Can I Do Anything To Prevent The Development Of Oropharyngeal Cancer
You may not be able to prevent oropharyngeal cancer, but you can take steps to lower your risk. Changes you can make include:
- Dont start smoking. If you smoke or use tobacco products, quit. Continuing to smoke greatly increased the risk of developing a second cancer in the mouth, throat or voice box or lung. Ask your healthcare provider for help. They have many resources and can put you in touch with the information need or other health professionals that can help you quit.
- Dont drink alcohol regularly or heavily. Alcohol increases the cancer-causing effects of tobacco, so its especially important to avoid this combination.
- Avoid human papilloma virus infection. Ask your doctor about the HPV vaccine. Multiple sex partners and oral sex increases your risk of HPV.
- Eat a healthy, well-balanced diet and exercise regularly.
- See your healthcare provider and dentist on a regular schedule. They can check your mouth and throat and catch any changes early in their development.
What Are The Symptoms Of Tongue Cancer
Oral Tongue Cancer
- A lump on the side of the tongue that touches the teeth.
- The lump often looks like an ulcer and is grayish-pink to red.
- The lump bleeds easily if bitten or touched.
Base of Tongue Cancer
- The tumor is often difficult to see in the early stages, so it is usually diagnosed when it is larger.
- There are few symptoms in the early stages.
- In later stages, the cancer may cause pain, a sense of fullness in the throat, difficulty swallowing, the feeling of a lump in the neck or throat, voice changes or ear pain.
Tongue Cancer: A Review
Charles H. Brown, MS Pharm, RPh, CACPProfessor Emeritus of Clinical PharmacyPurdue University College of PharmacyWest Lafayette, Indiana
US Pharm. 2015 40:8-11.
ABSTRACT: Tongue cancer is a serious, life-threatening type of oral cancer. Oral cancer can develop in any part of the mouth, including the lips, gums, tongue, cheeks, and roof and floor of the mouth. Most cases of oral cancer are linked to tobacco use, heavy alcohol use, or infection with human papillomavirus . Sexually transmitted HPV infections have been linked to a subset of oral cancers. Many oral cancers are detected by dentists through routine dental-hygiene procedures, and individuals should receive an oral examination at least annually. When identified early, tongue cancer is highly curable, but it can be deadly if it is not promptly diagnosed and treated.
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What Are The Risk Factors For Squamous Cell Carcinoma Of Tongue
The risk factors for Squamous Cell Carcinoma of Tongue include:
- Smoking and chewing of tobacco are strong risk factors for this type of Tongue Cancer
- Radiation therapy in the region of the tongue
- Arsenic exposure
- Coal tar exposure
- Individuals with weak immune system, which could be due to cancer treatment, AIDS, or those on immunosuppressant drugs after receiving an organ transplant
- Caucasians are more vulnerable compared to other dark-skinned individuals
It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.
Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.
What Are The Possible Complications Of Squamous Cell Carcinoma Of Tongue
The possible complications due to Squamous Cell Carcinoma of Tongue could be:
- Severe discomfort while eating, chewing, or swallowing food this can even lead to weight loss
- A partial of complete loss of taste sensation
- They can metastasize to the lymph nodes SCC of Tongue has a higher chance of metastasis than if they are at other locations
- Tumors that invade into nerves have higher chances of recurrence and metastasis
- Tumors that are over 2 cm in size have a higher incidence of recurrence and metastasis, than tumors that are less than 2 cm in size
- Severe emotional and psychological stress
- Complications that arise from cancer therapy
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Prognosis For Oral Squamous Cell Carcinoma
If carcinoma of the tongue is localized , 5-year survival is > 75%. For localized carcinoma of the floor of the mouth, 5-year survival is 75%. Lymph node metastasis decreases survival rate by about half. Metastases reach the regional lymph nodes first and later the lungs.
For lower lip lesions, 5-year survival is 90%, and metastases are rare. Carcinoma of the upper lip tends to be more aggressive and metastatic.
What Questions Should I Ask My Healthcare Provider If I Have Been Diagnosed With Oropharyngeal Cancer
- Exactly where is my cancer?
- Has my cancer spread? What stage is it? What does that mean?
- What tests will I undergo?
- What healthcare providers will be on my care team?
- Is my cancer related to the human papillomavirus ?
- What lifestyle changes should I make?
- Whats my treatment plan? What are all my options?
- Whats my chance of being cured?
- What are the side effects of treatment?
- What will happen if the cancer comes back? What are my options?
These are just a few questions. Be sure to write down others as you think of them. Your healthcare team wants to help you understand everything concerning your cancer and care.
Last reviewed by a Cleveland Clinic medical professional on 09/24/2020.
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How Is Oropharyngeal Cancer Treated
The stage of cancer, where the oropharyngeal cancer is located, your age and general health determines your treatment plan. The goal is to treat cancer cells while retaining your ability to speak and swallow as normally as possible.
