The carried out researches of malignant formations of an oral cavity have allowed to establish, that the group of these diseases in most cases arises under the influence of bad habits. That's why the cancer of the tongue is most often diagnosed in men.
This pathology is characterized by an aggressive course, the difficulty of detecting malignant language formation at an early stage of its development is due to the low-symptomatic course of the disease during this period.
Classification of the cancer of the tongue
Cancer of the tongue is accepted in medicine to be subdivided by its localization in the organ, form, character of growth and histological structure.
By localization, that is location in the language, malignant neoplasm is divided into:
- Cancer of the body of the tongue. This localization is found in approximately 70% of patients, usually with this arrangement, the tumor affects the lateral surface of the organ or its median part.
- Cancer of the root of the tongue is detected in 20% of cases. This localization is also referred to as oropharyngeal cancer. The appearance of malignant tumors in the posterior half of the oral cavity is always characterized by a more aggressive course.
- Cancerous formation localized from below the tongue. Discovered in 10% of cases.
This photo clearly shows the root cancer of the tongue
. In form, the cancer of the tongue is divided into:
- Ulcer. An ulcer formed in the tongue, which has uneven and often bleeding edges. Ulceration affects the lower part of the tongue and its middle.
- Infiltrative form. The patient in the thickness of the tongue can palpate a tuberous, dense lump - an infiltrate. The mucous layer above the compaction is thinned, with this form of cancer expressed pain syndrome. Infiltration in most cases is formed on the tip of the tongue and in its posterior part.
- The papillary form of is exposed when a tumor grows above the tongue in different parts of the mucous layer on a thin or thick stalk. This type of malignant neoplasm is characterized by slow growth and usually affects the lateral parts of the tongue.
In the photo you can see what the initial stage of the papillary form of the
cancer looks like. According to the histological structure:
- In 95% of cases, squamous cell carcinoma is ( keratinizing and non-keratinizing).
- Adenocarcinoma is rarely seen and usually affects the root of the tongue.
By the nature of growth, the cancer of the tongue can be:
- Exophytic tumor. In this malignant neoplasm grows into the oral cavity.
- Endophytic tumor. The location of the formation is limited by the thickness of the organ.
Photo of squamous cell carcinoma of
Causes of development of
Among the reasons for the development of cancer of the tongue, the leading importance of oncologists is attributed to external unfavorable factors, such as:
- Long-term smoking and drinking of alcohol-containing beverages. If a person is addicted to both, the probability of a malignant neoplasm in the oral cavity is increased many times. Alcohol significantly enhances the carcinogenic properties of tobacco mixtures.
- Chronic mechanical trauma of the tongue. Similar occurs when wearing poorly installed prostheses, when traumatizing the mucous layer with the edge of a broken tooth, by regularly biting the organ.
- Occupational hazards - work with salts of heavy metals, products of the oil industry.
- Constant use of too hot, scorching mucous dishes. A preference for edible spices.
- Chronic inflammation of the oral cavity - stomatitis, gingivitis.
Simultaneous effect on the human body immediately two or three adverse factors increases the likelihood of cancer in the oral cavity.
There are also some precancerous diseases, the development of which increases the risk of formation of a malignant tumor of the tongue several times. These diseases include:
- Bowen's disease is the formation of a single spot on the tongue, its surface is smooth. The hearth may fall or in its place erosion is formed.
- Leukoplakia - a site of constant inflammation, can look like a spot of whitish color or growing gradually wart. Such changes tend to be corrupting.
The likelihood of cancer of the tongue with different locations increases with age. Most people who are treated for this disease are men from 40 to 60 years old. After 80 years, this disease rarely begins to develop initially. There are data on the detection of cancer of the tongue and in young children, although this pathology is not typical for this age.
The first symptoms and signs of the initial stage
Language cancer has three stages of its development: it's initial, developed and running .
The complexity of the diagnosis at the initial stage is that during this period most patients rarely experience those feelings that can be taken seriously.
But all the same, with a careful attitude to their health, certain problems in the oral cavity can be suspected by the following signs:
- The appearance of uncomfortable sensations in the place of growth of education. Initially, these symptoms are expressed by periodic burning, tingling, numbness, as the growth of the tumor begins to disturb the cutting pain. Strong pains are given to the temple, lower jaw, ear.
