Tongue Cancer: What is it, Symptoms, Types

Tongue cancer is one of the types of oral cancer that develops from cells in all parts of the tongue. This may lead to the formation of tumors and lesions in the mouth. Tongue cancer is divided into different subtypes depending on which part of the tongue it develops. These types have their own unique symptoms. The most common symptom of tongue cancer is non-healing sores on the tongue. Although tongue cancer is more common in older individuals, there is a recent trend towards its incidence in young and middle-aged people. It can be controlled and treated with early diagnosis and treatment.

What is Tongue Cancer?

Tongue cancer is the most common subtype of oral cancer in our country, which can occur in different cells in the tongue and cause masses or lesions in the tongue. Since cancerous cells tend to grow and multiply abnormally, they can cause more serious problems if left untreated. Some other types of cancer that develop in the mouth can also affect the tongue. However, tongue cancer is an uncontrolled proliferation that develops directly in the cells in the tongue. Tongue cancer may show different and varying symptoms in the early stages. Symptoms usually seen in the early stages are red or white lesions in the mouth and non-healing and bleeding sores. Identifying the type of cells in the tongue where cancer develops can help choose the most appropriate method for treatment. In addition, where the tongue cancer develops is one of the factors that are effective in determining the treatment to be applied.

Types of Tongue Cancer

Tongue cancer is a general expression used to describe cancers that develop in different parts of the tongue. Tongue cancer is divided into two according to the region of the tongue where it occurs. These can be listed as follows:

• Oral (Oral) Tongue Cancer: Oral tongue cancer, which is the common type of tongue cancer, is felt more easily by individuals. This type of cancer starts in the tongue and can affect the floor of the mouth, the inside of the lips and cheeks, the jawbone, and the gums. Over time, the tumor metastasizes to the glands in the neck and manifests itself as a mass in the neck. It develops in the front ⅔ of the tongue.
• Oropharyngeal Tongue Cancer: This cancer develops at the root of the tongue, in the part of the tongue adjacent to the pharynx. In the later stages of this type, cancer may spread to the front of the tongue, tonsils, pharynx and larynx. Over time, the tumor metastasizes to the glands in the neck and manifests itself as a mass in the neck. It develops in the back part of the tongue.

Tongue cancer is also classified according to the cell from which it originates, such as squamous cell carcinoma, various salivary gland tumors, soft tissue tumors, or tongue base lymphoma.

What are the symptoms of tongue cancer?

Tongue cancer usually manifests itself in the early stages as wounds that do not heal, bleeding, and white and red plaques on the surface of the tongue that do not heal. Especially in oropharyngeal tongue cancer, which is a type of cancer that develops at the root of the tongue, symptoms often manifest themselves in the later stages. It may manifest itself with speech and swallowing disorders and pain at the base of the tongue, and impaired tongue movement. Tongue cancer symptoms are generally similar to other types of oral cancer. In addition, there may be pain around the tongue and mouth. In general, the symptoms of tongue cancer can be listed as follows:

• White or red lesions on the tongue that do not heal
• Non-healing ulcers on the tongue
• Feeling of pain and suffering when swallowing
• Persistent numbness in the mouth
• A persistent sore throat
• Bleeding in the tongue without any reason
• Lumps that do not go away on the tongue
• Feeling pain or pain while talking
• Lumps felt in the neck

If such symptoms that develop in the tongue continue for a certain period of time, it is important to go to a health institution and consult an ENT physician for early diagnosis and treatment.

What are the Risk Factors for Tongue Cancer?

Although there is no definitive cause of tongue cancer, various behaviors and factors can increase the risk of developing tongue cancer. These can be listed as follows:

• smoking heavily
• chew tobacco
• Having a sexually transmitted human papillomavirus (HPV) infection (for tongue base cancer)
• Having a family history of tongue or oral cancer
• History of cancer developing in other squamous cells in the body
• A diet low in fruits and vegetables
• Poor oral hygiene
• Having jagged teeth

Oral and tongue cancer is more common in individuals over the age of 55. The risk is especially higher in older men than in women and young people.

