Incidence of tongue cancer
oral cancer treatment
The cancer of the tongue accounts for about 2% of all the neoplasia diagnosed in Italy and affects men more frequently than women. In general, it should be emphasized that this type of pathology affects smokers and / or drinkers much more frequently than non-smokers and non-smokers.
Critical factors in the treatment of language cancer
F This is a complex pathology to treat because, in addition to the oncological problems and the poor prognosis of advanced forms, the otolaryngologist is faced with all the problems that may arise by going to change the anatomy of a district as special as the mouth. Until a few years ago, a demolition intervention on the tongue could cause permanent difficulties in swallowing and phoning the patient. Fortunately, the advent of modern reconstructive techniques allows today to greatly limit these disorders and to ensure a satisfactory post-operative quality of life even for patients affected by very severe forms.
Risk factors for cancer of the tongue
F The risk factors mainly responsible for the genesis of this disease are different. The incidence of tongue cancer in smokers is about six times higher than that of non-smokers and about 90% of those who develop the disease are smokers. In addition to this, some studies have shown that many subjects (40%) who continued to smoke after tongue cancer surgery have developed a second tumor or relapse while this occurs only in 6% of cases in non-smokers. . Among the most dangerous uses of tobacco we mention the chewing of tobacco still very frequent in some Asian countries. The cancer of the tongue affects six times more subjects who drink alcohol, especially if spirits. 75% of those who develop the disease are alcohol drinkers. If the subject is a heavy drinker and a heavy smoker the risk of developing the disease is 15 times higher than that of a person who does not drink and does not smoke. The role of the human papillomavirus on the genesis of these diseases is still the subject of study today. Plummer Vinson syndrome, characterized by sideropenic anemia and atrophy of the mucous membranes of the mouth, pharynx and esophagus, seems to play a role in the genesis of the pathology.
Symptoms of cancer of the tongue
S
As for the symptoms it must be said that, in addition to the superficial forms, immediately evident to the patient, there are more subtle forms that grow inside the lingual belly or in the less visible portions of the organ. The tissues of the tongue, because of their laxity, prevent very little the extension of the disease which, if not superficial, often becomes symptomatic only when lingual mobility is impaired. The most frequently affected areas are the edges of the mobile portion of the tongue, but unfortunately the tumors of the base of the tongue are also frequent, the posterior portion less visible to the patient. The first symptoms of a non-visually evident disease are often represented by difficulty in speaking (voice from encumbrance: the subject speaks as if he had something in his mouth) and difficulty in swallowing. In cases where there is an involvement of the lingual nerve a painful symptomatology may develop, possibly radiated to the ear, but it should be emphasized that in most cases there is no pain. Unfortunately, in these cases, already at the time of diagnosis, a metastatic involvement of the lymph nodes of the neck (which are palpated with tumefatti) may be evident at palpation.
Diagnosis of tongue cancer
DThe diagnosis of this type of pathology is based on the clinic, or on an otorhinolaryngology visit. The visit is based on an accurate collection of the patient's medical history, illness (smoking, alcohol, pain, weight loss, otalgia, dysphagia will all be factors to investigate) and a thorough physical examination that also provides a bimanual palpation of the structures of the oral cavity and perioral lymphatic glands and neck. It is also very important to make sure of the nutritional status of the patient as, in some cases, patients arrive at malnourished observation due to problems with swallowing. Fortunately, given the location of the organ affected by pathology, this type of neoplasia is often diagnosed in the early stages, or as soon as the patient notices the appearance of a nuisance swelling in the mouth. In some cases, however, the pathology can begin in a sneaky way and patients can get to the doctor's observation only when the pathology is already at an advanced stage. For this reason, it is wise and desirable to have recourse to a medical consultation whenever we notice the appearance of a swelling on which it does not recede within two weeks. Showing the problem to a specialist allows to intercept the neoplastic forms in their initial phase. An early diagnosis, in fact, guarantees a better prognosis and allows planning a type of surgery that is much less invasive than the more advanced forms. For the staging of the pathology and to know the involvement of the lymph nodes of the neck it is necessary to subject the patient to a radiological examination with contrast medium (CT or MRI) and it is also always advisable to perform a chest radiograph to exclude concomitant pulmonary masses. The diagnosis of certainty about the nature of the disease should be obtained by performing a biopsy of the lesion. Biopsy can be performed under local anesthesia for easily accessible areas or under general anesthesia in the minutes preceding the execution of the surgery.
Language cancer therapy
The treatment of this type of pathology is usually of a surgical type. In the less advanced forms it is possible to cure the patient by simply removing the oral neoformation (sometimes even under local anesthesia). In some cases (depending on the location and depth of infiltration of the neoformation), even in the initial forms it may be appropriate to proceed with the removal of some neck lymph node stations that may have been invaded by tumor metastases. The tumors of the tongue, as well as most of the head-neck district tumors, in fact, tend to give local metastases (mainly at the neck level) while only rarely they give distant metastases. In advanced forms the surgical exeresis can be much wide to require a reconstruction of the district operated to ensure good functional and aesthetic outcomes. In these cases, the tongue or the oral floor are often reconstructed through the use of free flaps or through the transposition of muscle-cutaneous tissue from another district of the patient's body.
Prognosis of tongue cancer
P The prognosis for small tumors (T1-T2) is good with a survival of 80% at 5 years. Survival drops due to new growths with extended local lymph node involvement.