Surgery and/or radiation therapy are usually tried first for early stage cancer that are small and havent spread.
Chemotherapy is used in several ways:
- Combined with radiation therapy in place of surgery.
- Usually combined with radiation therapy to kill any cancer cells that remain after surgery.
- Alone or combined with radiation therapy to shrink larger cancers before surgery.
- Alone or combined with radiation therapy to treat larger cancers and cancers that have spread that cant be treated with surgery.
Targeted drug therapies are man-made versions of a protein in your immune system called a monoclonal antibody. These drugs slow or stop cancer by blocking a protein the cancer cells need to divide, grow and spread. Cetuximab is a commonly used target drug used to treat oropharyngeal cancer. Its used alone, in combination with radiation therapy or with other traditional chemotherapy drugs.
What Is The Prognosis Of Squamous Cell Carcinoma Of Tongue
- In general, Squamous Cell Carcinoma of Tongue is an aggressive form of cancer. If metastasis is observed, then the prognosis is guarded or unpredictable
- Tumors in their early stage with complete excisional treatment typically have good prognosis
- In cases of metastasis, its prognosis depends upon a set of several factors that include:
- Stage of tumor: With lower-stage tumors, when the tumor is confined to site of origin, the prognosis is usually excellent with appropriate therapy. In higher-stage tumors, such as tumors with metastasis, the prognosis is poor
- The surgical respectability of the tumor
- Overall health of the individual: Individuals with overall excellent health have better prognosis compared to those with poor health
- Age of the individual: Older individuals generally have poorer prognosis than younger individuals
- Whether the tumor is occurring for the first time, or is a recurrent tumor. Recurring tumors have a poorer prognosis compared to tumors that do not recur
- Response to treatment: Tumors that respond to treatment have better prognosis compared to tumors that do not respond so well to treatment
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What Are The Stages
Doctors classify most cancer types into stages according to how much cancer is present and whether or not it has spread, or metastasized, to other parts of the body.
The classification system uses letters and numbers. The letter T indicates a tumor, and the letter N refers to neck lymph nodes. These letters each have a grading from 14 or 03 respectively.
People with a T1 tumor have the smallest grade of tumor, while people with a T4 tumor have the largest grade.
An N0 classification signifies that the tongue cancer has not spread to any neck lymph nodes. Tongue cancer that has spread to a significant number of lymph nodes has an N3 classification.
It is also possible to grade tongue cancer in the following ways:
- low grade
- high grade
This grading denotes how aggressively the cancer is growing and how likely it is to spread to other parts of the body.
Experts do not fully understand why some people get tongue cancer. However, specific risk factors can increase a persons likelihood of developing this disease.
Known risk factors include:
- smoking or chewing tobacco
- consuming alcohol in excess
Anyone who is concerned that they might have tongue cancer should make an appointment with a doctor as soon as possible.
At the appointment, the doctor is likely to spend time:
- asking about any relevant medical history, including family medical history
- examining the tongue and mouth
- examining the lymph nodes to see if there is any enlargement
How Is Tongue Cancer Diagnosed
To make a diagnosis, the doctor will take a medical history and ask specific questions about symptoms. A patient’s tongue and neck will be examined and a small, long-handled mirror will be used to look down the throat.
Several tests are used to aid in the diagnosis. These tests include:
- X-rays of the mouth and throat, including CT scans .
- PET scans , which use radioactive materials to identify excessive activity in an organ. This may indicate the tumor is growing.
- Tongue cancer usually requires a biopsy, a small sample of tissue that is removed from a tumor to diagnose cancer. After the surgeon removes the tissue, a pathologist will examine the cells under a microscope. There are different methods to obtain a biopsy:
- Fine needle aspiration biopsy. A thin needle is inserted into the tumor mass and a sample is drawn out by suction into a syringe.
- Incisional biopsy. A sample is removed with a scalpel .
- Punch biopsy. A small circular blade removes a round area of tissue.
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Health Literacy To Empower Patients
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Risk Factors For Oral Cavity And Oropharyngeal Cancers
A risk factor is anything that increases a persons chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed. Others, like a persons age or family history, cant be changed.
But risk factors don’t tell us everything. Having a risk factor, or even many, does not mean that a person will get the disease. And many people who get the disease have few or no known risk factors.
Oral cavity and oropharyngeal cancers are often grouped with other cancers in the head and neck area. These cancers often have many of the same risk factors listed below.
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Advanced Care For Base Of Tongue Cancer
The back third of the tongue, which starts in the throat, isknown as the base of the tongue. It is part of the oropharynx, which alsoincludes the tonsils, the walls of the throat, and the soft palate . Cancer that develops in the base of the tongue is atype of head and neck cancer.
