Tongue Cancer

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Cancer of the tongue is a less common cancer. Its danger depends on the exact location of its growth (which part of the tongue is affected) and the current stage when the tumor is diagnosed. It is advisable to differ the tumors of the front part of the tongue (earlier diagnosed, better prognosis) and cancers of the back side of the tongue (later diagnosed, worse prognosis).


The main cause of tongue cancer is smoking. The tobacco contains an enormous amount of cancer-causing chemicals and its chronic contact with the oral cavity and airways increases risk of local malignant diseases. The tongue cancer is especially high in pipe smokers and in people chewing the tobacco. Another important risk factor is alcoholism, typically when drinking hard liquors. Liquors with a high content of alcohol are quite aggressive substances directly damaging the mucous membranes, causing cell necrosis and increasing the chance of developing cancers.


Malignant tumors of the front part of the tongue can be seen by the naked eye even in their early stages. They look like gradually growing gray-pink or red ulcerated lesions that may easily bleed. If these symptoms are ignored, the tongue grows and it may even cause troubles when swallowing or speaking. The tumor usually metastasizes to the cervical lymph nodes and they may painlessly enlarge.


Much more insidious are malignant tumors of the back part of the tongue. This area is not normally seen and the tumor has more time to enlarge and spread. It manifests later with symptoms such as dysphagia, pain during swallowing, voice changes, throat pain, etc. For this reason, these types of tongue cancer are often discovered too late when the deep cervical lymph nodes have been already affected by metastases.


Any suspicious lesion of the tongue should be examined by an otolaryngologist. The back part of the tongue usually requires usage of special otolaryngologic tools (such as small mirrors). The doctors should take sample of any tissue and send it for histological examination. The exact size and local extent of the tumor may be examined by imaging methods such as the computed tomography or magnetic resonance imaging.


The best prevention is to not smoke and drink alcohol only occasionally. Particularly suitable is to avoid or limit hard liquors.


Early forms of the tongue cancers may be removed by a relatively minor surgery. Larger tumors have to be dealt with more extensive surgical procedures with removal of various parts of the tongue and surrounding anatomical tissues and local cervical lymph nodes. The surgery may be mutilating and significantly impair the ability to speak or swallow. The surgery is commonly combined with chemotherapy or radiotherapy as these methods can reduce the tumor mass and thus enable smaller extent of surgery. The exact procedure in a particular patient depends on the decisions of experienced oncologists and surgeons.


If we are concerned that the tumor growth is soon going to disrupt the patient's ability to eat, we can consider introduction of a special hose into the stomach through the abdominal wall. This feeding tube is also known as PEG (percutaneous gastrostomy) and it allows feeding the patient with nutrient-rich liquids.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources