Cancer!The C-word which now has competition from Corona.Just like COVID19 prevention, with lockdown and social distancing
, for this cancer prevention works.
The slightly raised edges, feeling of roughness, giving rise to a small nodule that breaks down and forms an ulcer. The ulcer doesn’t heal with all your self-medication, alternative medicines and several multivitamin tablets supplied by the friendly pharmacy shop owner. This is, in short, the life story of cancer of the tongue
I have written about throat cancer and extensively about mouth cancer. Cancer of the tongue falls under mouth cancer or oral cancer, and broadly the treatment policy follows a similar pattern.It often follows the abuse of gutkha paan masala and other tobacco chewing habits.
If you want some different reading material with the letter C, try Coronavirus outbreak, Taiwan fight with New Corona virus:why they ignored Chinese data, or Home Quarantine For Corona: the right way
How does tongue cancer present?
It can present in the anterior two-thirds(45%) or posterior one-third of the tongue. The majority of those in the anterior part is seen at the lateral border of the tongue.
Nonhealing ulcer of the tongue.
A raised area with areas of ulcer and tissue piled up. There may be bleeding from the tongue.
The doctor will take a wedge biopsy or an excisional biopsy depending on the size of the lesion.
In uncontrolled diabetes, a nonhealing ulcer may often confuse clinical diagnosis.
On palpation of the tumor/ulcer, it most often will have an indurated base In advanced cases there will be a pain in the tongue
There will be difficulty in complete protrusion of tongue and difficulty articulating clearly. This happens due to the spread to the floor of the mouth.
If cancer involves the posterior part and base of the tongue, the treatment is often difficult.
A neck lump is an indication of spread to the neck or may be due to secondary inflammatory changes in the lymph node. Loosening of teeth of the lower jaw indicates, spread to the mandible,if not proved otherwise.
Where can Tongue Cancer it spread?
The floor of the mouth.
Mandible(lower jaw).
Cancer of the posterior part of the tongue can spread to tonsils, pharynx and into the larynx
Most people (70%)will have neck mass at presentation. Sometimes neck nodes on both sides may be involved.
What tests will be needed?
Diagnostic tests involve biopsy, FNAC MRI tongue, and imaging for the neck and chest. Mandibular involvement and status of dentition need to be evaluated.
The MRI of the tongue and a CECT of the neck and chest helps us know about the spread of the disease.
An FNAC from the neck mass will help in finding out the nature of the neck lump, and the biopsy of the tongue ulcer will help us know about the tongue lesion.
Treatment often involves.
Treating primary lesions depending on size. Excision is done with adequate margin and reconstruction depending on mass resected. The neck needs to be treated. A combination of surgery and radiotherapy may give best results
Preoperative counseling:Why is it crucial?
To stop all addictions.
Treat withdrawal symptoms.
Improve lung function.
Improve oral hygiene.
The potential need for tracheostomy and loss of voice explained.
The possible need for re-construction with flaps explained.
Speech therapy needed postoperatively.
Explanation regarding Adjuvant radiotherapy/chemotherapy or both, depending on tumor-free margin after biopsy report.
Need for post-operative followup at a Head Neck Cancer /tumor clinic.
Our friend’s father-in-law had tongue cancer, it was horrible as to what he went through.
Informative post, this. Quite detailed too.
I wanted to know how much risk a non-tobacco addict, non-diabetic has of contracting oral cancer?
Thank you for the post.
Best wishes for the rest of A2Z.
It is rare for nontobacco chewers, non-smoker, non-alcoholic to acquire oral cancers . But genetics and other environmental factors do play a role. But data about it is limited due to the rare nature of the occurrence.
Alright. Thanks. ????
Very informative.
Another reason to avoid all those chewing stimulants.
Cancer – The other dreaded “C” of our lives. Another Informative post as yours usually are.
Very informative post doc.
Wow, that is a lot of information about cancer of the tongue. I like that you share some of the beginning signs, and the treatment.
Great information about tongue cancer and you had covered all points well in detail. yes, addiction play a major role in this and early detection is key to increase survival rate.
reading this gave me the chills, but important information like this must be read and shared to alert everyone.
Informative!