Almost all cancers in the base of the tongue are squamouscell carcinomas, which form in the thin, flat cells that line the larynx.Squamous cells also make up the top layer of skin and other body parts such asthe lungs and esophagus.
Our highly trained surgeons, doctors, nurses, and otherproviders at the Harold C. Simmons Comprehensive Cancer Center specialize intreating cancers of the head and neck. Our team for base of the tongue cancer includesotolaryngologists , radiation and medicaloncologists, oral and reconstructive surgeons, physical and occupationaltherapists, and speech pathologists.
How Common Are Head And Neck Cancers
Head and neck cancers account for nearly 4% of all cancers in the United States .
These cancers are more than twice as common among men as they are among women . Head and neck cancers are also diagnosed more often among people over age 50 than they are among younger people.
Researchers estimated that more than 68,000 men and women in the United States would be diagnosed with head and neck cancers in 2021 . Most will be diagnosed with mouth, throat, or voice box cancer. Paranasal sinus and nasal cavity cancer and salivary gland cancer are much less common.
Base Of Tongue Cancer
UT Southwestern Medical Centers head and neck cancerexperts have the experience and training to treat complex cancers such as thoseaffecting the base of the tongue.We offer exceptional care and supportive services to guide patients and theirfamilies from diagnosis through the treatment journey.
As the only National Cancer Institute -designated comprehensivecancer center in North Texas, we deliver the best cancercare available today and make it our mission to discovernew treatments. NCI designation means we offer patients the abilityto participate in the broadest possible range of clinical trials,with access to potential therapies not available at other facilities.
Cancer Care at the Highest Level. Anywhere.
Our team of hundreds of leading cancer physicians and oncology-trained support staff is a trusted partner in returning patients with cancer to good health.
What Causes Squamous Cell Carcinoma
Although researchers know what causes many cases of squamous cell carcinoma most notably, excessive exposure to ultraviolet radiation studies are still underway to determine how this type of cancer develops in parts of the body that are seldom or never exposed to sunlight. Past studies show that nearly 95 percent of all nonmelanoma skin cancers are the direct result of DNA changes that occur in the skin after cells are damaged by UVA or UVB rays, and scientists continue to investigate the possible causes of the remaining 5 percent.
Through ongoing studies, researchers are also investigating the exact changes that occur within the body after squamous cells are damaged by UV exposure. Currently, with regard to what causes squamous cell carcinoma, medical professionals know that:
- Healthy skin regenerates itself every few days. As old cells die, they are pushed to the surface of the skin by the new cells developing underneath. The old cells are then sloughed off.
- When squamous cells sustain DNA damage, the cells arent able to regulate their own growth as they normally should. Abnormal cells can accumulate without dying off and create bumps or sores on the skin.
- Although squamous cell carcinomas are slow to spread, they can eventually grow into nearby tissues, bones or lymph nodes if not properly treated.
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Formation Progression Cell Of Origin
HNSCC originates from mucosal epithelial cells that line the oral cavity, pharynx, larynx and sinonasal tract. Histologically, progression to invasive HNSCC follows an ordered series of steps beginning with epithelial cell hyperplasia, followed by dysplasia , carcinoma in situ and, ultimately, invasive carcinoma . However, of note, most patients diagnosed with HNSCC do not have a history of an antecedent premalignant lesion. Given the heterogeneous nature of HNSCC, the cell of origin depends on anatomical location and aetiological agent . However, in each case, normal adult stem or progenitor cells are likely candidates for the cell of origin, giving rise, following oncogenic transformation, to cancer stem cells with properties of self-renewal and pluripotency. HNSCC CSCs with the capacity to generate tumours in transplantation assays constitute only a minor fraction of the cells in primary tumours but, despite their inherent resistance to conventional drugs, represent attractive targets for novel targeting agents.
Progression of HNSCC and key genetic events.
Management Of Malignant Tumors Of The Mobile Tongue
Radiation therapy may be used as a single-modality treatment for small or superficial tongue lesions. The local control rates for T1 and T2 oral tongue cancers are similar for surgery and radiation therapy. However, radiation therapy has the advantage of preserving normal anatomy and tongue function.
The role of chemotherapy in the management of cancer of the oral tongue is still unclear. Early tumors are not treated with this modality, because of the high success of either radiation therapy or surgery. Patients who present with extensive primary lesions or with distant metastases and poor prognoses are good candidates for chemotherapy. A newer strategy for using chemotherapeutic agents is concomitant chemoradiation. With this modality, chemotherapy is administered at the same time as radiation therapy.
The ideal surgical approach to oral tongue tumors depends on the tumor size and the involvement of adjacent structures. For most small T1 and T2 lesions confined to the tongue, peroral horizontal wedge excision with primary anterior-to-posterior closure may be achieved quite easily. With larger lesions and impaired tongue mobility, implying deep tongue infiltration or floor-of-mouth extension, a more radical approach is required.
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