Tongue cancer

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Tongue cancer, also known as tongue cancer, is a form of oral cancer. The malignant and aggressive tumor mainly affects the front two thirds of the tongue. Most of the time, the condition is triggered by excessive tobacco and alcohol consumption. The earlier it is diagnosed and medically treated, the greater the chances of recovery. Learn more about symptoms, treatment, and prognosis here.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. C02

Brief overview

• What is tongue cancer? A malignant form of oral cancer, it affects the front two-thirds of the tongue
• Causes: Carcinogenic substances (carcinogens) trigger the formation of altered mucous membrane cells on the tongue.
• Risk factors: consumption of tobacco, alcohol and betel nuts, radiation exposure, poor oral hygiene, disposition; rarer: human papillomavirus (HPV)
• Signs (symptoms): White and reddish discoloration, ulcers, pain, chewing and swallowing difficulties, swelling, bleeding, sensory disturbances, bad breath, loss of appetite, weight loss, poor performance, tiredness
• Treatment: Surgical removal, reconstruction, radiation therapy and / or chemotherapy
• Course and prognosis: With the earliest possible diagnosis and therapy, a cure is possible. Relapses may occur within two years of treatment.
• Diagnostics: tissue examination (mirroring and biopsy), x-rays, ultrasound, computed tomography (CT), magnetic resonance tomography (MRT)
• Prevention: Refrain from consuming tobacco and alcohol, take careful oral and dental care, and have dental check-ups

What is tongue cancer?

Tongue cancer or tongue cancer is a malignant (malignant) form of oral cancer. It occurs mainly in the front area of ​​the tongue. Tumors under the tongue are mostly cancers of the floor of the mouth, which are also cancer of the oral cavity. Cancer that occurs in the back third of the base of the tongue is a form of throat cancer.

Tongue cancers, like most cancers, develop gradually in several stages. Early stages and precancerous stages can usually be recognized by white discoloration (leukoplakia) and slight swellings. In advanced stages, clear ulcers are visible. The tumor is then larger or more extensive. It is typical of tongue cancer that it extends into neighboring tissue and forms metastases (daughter ulcers). Several individual tumors may be present at the same time.

frequency

Tongue cancer is one of the most common forms of oral cancer. Men over the age of 50 are on average three times more likely to be affected than women. Most of the sick drink a comparatively large amount of alcohol or smoke. A decline has been observed in recent years. This is probably due to the fact that fewer and fewer people smoke in general. Scientists have found that teenagers, young adults and women smoke more than they did a few years ago.

How does tongue cancer develop?

Like most cancers of the oral cavity, tongue cancer begins when the cells in the upper layers of the lining change. In medicine one speaks of a squamous cell carcinoma of the tongue. Carcinogenic substances (carcinogens) penetrate the cells and trigger pathological changes there. These substances include nitrosamines found in tobacco or heavily roasted meat. They cause damage to the genome of the affected cells. This leads to developmental disorders in the further course. These cancer cells are neither hindered in their growth by the body's own defense system, nor do they die like normal skin cells after a certain lifetime. As a result, tissue growths and ulcers develop, which gradually develop from an early stage into a mature tumor.

How is the development of tongue cancer encouraged?

The main risk factor for tongue cancer is excessive consumption of tobacco and alcohol. Smokeless tobacco extracts inhaled with e-cigarettes are also suspected of being carcinogenic. In Asia, the betel nut is a major risk factor. Betel nuts contain psychoactive substances and are either chewed like tobacco or drunk dissolved in tea.

Doctors are discussing human papillomaviruses (HPV) as another risk factor for tongue cancer. These viruses mainly favor malignant tumors that form in the back third of the tongue and thus count as throat cancer. So far, however, there is no clear indication that an HPV infection causes more tongue cancer. Poor oral hygiene, diseases such as laryngitis, leukoplakia, a weak immune system and increased radiation exposure are other risk factors.

How do you know if you have tongue cancer?

Typical symptoms that indicate tongue cancer at an early stage are noticeable white or reddish discoloration of the mucous membrane. These spots are known as leukoplakia and erythroplakia and are precancerous lesions. In many cases they develop into mature malignant tumors.

Other symptoms of tongue cancer include:

• Swelling of the tongue and mouth
• Ulcers
• Pain in the tongue
• Bleeding of unknown origin
• Numbness of the tongue
• Problems swallowing, chewing, and speaking
• Bad breath (foetor)
• Exhaustion, tiredness
• Loss of appetite
• Weight loss of unclear origin
• Fever flare-ups

If one or more of the above symptoms persist for more than two weeks, please consult a doctor.

These symptoms may also be signs of other illnesses (harmless or serious). Therefore, have the cause clarified by a doctor.

Is tongue cancer curable or fatal?

