Tongue cancer refers to malignant tumors of the oral cavity and oropharynx, which, in turn, are a type of head and neck cancer. This is a rare type of malignant tumor. Oral cancer accounts for about 3% of all cancers. People over 62 years of age are most often affected.
- Causes: what causes tongue cancer?
- Types of tongue cancer
- Symptoms and signs of tongue cancer
- Methods for diagnosing tongue cancer
- Stages of tongue cancer development
- Modern methods of treatment
- How long do people live with tongue cancer? What is the prognosis for recovery?
Causes: what causes tongue cancer?
Like any malignant tumor, tongue cancer occurs when genetic mutations occur in one of the cells. Because of these mutations, the cell does not respond to molecular signals and begins to multiply uncontrollably. Over time, there are so many of these “wrong” cells that they form a malignant tumor. The exact causes of tongue cancer are unknown. It is impossible to say unambiguously why genetic changes occurred in a particular cell, and it began to behave so aggressively. There are some risk factors:
- Smoking cigarettes, pipes and cigars. The risk of tongue and oral cancer in smokers is several times higher than in non-smokers, and it directly depends on the smoking experience and the daily number of cigarettes smoked. Tobacco smoke contains thousands of different substances, many of which are carcinogenic.
- Alcohol consumption. 70% of people diagnosed with malignant tumors of the tongue regularly drank alcohol. If a person smokes and often drinks alcohol, his risks increase even more: according to some data, 100 times compared to non-drinkers and non-smokers.
- Floor. According to statistics, men suffer from tongue cancer more often than women. This is probably due to the fact that they are more likely to have bad habits.
- The human papillomavirus (HPV) is transmitted through sexual contact, including oral sex. More than 150 types of pathogen are known. 13 of them can cause cancer.
- HPV type 16 is associated with malignant tumors of the mouth. Recently, the prevalence of oral and throat cancer in non-drinkers and non-smokers has been increasing, and human papillomavirus infection is often detected in them.
- Age. Most often, people over 55–60 years old get tongue cancer. But HPV-related tumors are usually found in younger people.
- Nutritional features. Some studies have shown that people whose diets are low in vegetables and fruits get sick more often.
- Weakened immunity. At increased risk are people suffering from AIDS and immunodeficiency conditions caused by other reasons.
None of these factors leads to malignant tumors of the tongue with one hundred percent probability. Their presence only means that a person has increased risks.
The role of such factors as rinsing the mouth with liquids with a high content of certain substances, irritation of the mucous membrane with dentures, and chronic inflammation in the oral cavity has not been proven. More research is needed to assess whether there are any risks in these cases.
Types of benign tumors of the tongue
Due to the involvement of various tissues and structures of the tongue in the process of tumor formation, as well as the presence of atypical cells due to impaired embryogenesis, there is a wide variety of forms of benign tumors of the tongue.
- Papilloma. It is formed from epithelial tissue, namely from the stratified squamous epithelium of the tongue mucosa. Most often observed on the tip and back of the organ. The formation is represented by multiple or single tumors of various sizes (rarely large), which have a round or slightly elongated shape. The color of the papilloma can be pale pink, but the appearance of keratosis indicates malignancy of the formation.
- Adenoma. It is formed by glandular tissue, cystadenomas are formed at the tip of the tongue, and polyps from heterotopic gastric mucosa can be observed in the root area.
- Botriomyxoma. It has a flat or spherical shape, sometimes represented by several lobes. At the beginning of its formation, it is characterized by a red color; over time, bothryomyxoma becomes brown. It reaches quite large sizes (up to several centimeters), the surface can be either coarse-grained or smooth, and becomes covered with crusts over time. It is provoked by injuries, cracks of the tongue, namely the penetration of pyogenic bacteria deep into the tissues.
- Fibroma. It originates from connective tissue and looks like a round tumor with an elastic structure. It may have a stalk, the color does not differ from the healthy surrounding mucosa, in some cases it may acquire a whitish, yellow tint.
- Retention cyst. It is of glandular origin - formed from the glands of the superficial muscular layer of the tongue. It is localized on the lower surface of the organ, in the tip area, and is often multiple in nature.
- Lipoma. It is formed from adipose tissue and develops in the submucosal layer of the tongue. It has a lobed structure and a soft elastic consistency. Most often it is localized in the posterior region of the tongue on its lower surface. This type of tumor is characterized by painlessness, slow development and growth.
- Myoma. It is of muscular origin and occurs during the proliferation of muscle cells of the organ. The dimensions rarely exceed 100 mm, the formation has a dense structure and is covered with a mucous membrane. Most often found on the upper surface of the tongue. In some cases, small papillary projections may also be present.
- Neurofibroma. It originates from the tissues of the nerve branches of the tongue, and is often localized in the posterior region of the organ. It is characterized by slow growth and is one of the few forms of tumor that is accompanied by pain. It is quite rare in comparison with other types of formations.
