CANCER OF TONGUE

Introduction:

Tongue cancer is a type of oral cancer that affects the tongue, a vital organ for speech, taste, and swallowing. While the thought of having cancer can be overwhelming, understanding the disease, its symptoms, treatment options, and preventive measures can empower patients to make informed decisions and seek timely medical care. In this article, we will discuss tongue cancer in a patient-friendly manner, aiming to provide knowledge and support to those who may be facing this condition.

What is Tongue Cancer?

Tongue cancer refers to the abnormal growth of cancerous cells on the tongue's surface or within its tissues. There are two main types of tongue cancer: squamous cell carcinoma (most common) and adenocarcinoma (less common). Several factors can contribute to the development of tongue cancer, including tobacco and alcohol use, human papillomavirus (HPV) infection, a weakened immune system, and poor oral hygiene.

Recognizing the Symptoms:

Early detection of tongue cancer plays a crucial role in successful treatment. Here are some common signs and symptoms to watch out for:

1. Persistent mouth ulcers or sores that do not heal within two weeks.
2. A red or white patch on the tongue or inside the mouth.
3. Difficulty chewing, swallowing, or moving the tongue.
4. Pain or discomfort in the mouth or throat.
5. A lump or thickening on the tongue or in the neck.
6. Numbness or tingling sensation in the mouth.

If you experience any of these symptoms or notice any changes in your oral health, it is essential to consult a healthcare professional for a proper diagnosis.

Diagnosis and Treatment:

Upon visiting your healthcare provider, they may perform a thorough examination and recommend the following diagnostic tests:

1. Biopsy: A small sample of tissue is taken from the affected area for laboratory analysis to confirm the presence of cancer cells.
2. Imaging tests: X-rays, CT scans, MRI, or PET scans may be conducted to determine the extent of the cancer's spread.

Treatment options

Most commonly applied treatment approach is :
1. Surgery: The removal of the tumor and nearby lymph nodes.
Following Surgery , depending on the staging reports further treatment modalities are used like:

2. Radiation Therapy: High-energy beams are used to target and destroy cancer cells.

3. Chemotherapy: Medications are administered to kill cancer cells or prevent their growth.

Your healthcare team will discuss the most appropriate treatment plan tailored to your individual needs.

Prevention and Oral Health Care: While tongue cancer can occur despite preventive efforts, adopting healthy habits can help reduce the risk. Here are some practical steps to promote oral health and reduce the chances of developing tongue cancer:

1. Avoid tobacco in any form, including smoking and chewing tobacco.
2. Limit alcohol consumption
3. Practice good oral hygiene
4. Visit your doctor regularly for check-ups
5. Maintain a balanced diet for overall health.

Surgical Management of Tongue Cancer

Surgery is the primary treatment option for tongue cancer. The surgical management aims to remove the tumor and nearby lymph nodes to prevent the spread of cancer. The specific surgical approach depends on the stage and location of the tumor. Let's delve into the surgical procedures commonly used in the management of tongue cancer:

Transoral Resection: This procedure involves removing the tumor through the mouth without making external incisions. It is typically performed for early-stage tongue cancers.

Partial Glossectomy: In cases where the tumor is larger or has spread to deeper layers of the tongue, a partial glossectomy may be performed. This surgery involves removing a portion of the tongue where the tumor is located while preserving as much healthy tissue and function as possible. (image primary closure)

Depending on the extent of the tumor, a hemiglossectomy (removal of half the tongue) or subtotal glossectomy (removal of a significant portion) may be performed. In some instances, reconstruction techniques such as local tissue flaps /free flaps may be used to restore tongue function and aesthetics. (Image of flap)

3.

Total Glossectomy: In advanced cases of tongue cancer where the tumor involves a significant portion of the tongue or has spread extensively, a total glossectomy may be necessary. This procedure involves the complete removal of the tongue. While losing the ability to speak and swallow normally can be challenging, advances in reconstructive techniques have improved outcomes. Reconstructive options may include using tissue flaps from other parts of the body or surgical implants to restore some functions.

4.

Neck Dissection: Since tongue cancer can spread to the lymph nodes in the neck, a neck dissection may be performed in conjunction with tongue surgery. This procedure involves the removal of lymph nodes from the neck to determine if cancer has spread beyond the tongue. It helps prevent the spread of cancer and provides valuable information for staging and further treatment planning. 

Recovery and Rehabilitation: Recovery after tongue cancer surgery varies depending on the extent of the procedure and individual factors. Following surgery, patients may experience temporary difficulty speaking, swallowing, or tasting. A multidisciplinary healthcare team, including speech therapists and nutritionists, will provide support and guidance throughout the recovery process. Post-surgical rehabilitation may involve exercises to restore tongue movement and function. Speech therapy can help patients learn alternative methods of speaking and swallowing, if needed. Nutritional counseling may be provided to ensure adequate nutrition during the recovery period.