Tongue Cancer: Symptoms, Causes, Risks, Diagnosis, Treatment and Outlook

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A doctor check if the women have Tongue Cancer

1Overview

The tongue is a muscular organ in the mouth that is vital for chewing and swallowing food, as well as for speech. The tongue anchors numerous taste buds to let people experience the various flavors of food.

The tongue may seem like a simple organ in the body, but it has a broad spectrum of uses like breathing, swallowing, articulating speech, tasting and licking. This organ is around 3.3 inches for men and a little shorter for women at just 3.1 inches.

It consists of eight striated and interwoven muscles that can move in many directions, making the tongue a very flexible organ. On the tongue are 50 to 150 taste receptor cells inside every taste bud and these are responsible for the many flavors of food. Without the tongue, many abilities can be altered such as

Just like any part of the body, the tongue can also develop cancer. Tongue cancer is a type of oral cancer that develops in the front two-thirds of the tongue. This is because when cancer develops on the back of the tongue, it is now considered a type of neck and head cancer.

Tongue cancer is part of oral cancer or mouth cancer. Many types of cancers could occur inside the mouth. According to the American Cancer Society, there are about 49,670 people who will develop oral or oropharyngeal cancer and 9,700 people will die from these cancers, including tongue cancer.

Who are at risk of tongue cancer? About one in 324 individuals will be diagnosed with tongue cancer in their lifetime. In fact, this type of oral cancer is about twice as common in men than in women. Older people are also at a higher risk of developing this condition.

The National Cancer Institute reports that about 12,060 people had tongue cancer in 2011 alone. Of this number, 71 percents were men and 29 percent were women.

This type of cancer often starts as a small lump, sore on the tongue or a white patch. Usually, tongue cancer is not diagnosed until it has grown and spread to the other parts of the oral cavity. However, if it’s detected early and treated promptly, the prognosis and outlook are good. However, if the disease has spread to the lymph nodes and other organs, successful treatment is hard to achieve.

Tongue cancer often starts in the thin, flat squamous cells that line the surface of the tongue. This type of cancer can occur in the:

  • Mouth – This type of tongue cancer is often diagnosed when the tumor is still small and can be removed through a surgical procedure.
  • Throat – This type of cancer happens at the base of the tongue. This cancer is often diagnosed when the tumor cells have become larger and they have spread to the lymph nodes in the neck.

2Symptoms

The symptoms of tongue cancer are similar to the other types of oral cancer.
Sometimes, tongue cancer can be mistaken as a cold that won’t go away or a persistent mouth sore. Some of the signs and symptoms of tongue cancer include:

  • Continuous pain in the jaw and tongue
  • A lump inside the mouth
  • Red or white patch on the tongue
  • A sore throat or a feeling that something is stuck in the throat
  • Hard time swallowing or moving the tongue
  • Loose teeth
  • Poorly fitting dentures
  • Tongue pain
  • Jaw stiffness

3Causes

There is still no known clear cause of tongue cancer. However, they have linked genetic mutations to the development of this type of cancer. Oral cancer happens when the cells in the mouth develop changes or mutations in their DNA. These changes make cancer cells grow uncontrollably. When this happens, the faulty cells accumulate, forming a tumor.

Tongue cancer, specifically, can be caused by the human papilloma virus (HPV).
This type of virus does not only contribute to the development of cancer in the oral cavity but also in the genitals. It has also been linked to cervical cancer.

4Risk Factors

Since the exact cause of tongue cancer is unclear, some factors may increase one’s risk of tongue cancer.

  • Smoking cigarettes, pipes, tobacco, and cigars, etc.
  • Heavy drinking of alcohol
  • HPV infection
  • Cirrhosis of the liver
  • Jagged teeth
  • Dentures that don’t feel
  • Poor oral hygiene habits
  • Smoking
  • Syphilis

Tobacco use and tongue cancer

Some studies have shown that using tobacco or alcohol can dramatically increase the risk of developing tongue cancer. If these are used more frequently, the risk increases further. People who were diagnosed with tongue cancer use or have used cigarettes, tobacco, and alcohol.

