Tongue cancer is a malignant neoplasm that develops in the maxillofacial area. It is characterized by multiple or local compactions, ulcers, papillomatous growths, which can be located in the anterior part of the tongue or in the area of its base. The disease begins with the process of mutation of epithelial cells. Their incorrect division leads to the formation of pathological growths on the mucous membrane of the organ. Over time, they can penetrate deeper into the tissue, spreading to the jaw, lips, throat, ear, or temple. Metastasis often occurs in the area of the cervical and submandibular lymph nodes.
Tongue cancer is an oncological disease that is quite rare compared to other oral tumors.
Only about 2% of cases of all oral tumors belong to this type of oncology. It has been found that men are more likely to experience tongue cancer. According to experts, this is due to the culture of alcohol and tobacco abuse. IMPORTANT:
tongue cancer most often develops on the lateral surface. In most cases, a squamous cell tumor or adenocarcinoma is diagnosed.
Early diagnosis of tongue cancer increases patients' chances of recovery, so you should definitely consult a doctor if any growths appear in the oral cavity.
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.
Anatomy and structure
The tongue consists of 2 main parts: the root and the body of the tongue. The body of the tongue occupies 2/3 of its size and ends with a narrowed round end. The root of the tongue (1/3 of its size) is wider in size and faces the oropharynx. It is attached at the base of the neck.
The root of the tongue rests on the lower palate between the teeth. When moving, its size changes due to muscle stretching.
The main part of the tongue is muscle tissue, which is represented by a group of muscles common to the entire tongue. The quality of the muscles of a given organ depends on its mobility and frequency of use. They are divided into 2 main groups depending on their location and fastening.
Skeletal muscles
Skeletal muscles (having a base on a skeletal part) include:
- hyoid muscle , which is attached with its base to the hyoid bone. Then it stretches along the side of the tongue to the very end. This muscle performs several main functions. It not only pulls the tongue down and back, but also has the ability to push the epiglottis down. Thanks to this, the larynx closes when swallowing;
- styloglossus muscle , which originates on the mental part of the lower jaw. It is located in the lower and lateral areas of the tongue. This muscle helps lift the tongue and pulls it back;
- The genioglossus muscle is the primary accessory muscle of the tongue. It runs from the chin to the end of the vertical part of the tongue. Its main function is to pull it forward;
- The palatoglossus muscle is considered internal and is located inside the hyoid part. This muscle elevates the root of the tongue and complements the other muscles.
Intrinsic muscles of the tongue
Intrinsic muscles of the tongue that have no skeletal attachment include:
- lower longitudinal;
- transverse;
- upper longitudinal;
- vertical.
Internal muscles are located in the tongue in accordance with their name. These muscles, complementing each other, are able to change the shape of the tongue and largely determine its movements. This muscle group works only in conjunction with other muscles.
The outer side of the root of the tongue is covered by intermuscular connective tissue and mucous membrane. There is no submucosal layer in the tongue, so the mucous membrane (stratified epithelium) does not form folds on the surface, but lies firmly on the base. At the end of the root of the tongue on the upper side, there are roughness and small papillae on the surface of the tongue.
On the root and body of the tongue you can find 5 main types of papillae:
- thread-like, which have the ability to touch and help keep food on the tongue;
- mushroom-shaped, which are responsible for taste sensations and recognize sweetness;
- cone-shaped ones feel pain, food temperature and have tactile functions;
- groove-shaped, which fill the upper part of the tongue especially densely. They are also responsible for the perception of taste;
- leaf-shaped ones are responsible for the sensation of sour taste.
Taste buds are also located at the top of the tongue at the root of the tongue. They have a taste analysis system and help you feel all possible sensations. There are several glands at the root of the tongue. They originate at the root of the tongue and are located along its entire length.
There are several types of glands:
- mucous membranes located in the papillary layer;
- serous, running in the lateral parts and partially inside the tongue;
- mixed.
The posterior glands are concentrated at the root of the tongue. These are numerous glands of different types that are located and penetrate the muscle fibers of the organ. Through small ducts, the posterior glands exit into the grooves and small papillae of the posterior part of the tongue, creating a dense part of the organ.
Further than the posterior groove at the root of the tongue there is a node of lymphoid tissue, which is formed by follicles of different sizes. This lymphoid connection is called the lingual tonsil. It is in this place that the mucous membrane of the tongue has an elevation with a pit in the center (script). The lingual tonsil forms part of the lymphatic system of the epithelium in the pharynx.
Lymphatic fluid enters through the nodes of the lymphatic system, which are located under the jaw and chin, as well as in the pharynx.
The tongue is supplied with nutrients and oxygen through the large vascular branches of the organ, which permeate its entire body. And venous outflow occurs through the jugular vein. All vessels in the tongue are quite large and often penetrate its main body.
The nervous system of the tongue is represented by a network of nerve endings that penetrate the entire body of the organ. They provide its increased mobility.
Symptoms
Often a person begins to notice symptoms of tongue cancer when a non-healing ulcer appears in his mouth or, conversely, some kind of lump (growth). If it is an ulcer, it does not heal and may bleed. When it comes to damage to the root of the tongue, there is pain when swallowing, a change in voice, and a feeling that something is blocking the throat.
