Tongue cancer, symptoms, treatment methods, prognosis and complications

Tongue cancer is a fairly rare disease, but despite this, more and more cases of this pathology are registered every year. The most important thing is to pay attention to the early signs when a tumor appears; besides, it is quite difficult to miss. It should be noted that most often males suffer from tongue cancer, while women are least affected by this disease. What are the symptoms of tongue cancer?

Causes of tongue cancer

The symptoms of tongue cancer cannot be confused with anything!

Tongue cancer, like any other form of malignant tumor, appears for a reason. Its appearance is preceded by many factors that provoke cell mutation. The main causes of tongue cancer include:

Excessive smoking. But in some cases, even smokers with little experience may develop a tumor. This is due to the individual characteristics of the body and the structure of the mucous membrane
Chewing nicotine gum, which is used by people if they want to get rid of a bad habit.
Chewing tobacco, which irritates and damages the mucous membranes
Excessive consumption of alcoholic beverages
Heredity. Many people know that if someone in their family had one or another cancer disease, then their descendants are at risk
Serious diseases that can provoke a decrease in the body’s defenses, that is, immunity
Papilloma virus. Scientists attribute an increase in the number of cases of patients with tongue cancer to this reason. This is because people are engaging in oral sex more often. And, as you know, papilloma is transmitted both sexually and oral
Inflammation of the gums that remains untreated for a long period of time
Poor dental condition

Despite the fact that almost everyone knows about the main causes of tongue cancer, few people pay attention to them. And therefore, every year the number of people with this disease, which is not so easy to treat, is growing.

Precancerous conditions

We should also talk about those diseases that are classified as precancerous conditions. It is they who need to pay more attention and treatment, since any factor can provoke the degeneration of simple cells into cancerous ones. Such diseases include:

Leukoplakia. This is keratinization of the mucous membrane in the mouth, most often a red stripe appears on the lips. The main reason for the appearance of this disease is a decrease in the stability of the mucous membrane in the gastrointestinal tract, which leads to the penetration of harmful microbes and viruses into it, which can provoke cell mutation
Papilloma. This is a benign formation, which consists of papillary growths of connective tissue. In themselves, such formations are painless, but they pose a great danger associated with the possibility of the tumor degenerating from benign to malignant
Ulcer. It often happens that a person damages the oral mucosa. This can occur as a result of biting the cheek, tongue, cut, or thermal burn. In the event that no antibacterial treatment is carried out, the likelihood of ulcers on the mucous membrane increases, and as a result, in the future, the formation of cancer cells
Glossitis. This is a very rare disease, but still encountered in medical practice, which is characterized by pain in the tongue, as well as increased salivation.
Bowen's disease. This disease is characterized by the appearance of a small spot on the tongue, which has a rough surface. Over time, erosion may appear on it

If a patient is diagnosed with one of the above diseases, then close attention is paid to its course, as well as treatment. Due to the fact that some of these diseases cannot be completely cured, a person is recommended to visit a specialist every six months or year for a full examination and examination in order to control the situation.

What is glossitis?

Glossitis (from the Greek glossa (tongue) + suffix –itis) is an inflammation of the tongue. The reasons for its occurrence are different. Glossitis can develop as a result of a viral or bacterial infection, or as a result of another disease in the body. In addition, there are some other factors that provoke the development of the disease. These include mechanical, chemical and thermal damage to the oral cavity; nicotine; food that is too spicy or too hot; alcohol; caramel; some components present in toothpastes.

Glossitis has the following forms:

folded
diamond-shaped median
desquamative
hairy black
Gunter's
interstitial

According to the duration of the inflammatory process, acute and chronic glossitis are distinguished. The acute form of glossitis manifests itself as inflammation of the tongue, a change in its structure or color. Symptoms of the chronic form are more varied, but in most cases the disease is diagnosed by the presence or absence of papillomas - fungal growths on the tissues of the tongue. There are cases when the cause of the disease can be identified only after comprehensive medical research. True, this happens quite rarely and, as a rule, is associated with the presence of congenital, hereditary diseases.

Symptoms of tongue cancer

Papillomas can cause cancer

Tongue cancer is one of the diseases whose symptoms are so vivid that they force a person to independently seek medical help from a specialist. The main symptoms of tongue cancer include:

The appearance of plaque or spots on the tongue itself. The spots and amount of plaque may vary for each person, as it depends on what stage of cancer, where in the tongue it is located, etc.
The appearance of ulcers on the tongue
The appearance of a small lump on the surface of the tongue, which indicates that the person has the first stage of tongue cancer
Painful sensations that primarily appear at the site of the tumor. But sometimes the pain can radiate to the jaw, throat, ear or nose. Very often, pain intensifies when a person eats food, especially solid food.
Bad breath, which occurs due to the presence of cancer cells in the mouth
Inflammation of nearby lymph nodes. One of the most obvious signs of any cancer is enlarged lymph nodes. This pathology is characterized by enlargement of the cervical and submandibular lymph nodes. Separately, it is worth saying that not one node will be enlarged, but the entire group at once, which should alert any person
Increased production of saliva, which has nothing to do with food intake or hunger

Depending on where the tumor is located on the tongue, certain symptoms will be more pronounced, or, conversely, more blurred.