- The appearance of an unpleasant odor from the mouth. Especially this symptom is characteristic for ulcerative forms of neoplasm.
- Appearance of certain swallowing disorders. The patient complains of poor swallowing of the food lump or saliva.
- Increased salivation.
- Changing spoken language.
- Increased lymph nodes located behind the ears, under the jaw.
Often at an early stage of the development of cancer, the patient's language is concerned only with pain, which has no clear localization. This kind of pain is mistaken for the manifestations of stomatitis, caries or inflammation of the throat.
As the disease develops, the bleeding of the tongue, the violation of its mobility, is added to the initial symptoms. Patients also experience severe symptoms of cancer intoxication, severe pain that does not undergo analgesics. In advanced cases, the cancer captures most other structures of the oral cavity and passes to the internal organs.
Diagnostic procedures
A preliminary diagnosis is made by the dentist when the patient first examines the oral cavity. If necessary, the doctor uses palpation, examination of the oral cavity with the help of mirrors. It is necessary to find out the entire history of the disease and the patient's feelings. For further examination, the patient goes to the oncologist.
Diagnostic procedures use:
- Histological examination of a sample taken from a tumor or an ulcer( biopsy).
- Cytological examination of a smear taken from the surface of ulceration.
- ultrasound is assigned to determine the depth of coverage of a cancerous tumor of the tongue and to detect metastases in internal organs.
- Radiography is used to identify foci of cancerous changes in the skull's bone structures.
- CT or MRI is assigned to detect metastases in the brain.
If necessary, the patient may be assigned to other examinations. To distinguish the cancer of the tongue is necessary from a solid chancre in primary syphilis, from a tuberculous ulcer, from benign tumors and leukoplakia.
How is cancer treated?
The choice of method of treatment of malignant language formation depends on the stage of this pathology. Naturally, at the initial stage it is possible to achieve good results of treatment at the modern level of medicine, without resorting to extensive surgical intervention.
In general, the cancer of the tongue is treated by a combined method, that is, the patient is selected a different combination of radiation therapy, surgical methods, chemotherapy .
Surgical method
The operation is designed to completely remove the tumor. This may be a resection of a specific part of the tongue or a glossectomy, that is, a complete clipping of the organ. During surgery, the affected soft tissues, muscles and bone structures are removed. Orthostomy is possible.
After the main treatment, the patient is assigned a reconstructive surgery to restore bones, muscles and ligaments. If metastases are detected in the lymph nodes, they are also removed.
Radiotherapy
Radiation therapy is prescribed before and after surgery. In some cases, radiation can be the main method of treatment. Cancer cells are destroyed by high-energy X-rays, radioactive isotopes or directed electron beams.
Application of IMRT-technology allows to calculate with the highest accuracy the most effective dose of radiation and send it to a strictly defined place. This technique is characterized by the least amount of adverse reactions. Radiation therapy is usually prescribed for every day for 6-7 weeks.
Polychemotherapy
Chemotherapy is the use of drugs that destroy cancer cells. In the treatment of cancer of the tongue, polychemotherapy is often prescribed, that is, the simultaneous use of several chemotherapeutic agents.
Indications for such treatment are local, non-surgical tumors, distant metastasis, low-grade formation. The simultaneous use of 5-fluorouracil and platinum preparations - carboplatin, cisplatinum is considered effective.
The results of treatment improve with the simultaneous appointment of polychemotherapy and radiation, although at the same time the patients feel very ill during the days of treatment.
Forecasts
A favorable outcome of treatment for oncologists can give only at the initial stages of cancer of the tongue. According to statistical data in these cases, about 80% of people treated by different methods live for at least 5 years. If cancers are treated in an advanced stage, only about 35% of people survive in the first five years after therapy.
Preventive measures
In most cases, it is possible to prevent cancer of the tongue. The lowest probability of this disease in people who do not smoke, who rarely drink alcohol and who constantly pay attention to quality oral hygiene.
Two times a year, the dentist can not only detect cancer in the initial stage, but also helps to identify caries, chipped teeth, correct the traumatizing mucous layer of the prosthesis.