Some experts believe that the chemicals in tobacco and alcohol can damage the DNA in the cells in the tongue. When the DNA is damaged, it may lead to cells growing and dividing uncontrollably. They will soon form tumors, but not all tumors are cancerous.
Hence, consulting with a doctor is essential if the person suspects something in the mouth or tongue.

5Diagnosis

The doctor will conduct a physical examination of the mouth and he would ask questions about the symptoms the patient is experiencing.

Biopsy

If an area is suspected to have cancer cells, the doctor will remove a tissue sample and examine it under a microscope. This is called biopsy.

Imaging Tests

X-ray of the mouth and throat can provide a picture of possible tumor cells on the tongue. The doctor may also recommend the patient to have CT scan, MRI or PET scan.

All mouth cancers are staged depending on the severity and location of the cancer cells. The cancer is stage I when the cancer cells are just confined in one area. On the other hand, the highest stage, which is stage IV means that the tumor has spread to the other areas of the head, neck and the rest of the body.

6Treatment

The treatment for tongue cancer depends on the location and stage of the tumor.
Also, the doctor will take into consideration the patient’s overall health and treatment preferences. The treatment options include surgery, chemotherapy, and radiation.

Surgery

Many types of surgeries can help manage and treat tongue cancer. The surgery can be done to remove the tumor itself. The surgeon may remove the tumor and a margin of healthy tissue surrounding it to ascertain that all the tumor cells were removed.

For advanced stages, the surgeon may operate to remove cancer or tumor that has spread to the neck. If the cancer has spread to the lymph nodes, the doctor may recommend removing these cancerous lymph nodes.

Radiation Therapy

The doctor or radiation oncologist will perform the radiation therapy to a specific tissue of the tongue.

Chemotherapy

Sometimes, the doctor may recommend the combination of radiation therapy and chemotherapy. Chemotherapy is a treatment procedure wherein medicines and anticancer drugs are used to kill the cancer cells throughout the body. This is a good option for people with cancers that have spread to the other parts of the body.

Targeted Drug Therapy

This treatment procedure is done when the doctor wants to target the cancer cells by interfering with the growth of the cell on a molecular level.

Rehabilitation

In some cases, the patients may need to improve speech and to swallow after the treatment. Rehabilitation is very important to be able to go back to the normal activities you do even after the surgical procedure.

7Outlook

The survival rates of tongue cancer are the same as the outlook or prognosis. Some patients may have better survival rates depending on the stage of the disease,
the treatment used and the severity of the disease.

Survival rates are used by doctors to talk with their patients regarding their prognosis or outlook. For tongue cancer, the five-year survival rates are 78 percent for local tongue cancer, 63 percent for regional and 36 percent for distant. Meanwhile, for oral cancer,
the five-year relative survival rates are 83 percent for cancer that has not spread, 62 percent of tumor cells which have spread to surrounding lymph nodes and 38 percent for cancer that has spread to the other parts of the body, including distant organs.

The survival rates for tongue cancer rely on the stage and location of the cancer.
For stage I cancer, the five-year survival rate is 71 percent. This means that this percentage of people who underwent treatment over five years ago is still alive. About 39 percent of those have died from the illness. For stage II, the survival rate is 59 percent and for stage III, the rate is 47 percent. For the last stage of the disease, the rate is just 37 percent.

In 2011, about 25.69 percent of all oral cancer deaths were from tongue cancer. It is the second leading cause of death among patients with oral cancer, next to throat cancer. Tongue cancer is responsible for 30.75 percent of deaths.

The prognosis of tongue cancer depends on these factors:

  • The type of cancer
  • Location of cancer
  • Stage of cancer
  • The speed at which cancer will likely grow and spread
  • Age
  • Treatment options
  • General health
  • Cancer’s response to the treatment