There are basically different options for the therapy of tongue cancer. Which method the decision is made depends on the one hand on the tumor stage and on the other hand on the health status and age of the person affected. Therefore, a team of doctors from different specialties draws up a therapy plan after a detailed consultation with the patient. This includes both the priority treatment and the subsequent follow-up care.

surgery

The prerequisite for the greatest possible success of the treatment is to remove the cancerous tissue as far as possible through an operation. Doctors remove the tumor and part of the surrounding healthy tissue (resection). This will prevent tumor debris from lingering and developing again. The risk of relapse is correspondingly small.

If other areas, such as the lymph nodes, are already affected by cancer, these will also be surgically removed.

Surgery on the mouth or tongue to remove tissue can make it difficult to speak or eat.In order to prevent impairment, the affected section in the mouth is restored (reconstructed) as far as possible. To do this, the surgeon takes tissue from other parts of the body and reinserts it in the relevant area. The functions of the tongue as well as the chewing and swallowing apparatus and the appearance are preserved.

Radiation therapy and chemotherapy

In most cases, surgery is followed by radiation therapy and / or chemotherapy. Even in tongue cancer patients who cannot be operated on, these treatment methods are carried out as single therapies or both methods are combined.

Basically, radiation therapy (radiotherapy) takes place either from the outside through the skin (percutaneous) or in the oral cavity directly on the tumor (brachytherapy). There is also the possibility of inserting radiating substances directly into the tissue (interstitial procedure). Which method is suitable for the treatment of tongue cancer depends above all on its properties, i.e. on how large the tumor is and where it is located. It is also crucial whether metastases have already formed. The greatest possible treatment success is achieved by administering several small doses of radiation that are administered over a period of six to seven weeks.

In many cases, chemotherapy is combined with radiation therapy and is often carried out after an operation. Doctors often administer so-called cytostatics, for example with the active ingredient cisplatin. Treatment with cytostatics is usually supported by cancer immunotherapy. The active ingredient cetuximab (antibody) is administered here. Together they counteract the cell growth of tumor cells and thus fight tongue cancer.

Cancer therapy is usually a very drastic event for those affected and their relatives. Since both health and everyday life are impaired, comprehensive aftercare is extremely important. It includes regular checkups so that doctors can observe the healing process and prevent relapses. They also treat side effects and possible comorbidities. Psychosocial support from a psychologist or psycho-oncologist (a doctor who specializes in providing mental health care for cancer patients) before, during, and after treatment is another important part of the treatment plan.

Cytostatics influence all cells in their growth and also have an effect on healthy tissue. To avoid damage and severe side effects, doctors precisely fine-tune the dose and duration of use.

forecast

How successful the treatment of tongue cancer is is difficult to say on a case-by-case basis. As with all cancers, success depends on a number of factors. Doctors assume that the earlier the tongue cancer is diagnosed, the greater the chances of recovery. The prognosis worsens accordingly if tongue cancer is not treated or is already well advanced.

Another factor that affects the chances of recovery from tongue cancer is the general health of the person affected. If there are other diseases (such as heart failure, kidney failure), the prognosis is also worse.

Relapses are common in the first two years after tongue cancer treatment. Studies suggest that 40 to 60 percent of patients survive within five years of treatment. There is no precise information on life expectancy.

Can a Dentist Detect Tongue Cancer?

In general, diagnosis as early as possible significantly increases the chances of a cure for tongue cancer. Regular check-ups at the dentist's are particularly important, as dentists not only examine the teeth comprehensively, but also the entire oral cavity. Other specialists such as ear, nose and throat specialists, orthodontists or general practitioners also play a role in the initial diagnosis of tongue cancer.

If tongue cancer is suspected, the doctor will first examine the entire mouth. This is how he gets a first impression of the damaged areas. The doctor also asks the person concerned about their lifestyle. For example, he asks questions about nutrition, whether the patient frequently drinks or smokes and whether the family has already had similar illnesses.

The doctor uses a mirror examination (endoscopy) to inspect the oral cavity and, if possible, takes a sample of abnormal tissue (biopsy). This is then examined in the laboratory for cell changes.

If the suspicion of cancer is confirmed, further diagnostic methods are used. For the subsequent treatment, it is important to determine properties such as the location and size of the tumor. It is also clarified whether and where metastases have formed. To do this, the doctor orders further examinations, such as ultrasound and x-rays, computed tomography (CT) or magnetic resonance tomography (MRT).

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 a doctor immediately.

How can you prevent tongue cancer?

In order to prevent tongue cancer and other forms of oral cancer, doctors recommend, on the one hand, to generally avoid tobacco and the regular consumption of alcohol. On the other hand, it is advisable to attend the regular check-ups at the dentist and seek advice on careful oral and dental care.

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