Brief overview
- What is tongue cancer? A malignant form of oral cavity cancer, primarily affects the front two-thirds of the tongue
- Causes: Carcinogens trigger the formation of altered mucosal cells of the tongue.
- Risk factors: consumption of tobacco, alcohol and betel nuts, exposure to radiation, poor oral hygiene, predisposition; less frequently: human papillomavirus (HPV)
- Treatment: Surgical removal, reconstruction, radiotherapy and/or chemotherapy.
- Course and prognosis: If diagnosed and treated as early as possible, cure is possible. Recurrences sometimes occur within two years after treatment.
- Diagnostics: Tissue examination (mirror examination and biopsy), X-ray, ultrasound, computer tomography (CT), magnetic resonance imaging (MRI).
What is tongue cancer?
Tongue cancer or tongue carcinoma is a malignant (malignant) form of oral cavity cancer. It develops mainly in the front area of the tongue. Tumors under the tongue are usually oral floor cancers, which are also oral cavity cancers. Cancer that occurs in the back third at the base of the tongue is a form of throat cancer.
Frequency
How does tongue cancer develop?
How is the development of tongue cancer promoted?
The main risk factor for tongue cancer is the excessive use of tobacco and alcohol. Smokeless tobacco extracts inhaled with e-cigarettes are also suspected of being carcinogenic. In the Asian region, betel nut is considered a major risk factor. Betel nuts contain psychoactive substances and are either chewed like tobacco or drunk dissolved in tea.
How can you tell that you have tongue cancer?
Typical symptoms that indicate tongue cancer at an early stage are conspicuous white or reddish discolorations of the mucosa. These spots are called leukoplakia and erythroplakia and are precancerous. In many cases, they develop into mature malignant tumors.
Other symptoms of tongue cancer include:
- Swelling of the tongue and oral cavity.
- Ulcers (ulcers)
- Pain on the tongue
- Bleeding of unclear origin
- Problems with swallowing, chewing and speaking
- Bad breath (foetor)
- fatigue, tiredness
- Loss of appetite
- Weight loss of unclear origin
- Fever episodes
If one or more of the above symptoms persist for a period of more than two weeks, please consult a doctor.
The symptoms mentioned may also be signs of other (harmless or serious) diseases. Therefore, have the cause clarified by a doctor.
Is tongue cancer curable or fatal?
Surgery
A prerequisite for the greatest possible success of treatment is to remove the cancerous tissue as far as possible by surgery. In this process, doctors remove the tumor and part of the surrounding healthy tissue (resection). In this way, tumor remnants are prevented from remaining and developing again. The risk of recurrence is correspondingly small.
An operation in the mouth or on the tongue in which parts of tissue are removed may cause problems with speaking or eating. To prevent impairments, the affected section in the mouth is restored (reconstructed) as far as possible. To do this, the surgeon removes tissue from other parts of the body and reinserts it in the affected area. The functions of the tongue and the chewing and swallowing apparatus and the appearance are thus preserved.
In most cases, surgery is followed by treatment with radiation therapy and/or chemotherapy. Even in tongue cancer patients for whom surgery is not possible, these treatment methods are performed as sole therapies in each case or both procedures are combined.
In many cases, chemotherapy is combined with radiation therapy and is often administered after surgery. Doctors often administer so-called cytostatics, for example with the active ingredient cisplatin. Cancer immunotherapy usually supports the treatment with cytostatics. Here, the active substance cetuximab (antibody) is administered. Together, they counteract the growth of tumor cells and thus fight tongue cancer.
Cytostatic drugs affect all cells in their growth and also affect healthy tissue. To avoid damage and severe side effects, doctors fine-tune the dose and duration of use.
Prognosis
Another factor influencing the chances of curing tongue cancer is the general state of health of the affected person. If other diseases (such as heart failure, renal insufficiency) are present, the prognosis is also worse.
Can a dentist detect tongue cancer?
Generally speaking, early diagnosis significantly increases the chances of curing tongue cancer. Regular checkups with a dentist are particularly important, as dentists not only comprehensively examine the teeth, but also the entire oral cavity. Other specialists such as ear, nose and throat doctors, orthodontists or even family doctors also play a role in the initial diagnosis of tongue cancer.
By means of a mirror examination (endoscopy), the doctor inspects the oral cavity closely and – if possible – takes a sample of conspicuous tissue (biopsy). This is then examined in the laboratory for cell changes.
For the earliest possible diagnosis, it is important to attend the annual check-ups at the dentist. If you suspect tongue cancer (e.g. if you have symptoms), please see your doctor immediately.