If some kind of spot (white, red) or bump appears on the mucous membrane of the tongue, you should definitely go to the doctor. A sign may be a feeling of numbness, sometimes painful sensations radiate to the ear. The doctor must be chosen depending on the symptoms. If the symptoms of tongue cancer are localized to the tongue, you can start by visiting a dentist. When you experience a sore throat or a feeling of a lump, you should start a visit to the ENT specialist to rule out ENT diseases. A visit to a therapist is also possible. Any of these specialists, suspecting cancer, will redirect the patient to an oncologist.
Organ characteristics
The root of the tongue is located deep in the mouth, namely in the recess of the lower part of the palate between the teeth. It, like the rest of the tongue, is covered with a mucous membrane. The root of the tongue is its base and consists of several muscles that continue into the body of the tongue. The tongue is considered the strongest muscle of the body and combines 8 different muscles that are woven together and complement each other.
On the outside, the tongue is covered with a mucous membrane, which consists of papillae of various types. It is the presence of papillae that helps to sense taste and starts the digestion process.
The papillary layer forms a rough surface on the tongue, on which plaque from food or bacterial activity is quickly deposited. It is the quality and color of plaque that signals disturbances in the functioning of the body.
Often, based on the condition of the tongue, it is possible to determine the presence of diseases of individual organs for further examination and diagnosis, therefore, during the examination, the therapist must note the color of the tongue.
Causes, risk factors
Possible causes of tongue cancer look like this:
- The influence of carcinogens in tobacco and other smoking mixtures.
- Constant exposure to alcohol on the tongue. Interesting fact: recent studies show that alcohol can enhance the effects of carcinogens found in tobacco.
- Contact with harmful substances: salts of heavy metals, asbestos, petroleum products - for example, when working in hazardous industries.
- Regular mechanical injuries to the tongue - biting, exposure to dentures, rubbing the tongue with a splintered tooth or poorly chosen filling, etc.
- The effect on the body of HPV - specifically strains that have a high oncogenic risk. People with HIV and other viruses are also at risk.
- Precancerous conditions of the tongue, which can later develop into cancer. These are chronic ulcers, papillomas, lichen planus, Bowen's disease, etc.
Obviously, not all reasons can cause tongue cancer (and not always) - we are only talking about a significant increase in risks.
Classification, stages of tongue cancer
Histologically, tongue cancer is most often represented by squamous cell carcinoma. It consists of cells that resemble in appearance those that make up the mucous membrane of the mouth, nose, pharynx, and larynx.
The same staging system is used for malignant tumors of the tongue as for oral cancer. The international TNM system is used, in which the letter T denotes the size of the primary tumor, N - the presence of foci in regional lymph nodes, M - the presence of distant metastases.
Stages of tongue body cancer
Stage 1 - a malignant tumor up to 2 cm in size (T1), which does not spread to regional lymph nodes (N0) and does not give distant metastases (M0).
Stage 2 - a tumor measuring 2–4 cm (T2), N0M0, which does not spread to regional lymph nodes (N0) and does not give distant metastases (M0).
Stage 3 - tumor is more than 4 cm (T3), which can spread to the lymph nodes on the affected side (N0 or N1).
Stage 4A - a tumor that grows into the skin, bones, tongue muscles, maxillary sinus (T4a) and can spread to one lymph node on the affected side (N0 or N1), or a tumor of any size (T1-T3) that spreads to several lymph nodes on the opposite side, on both sides (N2). There are no distant metastases (M0).
Stage 4B is a tumor that grows into the base of the skull, the pterygopalatine artery (T4b), or a tumor of any size if foci larger than 6 cm are found in the regional lymph nodes (N3). There are no distant metastases (M0).
Stage 4C is a tumor of any size that has or has not spread to regional lymph nodes, but the main symptom is distant metastases (M1).
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Stages
Cancer of the root of the tongue or its body is divided into four stages:
- 1st (initial). At this stage, oncology is often confused with glossitis, stomatitis and other diseases. The person himself may mistake unwanted stains for plaque. There are few symptoms.
- 2nd. Clinical manifestations begin: compactions, tumors, pain. The pain often radiates to neighboring organs (neck, ears). Suppuration and infection of the tumor may occur. The tongue often swells and becomes numb. Already at this stage, metastases from tongue cancer are possible - usually to nearby lymph nodes.
- 3rd. If you ignore the symptoms of the second stage, aggressive penetration of cancer into the thickness of the tongue and neighboring tissues begins. Tissue breakdown also begins.
- 4th. At this stage, metastases are observed in various organs: lungs, liver, bones. Treatment at the fourth stage, as a rule, is limited to palliative care; patients rarely survive more than a year.
It is important not to let the situation get worse and pay attention to the signs of tongue cancer in time - then there will be a much greater chance of recovery.
Questions and answers
Is there a cure for tongue cancer?
Treatment of a tumor will be most successful if it is detected at an early stage of the disease. As the cancer process spreads to other organs, the effectiveness of treatment decreases, however, even in the most advanced cases, oncologists strive to prolong the patient’s life as much as possible.