Tongue Cancer Treatment

For the most appropriate treatment for tongue cancer, it is important to determine in which cells and in which region the cancer develops. The doctor first learns the patient’s medical history by examining the patient’s mouth and tongue structure in detail. Asks if there is any history of cancer in family members. He performs a physical examination on the patient and may also check the swelling of the lymph nodes in the neck. Then, if the doctor sees any signs of tongue cancer, he or she will perform various tests on the patient to know more about the condition. In the light of the findings obtained, it makes the most appropriate diagnosis for the patient. The methods used to make a definitive diagnosis of tongue cancer can be listed as follows:

• Incisional Biopsy: In this diagnostic method, the doctor takes a biopsy sample from the suspicious area on the patient’s tongue and evaluates whether cancerous cells are present. This type of biopsy is usually performed under local anesthesia.
• Brush Biopsy: The brush biopsy method involves applying a brush to the suspicious area on the patient’s tongue. During the procedure, the area where the brush is applied bleeds, so the doctor can collect the cells in the area for examination.

Once tongue cancer is diagnosed, the doctor plans the appropriate treatment options for the patient. Treatment for tongue cancer may vary depending on how large the cancer is and how far it has spread. The most ideal treatment for cancers of the anterior tongue area is surgery. After surgery, radiotherapy and/or chemotherapy may be added depending on the pathology result. Apart from surgery, radiotherapy treatments can also be used successfully for tongue base tumors, especially if they are caused by the HPV virus. Surgical methods can be listed as follows:

• Partial Glossectomy: If the cancer in the tongue is still at an early stage and has not spread, treatment can be provided by removing the cancerous area.
• Hemiglossectomy: If the cancerous cells developing in the tongue are in a larger area, especially if they approach the midline of the tongue, the hemiglossectomy method can be used. In this procedure, a larger part of the tongue is excised.
• Total Glossectomy: It is a method in which the majority of the tongue is removed in very large tumors.
• Reconstruction Procedure: If tongue cancer has spread to a large part of the tongue, reconstruction is performed by transplanting tissue from another part of the body to ensure the integrity of the tongue after surgery.
• Neck dissection: It is performed on almost all tongue cancer patients along with tongue surgery to clean the glands in the neck that have spread or are likely to spread.

After surgical procedures, the patient; may experience eating, speaking, swallowing and breathing problems. However, getting help from a speech therapist after the procedure may make it easier to cope with these problems. If the cancer in the tongue has spread to surrounding tissues and there is a large tumor that has spread to the neck, radiotherapy is applied after surgery. The doctor may also add chemotherapy to the treatment.

Tongue Cancer Stages

Tongue cancer can be grouped by staging and grading. Staging is based on how far the cancer has spread. The stages of tongue cancer can be listed as follows:

• T is used to express the size of the tumor. T1 is used to indicate a smaller tumor, while T4 indicates a larger tumor.
• N is used to express whether cancerous cells have spread to the lymph area. N0 means that the cancer has not spread, and N3 means that the cancer has spread to more than one lymph node.
• M is used to express whether cancerous cells have metastasized (spread) to other body parts.

The degree of tongue cancer is determined by how malignant the cancer is and the degree of risk of spread. Tongue cancer grades can be listed as follows:

• Low grade (slow growing and unlikely to spread)
• Moderate (not too slow or too fast growing)
• High grade (very fast growing and likely to spread)

To prevent developing tongue cancer, it is important to avoid actions that may increase the risk of tongue cancer. Things that can be done to reduce the risk can be listed as follows:

• not smoking
• getting the HPV vaccine
• Consuming plenty of fruits and vegetables in your diet
• Paying attention to oral hygiene
• Going to the dentist for a check-up every six months

If you think you have symptoms of tongue cancer, do not forget to visit your doctor or the nearest health institution for early diagnosis and treatment.