It is customary to distinguish several options for the location of the tumor:

At the root of the tongue
On the side surface. Most cases occur in this location of the tumor
On the bottom surface
On the top surface

The symptoms of tongue cancer cannot be confused with almost anything. In addition, discomfort in this area is noticed almost immediately, since the resulting tumor interferes with normal eating, and sometimes can even interfere with conversation.

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Periods of development of cancerous tumors

Tongue cancer develops very rapidly. That is why it is customary to distinguish several forms and periods, each of which will be characterized by its own symptoms of manifestation. It is customary to distinguish three periods of tongue tumor development:

Elementary. At this stage, the person begins to notice that a seal has appeared on the tongue, which causes him discomfort. After a short period of time, the tissue in this place becomes more and more dense, and white spots also appear. On top of everything else, there are also pain sensations that spread not only to the site of the tumor, but can also radiate to the throat, nose or ears. True, some patients associate pain with caries or sore throat. In the initial period, three forms of tumor can be distinguished, differing in anatomical characteristics:
Ulcerative. A lump appears that eventually develops into an ulcer
Knotty. The seal that has appeared has a whitish tint and is also very dense to the touch. In addition, there are clear boundaries of education
Papillary. Growths appear that are very similar to papillomas. Only if the papilloma itself is not hard, then the papillary tumor is very hard
Developed. During this period, all symptoms begin to worsen, and the person suffers from severe pain. In most cases, the pain becomes so severe that even painkillers do not help the patient. In addition, the pain is localized not only in the tongue, but also spreads to the throat.

Also, during an acute pain attack it radiates to the ear or nose. It is during this period that bad breath appears, which is caused by the breakdown of cancer cells. In the developed period, it is customary to distinguish two forms of tumor:

Exophytic. Ulcers increase in size slightly
Endophytic. The ulcers deepen and become very large
Neglect. During this period, the cancer spreads so quickly that the tissue begins to break down, the tumor increases in size, and the symptoms become very vivid.

As mentioned above, each period is characterized by its own course and symptoms. They manifest themselves most clearly in the second period, and already force any person, even those who do not take them seriously, to consult a specialist to find out the cause.

Kinds

In 70% of cases, cancer of the body of the tongue is detected, in 20% - damage to the root, and in 10% - to the lower surface of the organ. If we divide diseases according to cell characteristics, we can distinguish the following forms:

Papillary. It looks like a dense growth with papillary outgrowths and plaque-like formations.
Ulcerative. It is observed in approximately 50% of cases. Ulcers develop over time, can bleed, and often become infected, thereby masking the root cause of the disease.
Infiltrative. Cancer grows inside the tongue and hardens its tissues. The form can be diffuse or spread throughout the entire organ.

If we talk about microscopic analysis, then in 95% of cases we are talking about a squamous cell form of tongue cancer, other options are much less common.

Diagnostics

The tongue needs proper care

After the patient has contacted the doctor with complaints, he will be prescribed an examination, during which the following procedures will be carried out:

Interview, identification of chief complaints, and manual examination of the tongue and neck area
Referral for basic tests
Biopsy of organ cells
Ultrasound examination of the tongue and neck, as well as some abdominal organs
X-ray of the lower jaw, as well as all organs located in the chest
Lymph node puncture
Computed tomography or magnetic resonance imaging

After all the examination results have been received, the doctor will be able to make an accurate diagnosis and prescribe the correct treatment.

Prevention

The following are called preventive measures:

Regular visits to the dentist - once every six months.
Constant inspection of the tongue for strange formations.
Elimination of traumatic factors. If there is an interfering filling in the mouth or the dentures do not fit well, this must be corrected.
Quitting bad habits: alcohol, cigarettes.
Timely treatment of all problems in the oral cavity.
General strengthening of the immune system.

People who are attentive to oral hygiene, as a rule, notice the first signs of tongue cancer earlier than others and consult a dentist in time for initial diagnosis.

