Tongue Cancer

Tackling Tongue Cancer Together

What is Tongue Cancer?

Tongue cancer, categorized as a type of head and neck cancer, originates in the cells of the tongue and can manifest as ulcer or lump .

Tongue cancer may manifest in two primary locations: the front of the tongue, referred to as “oral tongue cancer,” or at the base of the tongue, close to its attachment point at the bottom of the mouth, known as “oropharyngeal cancer.”

The most prevalent form of tongue cancer is squamous cell carcinoma. Other rare cancers of minor salivary gland origin – Adenoid cystic carcinoma can arise in tongue as a pain less bulge in depth of tongue.

What causes tongue cancer?

Several behaviors and conditions can heighten your susceptibility to tongue cancer, including:

Tobacco use in the form of smoking or chewing.
Excessive alcohol consumption.
Infection with human papillomavirus (HPV), a sexually transmitted disease.
The habit of chewing betel, particularly prevalent in South and Southeast Asia.
A family history of tongue or other oral cancers.
A personal history of specific cancers, such as other types of squamous cell cancers.
Inadequate dietary habits (research suggests that a diet lacking in fruits and vegetables may elevate the risk of all oral cancers).
Subpar oral hygiene (constant irritation from jagged teeth or poorly fitting dentures can heighten the risk of tongue cancer).

Common signs and symptoms of tongue cancer

The primary early indication of tongue cancer that frequently appears is an unhealed sore on the tongue, which tends to bleed easily. Additionally, individuals may experience mouth or tongue discomfort.

Further signs of tongue cancer encompass:

The presence of a persistent red or white patch on the tongue.
An enduring tongue ulcer.
Pain while swallowing.
Numbness in the mouth.
A lingering sore throat.
Unexplained bleeding from the tongue.
The persistence of a lump on the tongue.

Diagnosis of tongue cancer

To diagnose tongue cancer, your doctor follows these steps:

Medical History: Your doctor will inquire about your medical history, including any family or personal history of cancer, tobacco and alcohol use, and HPV infection history.
Physical Examination: A thorough examination of your mouth will be conducted to identify potential cancer indicators, such as persistent ulcers. Additionally, nearby lymph nodes will be checked for swelling.
Biopsy: If suspicious signs of tongue cancer are observed, a biopsy will be performed. The most common biopsy method is an incisional biopsy, where a small portion of the suspected cancer is removed.
Imaging: If tongue cancer is confirmed, your doctor may recommend a CT scan or MRI to assess the depth and extent of the cancer’s spread.

Surgical treatment for tongue cancer

Treatment for tongue cancer is determined by the tumor’s size and the extent of cancer spread, often involving a combination of therapies:

Early-stage Mouth Cancer: When the cancer is localized and hasn’t spread, a small surgical procedure is usually sufficient to remove the affected area.
Larger Tumors: More extensive tumors often necessitate a surgery known as a partial glossectomy, where a portion of the tongue is excised.
Reconstruction Surgery: If a significant part of the tongue is removed, reconstruction surgery may be performed. This involves using skin or tissue from another part of the body to rebuild the tongue, with the aim of restoring speech and swallowing while eradicating cancer.
Potential Side Effects: Glossectomy can result in substantial side effects, impacting eating, breathing, speaking, and swallowing. Good reconstructive surgery (Flaps) and Speech therapy and swallowing therapy can assist patients in adapting to these changes.
Lymph Node Involvement: If the cancer has spread to lymph nodes, surgical removal of affected nodes may be necessary called neck dissection.
Advanced Cases: For large tumors or cases of cancer spread, a combination of surgery for tumor removal and radiation therapy to eliminate or destroy remaining tumor cells is often recommended. This may lead to side effects such as dry mouth and alterations in taste.
Chemotherapy: In some instances, doctors may suggest chemotherapy as part of the treatment plan, combined with surgery and/or radiation therapy

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Stay in Hospital

Most patients need an average stay of 4 days for minor surgery to 7 days in major surgeries. ICU stay is required for major surgery. Patients will have a feeding tube for maintaining nutrition during hospital stay.

Early Stage

Early stage tongue cancer is treated with wide excision of ulcer and primary closure followed by neck dissection.

Trans Oral Approach

Advanced stage

Advanced stage cancer requires removal of tumor from tongue(partial or hemi glossectomy or subtotal or total glossectomy) with neck dissection followed by reconstruction with flaps. Reconstruction improves speech and swallowing of patient.

Below is an example of patient who underwent hemi glossectomy and reconstructed with ALT (Antero-lateral thigh free flap). So this enables patient to have good speech and swallowing.