Tongue cancer is the development of cancer cells in the organ. It is quite rare, and occurs mainly in male smokers. It most often involves the base of the tongue or the mobile parts. Symptoms may include pain in the tongue, the appearance of “blisters” or difficulty swallowing. Treatment may be surgical, chemotherapy or radiotherapy. The different therapies can be used alone or in combination.
What is tongue cancer?
The body is made up of billions of cells that develop, divide and eventually die to make room for new cells in a healthy individual. When a cell is cancerous, it grows and multiplies much faster than an ordinary cell. Cancer cells do not work the same way, and can even be toxic to the human body. They compete with normal cells in the functioning of the human body. A tumour is when the number of cancer cells is large enough to form a visible mass.
Namely! A cell becomes cancerous when its DNA is damaged. This is because DNA contains all the instructions necessary for the body to function properly. Damaged DNA can be inherited or it can become damaged after exposure to certain substances.
For example, tongue cancer occurs when the cells of the tongue become cancerous and form a tumour. It is estimated that half of all tongue cancers affect the back of the tongue. In 95% of cases, it is called squamous cell carcinoma.
How common is tongue cancer?
Cancer of the tongue belongs to the family of cancers of the upper aerodigestive tract (VADS). These types of cancers are thought to affect nearly 17,000 individuals each year, including 10,500 deaths. They represent 10% of all cancers. France is, moreover, the country with the highest number of cases with an unequal geographical distribution: the departments of the East, West and North are the most affected. In 90% of cases, cancer is linked to alcohol and tobacco intoxication.
Namely! 25% of cancers of the upper aerodigestive tract involve the oral cavity.
The vast majority (90%) of patients with cancer of the upper aerodigestive tract (including the tongue) are men. However, for several years now, the number of cases in women has tended to increase.
What are the risk factors?
Risk factors can be of several types: inherited (a damaged gene making cancer development more likely), environmental (for example, pollution) or behavioural.
The main risk factors for tongue cancer are :
- Tobacco. 90% of patients with tongue cancer are smokers. This type of cancer is 6 times more common in smokers than non-smokers. The greater the amount of tobacco, the greater the risk;
- Alcohol. It is estimated that 75% of people with tongue cancer are alcohol consumers. As with tobacco, the risk of developing this cancer is 6 times higher among drinkers. It is 15 times higher in an individual who drinks and smokes ;
- Age, patients are generally between 50 and 60 years old;
- Gender, men are the most affected;
- Poor oral hygiene;
- Plummer-Vinson’s Syndrome (a rare eating disorder);
- Leukoplasia (a disease that causes white spots in the mouth);
- Erythroplasia (disease causing red spots in the mouth).
What are the symptoms?
The symptoms of tongue cancer can be:
- Pain;
- Weight loss;
- Difficulty swallowing (dysphagia);
- Pain in the ear;
- Coughing up blood (hemoptysis);
- Hoarse voice.
About the diagnosis
The diagnosis of tongue cancer most often requires a biopsy, where a piece of tissue is removed from the lesions and examined under a microscope.
Other tests can be used to assess the extent of the cancer: a CT scan, X-ray, MRI, etc. The diagnosis of tongue cancer usually requires a biopsy. With this data, doctors can determine exactly where the cancer is and what treatment will be most appropriate.
To know! Cancers are classified in stages according to the size of the tumour and its progression in the body. The higher the stage, the more severe and widespread the cancer. For tongue cancer, there are 4 stages:
- T1 for tumors less than 2 cm in size;
- T2 for tumours larger than 2 cm but smaller than 4 cm;
- T3 for tumours larger than 4 cm;
- T4 for damage to surrounding structures.
What treatments?
As with all cancers, there are different types of treatment that may or may not be combined:
- Surgery;
- Radiation therapy;
- Chemotherapy.
The treatment chosen differs according to the stage of the tongue cancer. The best therapeutic approach is first discussed and debated during a multidisciplinary consultation meeting (RCP) which brings together several professionals, including the oncologist and the ENT. At the end of this meeting, a report and a copy of the personalised care programme (PPS) is given to the patient’s doctor.
In most cases, tumours of the tongue have to be removed surgically. This is often the first step in treatment with associated chemotherapy or radiotherapy to ensure that all cancer cells are removed.
Radiation therapy can also be used because it targets cancerous tissue while sparing as much as possible the surrounding healthy tissue. Healthy cells that are very close to the cancerous lesions are still affected and are at the origin of the undesirable effects of the therapy: irritation or burning of the skin, fatigue, loss of appetite and hair loss.
Chemotherapy is based on oral ingestion or intravenous administration of products that are toxic to cancer cells. This type of treatment also causes nausea, vomiting, loss of appetite, hair loss and mouth ulcers. Most side effects disappear once the treatment is over, both for chemotherapy and radiotherapy.
Charline D., Doctor of Pharmacy