- Hemangioma. It is formed from the tissues of the blood vessels of the tongue, and is most often associated with disorders of embryogenesis. Diagnosed after birth or during the first months of life. There are several varieties of this form of neoplasm:
- capillary hemangioma - red spots of various shapes and sizes that do not rise above the healthy tissues of the tongue (when pressed, the spot tends to lose color brightness);
- cavernous hemangioma is a tumor of a purplish-bluish hue, has a soft structure, and rises somewhat above the healthy tissues of the mucous membrane.
- Lymphangioma. It originates from the walls of the lymphatic vessels of the tongue, just like hemangioma, and is diagnosed early in a child’s life. Its appearance causes diffuse damage to the tongue, which leads to a significant increase in its size. The formations most often take the form of warty-type growths along the tip or entire surface of the organ. The tumor is prone to inflammation, especially when traumatized.
- Struma of the tongue. It arises from the cells of the thyroid tissue located in the structure of the tongue due to a violation of embryogenesis. It looks like a node up to 3 cm in size, most often located at the root of the organ.
In the second case, deep germination into the underlying tissues of the tongue is possible. Pressing on the formation leads to a short-term decrease in size.
Any vascular tumors have a risk of bleeding, which can be caused by mechanical damage.
Types of tongue cancer
In 90% of cases, malignant tumors are represented by squamous cell carcinoma of the tongue. It develops from the cells of the mucous membrane that lines the surface of the tongue and the oral cavity.
The human tongue anatomically consists of two parts. The front two thirds are called the body of the tongue, the back third is called the root. Malignant tumors of the body are classified as oral cancer. They are usually easy to notice and diagnose early. Tumors of the root of the tongue are cancer of the oropharynx. He remains asymptomatic for a very long time. Often it can be diagnosed at a stage when there are already metastases in the lymph nodes of the neck.
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.
Symptoms and signs of tongue cancer
The first symptom of tongue body cancer is most often an ulcer that does not heal for a long time and begins to bleed easily when a person bites it with his teeth or eats solid food. Malignant tumors of the root of the tongue can manifest themselves in the form of pain in the tongue and surrounding tissues, changes in voice, difficulty swallowing, and a feeling of discomfort, as if something is blocking the throat.
Other symptoms of tongue cancer in men and women that require immediate medical attention:
- A red or white spot on the mucous membrane that persists for a long time.
- Pain while swallowing.
- An unclear “bump” or swelling on the side or tip of the tongue.
- Feeling of numbness in the mouth.
- Bleeding from the tongue for no apparent reason.
- In rare cases, ear pain may be bothersome.
Many other, less dangerous pathologies can manifest similar symptoms. In order to find out an accurate diagnosis and rule out tongue cancer, you need to visit a doctor and get checked.
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Causes of development of polyps in the throat
Experts have identified many factors that provoke the development of polyps in the throat, but the causes of this disease have not been fully studied. Polyps on the throat ligaments, tonsils and larynx develop as a result of the following reasons:
- allergic reactions, the source of which cannot be eliminated;
- regular overstrain of the vocal cords when singing, shouting, whispering;
- drinking alcoholic beverages and coffee that irritate the mucous membrane;
- smoking;
- inhalation of heavy metal impurities during work;
- hereditary predisposition;
- dysfunction of the thyroid gland.
An oncologist at the Yusupov Hospital, when a patient comes in with this problem, conducts an examination and determines whether it is dangerous to leave a polyp in the throat unattended, and what methods are necessary to treat it.
Methods for diagnosing tongue cancer
Doctors recommend that every person regularly examine their oral cavity using a mirror. Any strange sores, spots, or bumps should be a reason to visit a doctor. You need to have regular dental checkups.
If a malignant tumor of the oral cavity and oropharynx is suspected, the examination begins with an examination by a doctor. The doctor examines the oral cavity, pharynx (pharyngoscopy), larynx (laryngoscopy), and palpates the subcutaneous lymph nodes. If formations resembling cancer are found on the tongue, a biopsy is performed: a fragment of pathologically altered tissue is obtained and sent to the laboratory for microscopic examination. It is imperative to test for human papillomavirus.
If an oncological disease is diagnosed based on a biopsy, it is necessary to assess how far the cancer has spread in the body: whether the tumor has grown into neighboring organs, whether there are foci in regional lymph nodes, or distant metastases. The following diagnostic methods help with this:
- CT scan;
- chest x-ray;
- Magnetic resonance imaging;
- positron emission tomography;
- X-ray contrast studies.
Polyps in the throat: symptoms of the disease
Symptoms of polyps in the throat can be combined with manifestations of the underlying disease. Without exacerbation under the influence of negative factors, polyps do not appear in any way, so they may not be detected by patients for a long time.
