What is Tongue Cancer ?

Cancer that occurs on the tongue can be found either on the anterior end(oral end) of the tongue or the posterior end (base of the tongue). The anterior having 4 parts tip, dorsum, lateral borders, and ventral surface out of which the lateral borders get affected by a tumor in most cases. Oral cancer is found out during the initial stages but it is quite advanced when it spreads to the base of the tongue

Stages of Tongue Cancer

The 5 stages of tongue cancer can help the patient plan out his treatment accordingly.

Check out the simplest pictures to understand the 5 stages:

Tongue cancer treatment in Hyderabad

Stage 0: known as Carcinoma in-situ. This describes the presence of abnormal cells in the surface lining and having a high potential to invade the deeper layers.

Throat Cancer Surgery in KPHB

Stage 1: The size of the tumor is less than or equal to 2 centimeters and the cancer cells did not spread to the lymph nodes.

Tongue cancer treatment in KPHB

Stage 2: The size of the tumor is between 2 and 4 centimeters and the cancer cells did not spread to the lymph nodes.

Tongue cancer treatment in Hyderabad

Stage 3: The tumor is larger than 4cm and without spreading to lymph nodes, or is of any size and had spread to only a single lymph node(less than 3cm).

Tongue cancer treatment in KPHB

Stage 4: It is the most advanced stage. The tumor may be of any size, but it has spread to:

- Adjacent tissue, skin, or bone

- Single lymph node (more than 3cm) or multiple lymph nodes.

- Distant body parts like lungs etc.

Symptoms of Tongue Cancer :

1. Ulceration or lump on the tongue

2. Bleeding and numbness

3. Reddish or White patches on the tongue

4. Lump in the neck

5. Pain and difficulty in swallowing

Causes and Risk Factors of Tongue Cancer

Excessive Consumption of Tobacco and Alcohol is the biggest risk factor for tongue cancer. The cancers that are found on the base of the tongue are due to the presence of HPV-16. Chronic irritation by dentures, teeth and poor dental hygiene is another reason for tongue cancer.

Diagnosing Tongue Cancer

  • - A complete medical history and the patient's history of tobacco and alcohol consumption will help in diagnosis
  • - Fiber Optic Endoscope is employed to locate any abnormal growth or ulcers on the base of the tongue.
  • - The biopsy is another way to detect Tongue cancer as it removes a cell or a part of the infected portion to examine it closely. The biopsy varies from condition to condition.
  • - Neck biopsy will be done if only a bump on the neck is observed
  • - The complexity and the in depth analysis of the growth will be known through X-rays, CT-Scans and MRI Scans.

Treatment of Tongue Cancer

1. The treatment goals of tongue cancer are to eradicate the cancer and restore the form and function of the tongue.

2. The treatment modality for achieving these goals in tongue cancer is usually surgery. In case of advanced cancer, surgery should be followed by adjuvant radiotherapy and chemotherapy either alone or in combination.

3. The choice of treatment depends on the depth, extent and stage of the tongue cancer.

4. Surgery to remove a part of the tongue is known as partial glossectomy whereas advanced cases needed larger tissue removal.

5. People with large tissue removal may need a reconstructive surgery to restore the form and function.

Preventing tongue cancer

1. Refrain from smoking and consuming any tobacco products.

2. Avoid excess drinking of alcohol

3. Regular dental check-ups and maintaining good oral hygiene.

4. Take a balanced diet rich in fruits, vegetables, Vitamins A, C and E.

MANAGEMENT OF TONGUE CANCER ?

-These are aggressive with early tendency to spread to neck nodes.

-Also they have tendency to relapse after treatment.So early and aggressive treatment ensure cure.

-Following patient presented with non healing ulcer since 2 months.

-Associated with severe pain and earache and neck nodal swellings.

-DIAGNOSIS- Biopsy is done to confirm diagnosis

-IMAGING-CT scan or MRI is done to stage the disease.

TREATMENT

-Early stage disease is treated with surgery.

-Advanced stagewith multi modality treatment - surgery + radiotheraphy+/-chemotheraphy.

Reconstruction of tongue

- Early stage doesn’t generally require reconstruction.

- Advanced stage requires reconstruction with flaps, both local and free flaps.

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

-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.

-This is an example of treated case of tongue cancer where tongue reconstruction was done with Radial fore arm free flap

-Here local flap (sub mental flap) is used for reconstruction of tongue after hemi glossectomy.

FAQ's

Yes. Tongue cancers and oral cancers are fully curable if they are addressed by an expert head and neck oncologist at an early stage.
Tongue cancer needs to be addressed promptly at the right time. If it is not addressed, it can also develop to a stage where it can be a life-threatening issue
Chemotherapy has its benefits but has more side effects due to the high radiation. Surgeries are usually preferable for better results and relatively minimal side effects for oral, throat, and tongue cancers
Tongue cancers are very rare compared to other types of head and neck cancers. But, when the symptoms are observed, they are to be treated immediately
Yes, all types of head and neck cancers lead to weight loss due to which medical advice is necessary to maintain proper health and nutrition while getting treated

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