How to determine tongue cancer?
It is impossible to independently determine that a spot or growth that appears on the tongue is a cancerous tumor. A histological analysis of the tissue is necessary to confirm or refute the suspicion of tongue cancer. If there are any suspicious signs, you must contact a qualified oncologist and undergo a special examination.
How long do people live with tongue cancer?
According to medical statistics, with timely detection and treatment of tongue cancer, patients live from 5 to 15 years. In the absence of medical care, the patient’s life expectancy does not exceed one and a half years.
Attention! You can cure this disease for free and receive medical care at JSC "Medicine" (clinic of Academician Roitberg) under the State Guarantees program of Compulsory Medical Insurance (Compulsory Medical Insurance) and High-Tech Medical Care. To find out more, please call +7(495) 775-73-60, or on the VMP page for compulsory medical insurance
Diagnostics
If tongue cancer is suspected, diagnostics include the following:
- a visit to the dentist, during which a specialist will examine the oral cavity and palpate it;
- examination of a smear from the oral cavity (bacterioscopy);
- CT or MRI - to detect metastases in the brain;
- biopsy - examination of a small piece of affected tissue;
- radiography - helps to detect changes in the bones, if any;
- Ultrasound.
Diagnostic methods
If a person suspects tongue cancer, he should be carefully examined by a specialist doctor. The condition of the oral mucosa is assessed, pharyngoscopy (examination of the pharynx), and, if necessary, laryngoscopy (examination of the larynx), panendoscopy (endoscopic examination of the larynx, esophagus, trachea and bronchi) are performed. The subcutaneous lymph nodes in the neck are felt.
Next, you need to confirm that the detected formation (or formations) is a malignant tumor. To do this, a biopsy is performed - the doctor obtains a tissue sample and sends it to the laboratory to be examined under a microscope. A tongue biopsy can be done by scraping or removing part of the tumor. If enlarged lymph nodes are detected, tissue is obtained from them using a needle under ultrasound guidance.
Be sure to perform a test for human papillomavirus.
Next, you need to assess how far the malignant tumor has spread beyond its primary location and clarify the stage of the disease. For this, different diagnostic methods are used:
- chest x-ray
- Using computed tomography , the size and location of the tumor is clarified, its growth into surrounding tissues, spread to the lymph nodes, and distant metastases in the lungs are detected.
- MRI is used for the same purposes as computed tomography. This diagnostic method is especially useful when it is necessary to clarify the spread of a malignant tumor in the tissues of the neck and assess damage to the brain and spinal cord.
- PET scanning (positron emission tomography) is currently the gold standard in the diagnosis of distant metastases of malignant tumors. During this study, the patient is given a drug containing a safe radioactive tracer intravenously. This drug is actively absorbed by tumor foci and makes them visible in photographs taken using a special apparatus.
At the international clinic Medica24, examinations are carried out using modern diagnostic equipment from leading manufacturers. This makes it possible to timely establish an accurate diagnosis and prescribe optimal treatment.
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Treatment
If tongue cancer is detected, there are several types of treatment:
- Surgery. The operation is used most often and allows for recovery in 80% of situations. When the tumor is removed, the tongue may be partially or completely removed. In advanced cases, part of the jaw bone is also removed, then the jaw structures can be restored using special methods.
- Radiation therapy. When fighting tongue cancer it gives good results, also up to 80% effective. Can be used either alone or in combination with surgery.
- Chemotherapy. Prescribed if metastases are detected.
Both chemotherapy and radiation therapy can be palliative - that is, they are carried out in cases where the patient can no longer be cured, but his condition can be maintained and the quality of life can be improved.
Forecasts
With timely consultation with a doctor and proper treatment, the five-year survival rate for tongue cancer is about 90%. If the cases are advanced, but without metastases, this percentage drops to 60%. When metastases have spread, the five-year survival rate is less than 35%.
Functions and properties
The root of the tongue is located at the beginning of the pharynx and forms its basis. The root of the tongue performs many functions independently and as a single organ.
The main functions of the tongue root include:
- mixing food and pushing it down the throat;
- participation in swallowing, sucking food;
- perception of 5 basic tastes;
- sensitivity to the temperature of food consumed and any objects;
- participation in speech by determining the purity of individual sounds;
- tactile functions for the perception of various foods and objects;
- supporting the quality of work of the entire body;
- participation in the articulation and expression of feelings.
When chewing food, the tongue triggers the process of salivation and determines the beginning of digestion, so it is believed that it is also involved in the digestion process. The tongue can perform several functions simultaneously, and any disruption in its functioning affects the performance of its individual functions.
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.
Diagnosis and treatment of tongue cancer in Moscow
If you find external signs of tongue cancer, contact the Medicina clinic for prompt and high-quality diagnosis. Once the diagnosis is confirmed, qualified oncologists provide treatment in accordance with the protocols of the world's leading clinics. The examination is carried out using the most modern diagnostic equipment available at the moment. For treatment and the subsequent rehabilitation period, we offer comfortable wards in the inpatient department, where patients receive professional care and high-quality medical service.