With increasing polyps and frequent trauma, tears may occur, which worsen the patient's condition. A laryngeal polyp may have the following manifestations:
- pain when the vocal cords are tense;
- hoarseness of voice;
- feeling of a foreign summer;
- increased salivation;
- cough mixed with blood;
- pain syndrome in the neck area.
The Yusupov Hospital employs experienced oncologists who, when examining patients who complain, identify tumors in the throat. When visiting an oncology clinic, a patient can quickly and comfortably undergo an examination without queues at a convenient time by appointment.
Stages of tongue cancer development
The doctor determines the stage depending on the size of the primary tumor, its growth into neighboring tissues, the presence of lesions in regional lymph nodes and distant metastases. The classifications of body and root of tongue cancer are slightly different:
| Stage | Tongue body cancer | Tongue root cancer |
| Tongue cancer stage 1 (I) | The largest diameter of the tumor is 2 cm or less. | |
| Tongue cancer stage 2 (II) | The largest diameter of the tumor is more than 2 cm but less than 4 cm. | |
| Tongue cancer stage 3 (III) | One of the following signs:
| |
| Tongue cancer stage 4A (IVA) | One of the following signs:
| One of the following signs:
|
| Tongue cancer stage 4B (IVB) | One of the following signs:
| |
| Tongue cancer stage 4 °C (IVC) | It does not matter the size of the primary tumor, or whether there are lesions in the regional lymph nodes. If distant metastases are found, stage IVC is always diagnosed. | |
Polyps in the throat: photos and descriptions of tumors
Polyps in the throat, the symptoms of which depend on the size and location of the tumor, are formed by connective tissue, cellular elements and a small amount of fluid. Polyps are located in the throat on a thick stalk; they can have a white, pink or gray tint.
Some people who exhibit symptoms of this disease look at the laryngeal polyp in the photo and study the characteristic signs. Oncologists and otolaryngologists recommend not to carry out independent treatment of tumors, as it can cause chronic sore throat, infectious processes and irreversible changes in the voice.
The Yusupov Hospital uses modern methods for treating laryngeal polyps, which have successfully proven themselves in world medical practice. Highly qualified specialists remove the laryngeal polyp painlessly.
Modern methods of treatment
Approaches to the treatment of malignant tumors of the body and root of the tongue are somewhat different.
Treatment of tongue body cancer
If the tumor is less than 4 cm in size, it is removed surgically. In some cases, removal of regional lymph nodes is also indicated. Usually no other treatment is required.
Typical tactics for advanced cancer of the body of the tongue (the tumor is more than 4 cm or has managed to grow strongly into the surrounding tissues) involves a combination of three treatment methods:
- Surgical removal of the primary tumor, as well as regional lymph nodes.
- Radiation therapy. Before carrying out it, a consultation with a dentist and sanitation of foci of infection in the oral cavity are required.
- Chemotherapy.
In case of relapse, as well as in the last stage of tongue cancer with distant metastases, chemotherapy becomes the main treatment method.
Treatment of cancer of the base (root) of the tongue
If the tumor diameter is less than 4 cm, it is removed, and regional cervical lymph nodes are also excised. If the risk of relapse is high, radiation therapy to the neck area or chemoradiotherapy (radiation combined with chemotherapy) is prescribed after surgery.
If the tumor is larger than 4 cm or has grown into surrounding tissues, different treatment options are possible:
- chemoradiotherapy;
- removal of part of the tongue and surrounding tissues, regional lymph nodes, followed by a course of chemotherapy or radiation therapy;
- only radiation therapy.
The type of surgery for cancer of the body and root of the tongue depends on the location of the tumor, its size and the degree of invasion of surrounding tissue. Chemotherapy or radiation therapy may complement surgery. When used as a stand-alone treatment, they are usually prescribed for palliative purposes. They will not completely destroy cancer, but will help slow its progression, improve the patient’s condition, and prolong life.
In some cases, the targeted drug cetuximab (Erbitux) and the immunodrug nivolumab are prescribed.
Recommendations after treatment
Just getting rid of the growths will not be enough for a complete recovery - after intensive use of drugs and/or surgical intervention, preventive measures become necessary. To prevent further occurrence of tumors, you need:
- For the first days after surgery, eat semi-liquid or liquid food so as not to injure the wounded surface by chewing;
- Drink plenty of clean, warm water (using a straw will make the process painless);
- Treat the oral mucosa with antiseptic agents (sold in pharmacies);
- Avoid using toothpaste that irritates the mucous membrane for the first 2-3 days (it is recommended to clean the enamel with a cotton pad).
After treatment of polyps in the tongue, a visit to the dentist is required twice a year to monitor the condition of the oral cavity, prevent relapse or degeneration of the pathology into a malignant tumor.