The cancer of the tongue accounts for about 2% of all the neoplasia diagnosed in Italy and affects men more frequently than women. In general, it should be emphasized that this type of pathology affects smokers and / or drinkers much more frequently than non-smokers and non-smokers.
Critical factors in the treatment of language cancer
F This is a complex pathology to treat because, in addition to the oncological problems and the poor prognosis of advanced forms, the otolaryngologist is faced with all the problems that may arise by going to change the anatomy of a district as special as the mouth. Until a few years ago, a demolition intervention on the tongue could cause permanent difficulties in swallowing and phoning the patient. Fortunately, the advent of modern reconstructive techniques allows today to greatly limit these disorders and to ensure a satisfactory post-operative quality of life even for patients affected by very severe forms.
Risk factors for cancer of the tongue
F The risk factors mainly responsible for the genesis of this disease are different. The incidence of tongue cancer in smokers is about six times higher than that of non-smokers and about 90% of those who develop the disease are smokers. In addition to this, some studies have shown that many subjects (40%) who continued to smoke after tongue cancer surgery have developed a second tumor or relapse while this occurs only in 6% of cases in non-smokers. . Among the most dangerous uses of tobacco we mention the chewing of tobacco still very frequent in some Asian countries. The cancer of the tongue affects six times more subjects who drink alcohol, especially if spirits. 75% of those who develop the disease are alcohol drinkers. If the subject is a heavy drinker and a heavy smoker the risk of developing the disease is 15 times higher than that of a person who does not drink and does not smoke. The role of the human papillomavirus on the genesis of these diseases is still the subject of study today. Plummer Vinson syndrome, characterized by sideropenic anemia and atrophy of the mucous membranes of the mouth, pharynx and esophagus, seems to play a role in the genesis of the pathology.
Symptoms of cancer of the tongue
S
As for the symptoms it must be said that, in addition to the superficial forms, immediately evident to the patient, there are more subtle forms that grow inside the lingual belly or in the less visible portions of the organ. The tissues of the tongue, because of their laxity, prevent very little the extension of the disease which, if not superficial, often becomes symptomatic only when lingual mobility is impaired. The most frequently affected areas are the edges of the mobile portion of the tongue, but unfortunately the tumors of the base of the tongue are also frequent, the posterior portion less visible to the patient. The first symptoms of a non-visually evident disease are often represented by difficulty in speaking (voice from encumbrance: the subject speaks as if he had something in his mouth) and difficulty in swallowing. In cases where there is an involvement of the lingual nerve a painful symptomatology may develop, possibly radiated to the ear, but it should be emphasized that in most cases there is no pain. Unfortunately, in these cases, already at the time of diagnosis, a metastatic involvement of the lymph nodes of the neck (which are palpated with tumefatti) may be evident at palpation.
Diagnosis of tongue cancer
DThe diagnosis of this type of pathology is based on the clinic, or on an otorhinolaryngology visit. The visit is based on an accurate collection of the patient's medical history, illness (smoking, alcohol, pain, weight loss, otalgia, dysphagia will all be factors to investigate) and a thorough physical examination that also provides a bimanual palpation of the structures of the oral cavity and perioral lymphatic glands and neck. It is also very important to make sure of the nutritional status of the patient as, in some cases, patients arrive at malnourished observation due to problems with swallowing. Fortunately, given the location of the organ affected by pathology, this type of neoplasia is often diagnosed in the early stages, or as soon as the patient notices the appearance of a nuisance swelling in the mouth. In some cases, however, the pathology can begin in a sneaky way and patients can get to the doctor's observation only when the pathology is already at an advanced stage. For this reason, it is wise and desirable to have recourse to a medical consultation whenever we notice the appearance of a swelling on which it does not recede within two weeks. Showing the problem to a specialist allows to intercept the neoplastic forms in their initial phase. An early diagnosis, in fact, guarantees a better prognosis and allows planning a type of surgery that is much less invasive than the more advanced forms. For the staging of the pathology and to know the involvement of the lymph nodes of the neck it is necessary to subject the patient to a radiological examination with contrast medium (CT or MRI) and it is also always advisable to perform a chest radiograph to exclude concomitant pulmonary masses. The diagnosis of certainty about the nature of the disease should be obtained by performing a biopsy of the lesion. Biopsy can be performed under local anesthesia for easily accessible areas or under general anesthesia in the minutes preceding the execution of the surgery.
Language cancer therapy
The treatment of this type of pathology is usually of a surgical type. In the less advanced forms it is possible to cure the patient by simply removing the oral neoformation (sometimes even under local anesthesia). In some cases (depending on the location and depth of infiltration of the neoformation), even in the initial forms it may be appropriate to proceed with the removal of some neck lymph node stations that may have been invaded by tumor metastases. The tumors of the tongue, as well as most of the head-neck district tumors, in fact, tend to give local metastases (mainly at the neck level) while only rarely they give distant metastases. In advanced forms the surgical exeresis can be much wide to require a reconstruction of the district operated to ensure good functional and aesthetic outcomes. In these cases, the tongue or the oral floor are often reconstructed through the use of free flaps or through the transposition of muscle-cutaneous tissue from another district of the patient's body.
Prognosis of tongue cancer
P The prognosis for small tumors (T1-T2) is good with a survival of 80% at 5 years. Survival drops due to new growths with extended local lymph node involvement.
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