.The majority of tongue cancers are squamous cell carcinomas, which originate in the thin, flat cells lining the tongue. This type of cancer can spread quickly if not detected early, making awareness of the symptoms and risk factors particularly important.
Symptoms of tongue cancer
Early-stage tongue cancer might not cause noticeable symptoms, which is why regular dental check-ups are vital, says Dr Raman Narang, senior consultant and medical oncologist at Andromeda Cancer Hospital. However, as the disease progresses, the following symptoms may appear:
Persistent tongue pain: Unexplained pain in the tongue that doesn’t go away could be a sign of cancer.
Sore or ulcer: A sore or ulcer on the tongue that doesn’t heal within two weeks should be evaluated by a healthcare provider.
Red or white patches: The appearance of red or white patches on the tongue, especially if they are persistent, can be an early sign of cancer.
Difficulty swallowing or speaking: As the tumour grows, it may cause discomfort or difficulty when swallowing or speaking.
Numbness or tingling: Numbness or a tingling sensation in the tongue may occur if the cancer affects the nerves.
Ear pain: Unexplained ear pain can sometimes be associated with tongue cancer, even without an ear infection.
Lump in the neck: In advanced cases, tongue cancer may spread to lymph nodes in the neck, causing a noticeable lump.
Stages of tongue cancer
Tongue cancer is staged based on the size of the tumour, whether it has spread to nearby lymph nodes, and whether it has metastasised to other parts of the body, says Dr Narang. Staging helps determine the best treatment approach.
Stage 0 (carcinoma in situ): Abnormal cells are present only in the outermost layer of the tongue tissue. This is the earliest stage and is highly treatable.
Stage I: The tumour is 2 centimetres (cm) or smaller and has not spread to lymph nodes or other parts of the body.
Stage II: The tumour is larger than 2 cm but not more than 4 cm and has not spread to lymph nodes or distant sites.
Stage III: The tumour is larger than 4 cm or has spread to one lymph node on the same side of the neck as the tumour, but not to distant sites.
Stage IV: This is the most advanced stage, where the cancer may have spread to nearby tissues, lymph nodes, and potentially other parts of the body. Stage IV is further divided into IVA, IVB, and IVC, based on the extent of the spread.
Also see: Do you spend a lot of time on computer screen? Here's why you should worry about tech neck
Treatment options for tongue cancer
The treatment of tongue cancer depends on the stage and location of the cancer as well as the overall health of the patient, says the doctor. Here are the main treatment options:
Surgery:
Early-stage surgery: For small, localised tumours, surgery may involve removing just the cancerous tissue (partial glossectomy) while preserving most of the tongue.
Advanced-stage surgery: Larger tumours or those that have spread might require more extensive surgery, possibly including the removal of part of the tongue (glossectomy) and reconstruction using tissue from other parts of the body.
Radiation therapy: External Beam Radiation: High-energy rays are directed at cancer from outside the body to kill cancer cells.
Brachytherapy: In some cases, radioactive wires are placed directly in or near the tumour.
Chemotherapy: Chemotherapy uses drugs to kill cancer cells and is often used in combination with radiation therapy, especially in more advanced stages or if the cancer has spread.
Targeted therapy: Targeted drugs specifically attack cancer cells with certain mutations or proteins, sparing more of the healthy cells. These therapies are often used in combination with other treatments.
Immunotherapy: For advanced or recurrent tongue cancer, immunotherapy drugs may be used to help the immune system recognise and attack cancer cells.
Prevention and early detection
The best way to prevent tongue cancer is to avoid risk factors such as smoking, excessive alcohol consumption, and human papillomavirus (HPV) infection. Regular dental check-ups and self-examinations of the mouth can aid in early detection, significantly improving the chances of successful treatment.
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