillomavirus

• Asbestos exposure

• Factors related to poor nutrition

• Genetic predisposition

• Poor oral hygiene and prolonged irritation

How is tongue cancer diagnosed?

Biopsy is the first step in diagnosing tongue cancer. During a biopsy, a small amount of tissue is taken from the suspected cancerous area of the tongue. The tissue is sent to a pathologist who examines it under a microscope to aid in making a diagnosis. The examination of a tissue sample taken from a suspicious cancer area by a pathologist is the key to diagnosis. After the diagnosis of tongue cancer is made, radiological tests such as ultrasound, computed tomography (CT), and MRI are used to evaluate the size of the tumor, its stage, spread, and its relationship with other organs. This information helps determine the appropriate treatment method.

The stage of cancer at the time of diagnosis determines treatment options and strongly impacts the survival rate. The earlier tongue cancer is diagnosed, the higher the chances of a person surviving five years after the diagnosis.

What are the types of tongue cancer?

The most common type of tongue cancer is squamous cell carcinoma (SCC). Squamous cells are flat cells that cover the inside of the mouth, nose, throat, thyroid, and the surface of the skin. Squamous cell carcinoma is the name for cancer that originates from these cells.

What are the stages of tongue cancer?

The stage of cancer indicates how large the tumor is and whether it has spread. The classification that defines the stage of cancer within the body is called the TNM classification.

According to this classification:

T; indicates the size of the tumor at its origin site,

N; indicates the size and status of the tumor in the neck lymph nodes for head and neck tumors that have spread (metastasized) to lymph nodes,

M; indicates the presence of metastasis in distant organs beyond the neck, often indicated through the bloodstream.

In summary, the stage of cancer depends on the following factors:

How much the cancer has grown into nearby tissues,

Whether it has spread to nearby lymph nodes,

Whether it has spread to other parts of the body.

What are the treatment methods of tongue cancer?

Treatment options for tongue cancer vary depending on the patient's overall health, the type and stage of the tumor. Early diagnosis is crucial for both survival and quality of life in tongue cancers.

Surgical Procedure

For small tongue cancers, surgical removal of the tumor is often the primary required treatment. However, depending on the stage of the tumor and the results of radiological examinations, neck dissection might be necessary, involving the surgical removal of affected or potentially affected neck lymph nodes.

Radiation Therapy

Radiation therapy is often used in conjunction with chemotherapy or before/after surgery to halt the growth of cancer cells.

Intensity-Modulated Radiation Therapy (IMRT) can accurately calculate the necessary radiation dose to treat the tumor using an advanced computer system. This minimizes excessive radiation exposure to surrounding normal tissue, limiting potential side effects of radiation therapy and ensuring the most effective treatment.

Chemotherapy

Chemotherapy is used in combination with other treatments like surgery and/or radiation. The goal of chemotherapy is to help control the growth of the cancerous tumor. When combined with radiation, it's referred to as chemoradiation. When administered alone to manage symptoms of the disease, it's known as palliative treatment. Chemotherapy can also be used after surgery to reduce the risk of cancer recurrence.

Following surgical procedures, radiation therapy, and chemotherapy, rehabilitation therapies such as dietary adjustments, speech and swallowing therapies, physical and occupational rehabilitation can be implemented to enhance the quality of life for tongue cancer patients.

Preventing Tongue Cancer: What Can You Do?

While there is no proven method to completely prevent tongue cancer, the following recommendations can help reduce the risk of developing tongue cancer:

Avoid smoking or using tobacco products. Smokers and/or tobacco users should seek professional help if needed to quit these habits.

Limit alcohol consumption.

Regularly visit a doctor for check-ups and cancer screening examinations.

Maintain good oral hygiene.