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Everything You Need To Know About Tongue Cancer

Tongue cancer is a type of cancer that starts in the cells of the tongue, and can cause lesions or tumors on your tongue. It's a type of head and neck cancer.

Tongue cancer can occur on the front of the tongue, which is called "oral tongue cancer." Or it may occur at the base of the tongue, near where it attaches to the bottom of your mouth. This is called "oropharyngeal cancer."

  • on the surface of the skin
  • in the lining of the mouth, nose, larynx, thyroid, and throat
  • in the lining of the respiratory and digestive tracts
  • All of these parts of the body are covered in squamous cells.

    Tongue cancer is classified using stages and grades. The stage indicates how far the cancer has spread. Each stage has three potential classifications:

  • T refers to the size of the tumor. A small tumor is T1 and a large tumor is T4.
  • N refers to whether or not the cancer has spread to neck lymph nodes. N0 means the cancer has not spread, while N3 means that it has spread to many lymph nodes.
  • M refers to whether or not there are metastases (additional growths) in other body parts.
  • The grade of the cancer refers to how aggressive it is and how likely it is to spread. Tongue cancer can be:

  • low (slow-growing and unlikely to spread)
  • moderate
  • high (very aggressive and likely to spread)
  • In the early stages of tongue cancer, especially with cancer at the base of the tongue, you might not notice any symptoms. The most common early symptom of tongue cancer is a sore on your tongue that doesn't heal and that bleeds easily. You might also notice mouth or tongue pain.

    Other symptoms of tongue cancer include:

  • a red or white patch on your tongue that persists
  • a tongue ulcer that persists
  • pain when swallowing
  • mouth numbness
  • a sore throat that persists
  • bleeding from your tongue with no apparent cause
  • a lump on your tongue that persists
  • The cause of tongue cancer is unknown. However, certain behaviors and conditions can increase your risk, including:

  • smoking or chewing tobacco
  • heavy drinking
  • being infected with human papillomavirus (HPV), a sexually transmitted disease
  • chewing betel, which is particularly common in south and southeast Asia
  • a family history of tongue or other mouth cancers
  • a personal history of certain cancers, such as other squamous cell cancers
  • a poor diet (there is some evidence that a diet low in fruits and vegetables increases the risk of all oral cancers)
  • poor oral hygiene and poor-fitting prosthetics can trap or allow for carcinogens like alcohol and nicotine to be trapped against the gums and teeth.
  • Tongue cancer is also more common in older men than in women or younger people. Oral cancers are most common in people over 65 years old, and the rates start to increase dramatically after age 50.

    To diagnose tongue cancer, your doctor will first take a medical history. They'll ask you about any family or personal history of cancer, whether you smoke or drink and how much, and if you've ever tested positive for the HPV virus.

    Then they'll do a physical examination of your mouth to look for signs of cancer, such as unhealed ulcers. They'll also examine nearby lymph nodes, to check for swelling.

    If your doctor sees any signs of tongue cancer, they'll do a biopsy of the area of suspected cancer. An incisional biopsy is the most frequently used type of biopsy. In this type of biopsy, your doctor will remove a small piece of the suspected cancer. This is usually done under local anesthesia in your doctor's office.

    Instead of an incision biopsy, your doctor might do a newer type of biopsy called a brush biopsy. In this biopsy, they'll roll a small brush over the area of suspected cancer. This causes minor bleeding and allows your doctor to collect cells for testing.

    Cells from either type of biopsy will be sent to a lab for analysis. If you have tongue cancer, your doctor might do a CT scan or MRI to see how deep it goes and how far it's spread.

    Treatment for tongue cancer depends on how big the tumor is and how far the cancer has spread. You might only need one treatment or you might need a combination of treatments.

    Early mouth cancer that hasn't spread can usually be treated with a small operation to remove the affected area. Larger tumors usually need to be removed with a surgery called a partial glossectomy, in which part of the tongue is removed.

    If doctors remove a large piece of your tongue, you might undergo reconstruction surgery. In this surgery, your doctor will take a piece of skin or tissue from another part of your body and use it to rebuild your tongue.

    The goal of both the glossectomy and reconstruction surgery is to remove the cancer while damaging as little of your mouth as possible.

    Glossectomy can lead to severe side effects, including changes in how you eat, breathe, talk, and swallow. Speech therapy can help you learn to adjust to these changes. In addition, talk therapy can help you cope.

    If the cancer has spread to your lymph nodes, those will likely be removed with surgery.

    If you have a large tumor in your tongue or the cancer has spread, you'll probably need to have a combination of surgery to remove the tumor and radiation to ensure that all tumor cells are removed or killed. This can lead to side effects such as a dry mouth and taste changes.

    Doctors may also recommend chemotherapy to treat your cancer, in combination with surgery and/or radiation.

    The five-year relative survival rate for tongue cancer (which compares the survival of people with cancer with the expected survival rate for people without cancer) depends on the stage of the cancer.

    If the cancer has spread far, the five-year relative survival rate is 41 percent. If the cancer has only spread regionally (for example, to lymph nodes in the neck), the relative survival rate is 70 percent. If the cancer has not spread beyond the tongue, the five-year relative survival rate is 84 percent.

    As these survival rates show, earlier diagnosis leads to better outcomes. With early diagnosis, you can be treated before the cancer spreads.

    If you have a lump, ulcer, or sore on your tongue that doesn't go away after a long period of time, you should see your doctor. Early diagnosis of tongue cancer allows for more treatment options, with fewer side effects, and a good five-year survival rate.


    The Symptoms Of Mouth Cancer That Many People Ignore

    Health experts have warned that too many people are ignoring the warning signs of mouth cancer. According to Public Health Wales more than half of all mouth cancers are diagnosed at a late stage three or four, when the cancer is more advanced.

    There has been an increase in the number of cases of mouth cancer in Wales over the last few years, with the most deprived areas seeing the most impact. There are a number of risk factors for mouth cancers, including overexposure to sunlight (on the lips), tobacco and alchol (tongue and floor of mouth cancers) and the human papilloma virus (back of the mouth.)

    According to PHW, in 2023, most referrals for mouth cancer came from GPs and not dentists. The tongue is one of the most common areas where mouth cancer can develop, although it can be found in other areas of the mouth. For the latest health and Covid news, sign up to our newsletter here

    Mouth cancer is seen twice as often in men as in women with cases peaking at between 60 and 69 years old. More men die of mouth cancer in Wales than women. The latest figures show that nearly 120 men died of mouth cancer in Wales in 2022. 65% of people survive a mouth cancer diagnosis at five-years, and that figure is improving in the 15-54 year old age group.

    Symptoms of mouth cancer can be mistaken for other problems in your mouth like ulcers, candidal infections or white patches. A full list of warning signs and symptoms include:

  • a mouth ulcer in your mouth that lasts more than three weeks
  • a red or white patch inside your mouth
  • a lump inside your mouth or on your lip
  • pain inside your mouth
  • difficulty swallowing
  • difficulty speaking or a hoarse (croaky) voice
  • a lump in your neck or throat
  • losing weight without trying
  • Professor Paul Brocklehurst, Consultant in Dental Public Health at Public Health Wales, said: "As with all cancers, early diagnosis means prompt treatment to target cancers before they spread. If anyone notices one of the warning signs, they should either see their dental professional or their GP. It is also essential to attend routine dental check-ups as dental professionals are trained to spot the early signs of mouth cancer."


    Mouth Cancer Cases Hit New Record In England And Scotland—what You Need To Know

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