Treatment of the disease

The success of the chosen treatment depends on the stage at which tongue cancer was detected. Based on this, as well as on the individual characteristics of the person, treatment will be selected that will help reduce the tumor or get rid of it altogether. After the results of tests and all examinations have been received, and the alleged diagnosis has been confirmed, the patient will immediately be sent to an oncologist, who will begin treatment. Typically, three methods are used:

Surgical intervention. Depending on the size of the tumor, one or another method of surgical intervention will be chosen:

If there are many lesions or the tumor is very large, the person may undergo a glossectomy, that is, removal of the entire tongue or most of it.
In the event that it is possible not to remove everything completely, then partial resection is performed, and in some cases the person retains the ability to speak.
If the tumor has already affected other tissues, then those areas in which cancer cells are present can be removed. Sometimes partial resection of the tissues of the floor of the mouth or jaw may be necessary, as well as removal of the affected lymph nodes

Chemotherapy. Chemotherapy is the introduction of special drugs into the human body, the action of which is aimed at destroying cancer cells. Most often, chemotherapy is prescribed in cases where it is necessary to reduce the tumor to an operable size, as well as in the presence of metastases to other organs. Today, polychemotherapy has become especially popular, the effectiveness of which ranges from 50 to 70 percent (if we talk about standard monochemotherapy, its effectiveness is no more than 30 percent). A combination of drugs such as fluorouracil and platinum-based drugs is used here. Thanks to the unusual combination, the highest effect is achieved. And in the simplest cases, only one or two sessions of such chemotherapy are required. Chemotherapy is also given after surgery to kill remaining cells and reduce the risk of relapse.
Radiation therapy. It is used both as an independent treatment and as a combined treatment. For the first procedure, average values are selected, that is, when the total focal dose reaches 35 or 40. If after the first session there is no noticeable improvement or there is, but insignificant, then radiation therapy is completed and another treatment method is chosen. If at this dose the tumor has decreased by 50 percent, then radiation therapy is continued until there is significant improvement, and the total focal dose is increased to 60.

Under no circumstances should you ignore the advice and recommendations of an oncologist and try to treat cancer yourself. Many people believe that traditional medicine will help them. Unfortunately, in this case it is powerless, since it cannot have the effect on cancer cells that is required. In addition, treatment with folk remedies is not aggressive. And this is how you need to approach cancer.

Staging

The stage of tongue cancer depends on the size of the tumor, its growth, the presence of malignant foci, and distant metastases.

Stage 1. Tumor up to 2 cm.

Stage 2. Tumor 2–4 cm.

Stage 3. One of the characteristics is present: the tumor is 4 cm, there is a focus in the regional lymph nodes.

Stage 4A. One of the signs is revealed:

Tumor growth through the skin or inside the bone to the nerve, in the lymph nodes the lesion is up to 3 cm;
The size of the tumor is any, but lesions no larger than 6 cm in regional lymph nodes are diagnosed;
The tumor grows into the larynx, extending beyond the area of the muscles of the tongue, hard palate, lower jaw, and masticatory muscles.

Stage 4B. One of the signs is revealed:

The size of the tumor is any, regional lymph nodes are affected, the lesion is more than 6 cm;
The tumor has grown deeply into the surrounding tissues and organs.

4C stage. There are distant metastases.

Tongue root cancer

You should pay attention to even the slightest changes

This is one of the most difficult types of cancer, since the location of the tumor does not allow it to be removed without causing great harm to the person. In most cases, after cancer of the root of the tongue, that is, after treatment, a person loses the ability to speak, and his quality of life noticeably decreases.

Cancer of the root of the tongue is also dangerous because symptoms begin to appear only 2 or 3 months after the tumor has formed. In addition, a person cannot independently see any changes occurring at the root of the tongue, and therefore only a doctor can make a diagnosis or detect the problem. As for the symptoms of tongue cancer in later stages, these include:

Observation

After treatment, you need to undergo regular examinations, their frequency depends on how many years have passed since entering remission.

In the 1st year - every 1-3 months.
In the 2nd year - every 2-6 months.
In 3-5 years - every 4-8 months.
In the 6th year and thereafter – annually.

The following manipulations and examinations are carried out as control tests:

medical instrumental examination of the oral cavity, peripheral lymph nodes;
examination by a dentist if radiation therapy was performed in the oral cavity;
endoscopic examination of the pharynx and oral cavity;
for patients who have previously smoked - MRI (CT) of the soft tissues of the neck with contrast, CT of the chest and abdominal cavity with contrast. If necessary, PET with glucose, osteoscintigraphy.

Survival prognosis

Each type of cancer has its own prognosis, but it can be roughly represented as follows:

If a cancerous tumor is detected at the first or second stage, the survival rate is 75 percent
If a cancerous tumor is detected at the third stage, the survival rate is 50 percent
When a cancerous tumor is detected at the fourth stage, the survival prognosis is less than 30 percent. It should be noted that a period of time equal to five years is taken.

Those who promptly consult a doctor for medical help have every chance of recovery, since the earlier tongue cancer was detected, the easier it will be to cure.

Tongue cancer is one of the most dangerous diseases that develops rapidly. That is why, if you detect at least a few symptoms indicating cancer, you should not immediately contact a specialist in order to avoid the possible transition of the disease to the most severe stage.

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Kiani Ali
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