Tongue Cancer

Tongue cancer is one of many types of oral cancers. The cancer can form on any part of the tongue, including the top, sides, and underside of the tongue. It can even occur at the base of the tongue, where it attaches to the throat.

What Is Tongue Cancer?

The tongue is a complex muscular organ comprised of various tissues and muscles. Its surface is covered with a thin, moist, pink epithelial membrane of mucosa tissue made of squamous epithelium cells. More specifically, the top or dorsal surface of the tongue contains keratinized stratified squamous epithelium cells. These cells produce keratin proteins that give the surface its tough protective exterior. Meanwhile, the lateral and ventral (the sides and bottom) surfaces of the tongue are made of non-keratinized stratified squamous cells. These cells do not produce keratin, hence the surfaces' soft and smooth texture.

There are two types of tongue cancers, which generally start in the squamous epithelial cells of the tongue:

1. Squamous Cell Carcinoma of the Tongue

This is the most prevalent type of tongue cancer, accounting for 94.08% of epithelial tumors and 80.05% of all oral cancer cases. It affects the front or anterior part of the tongue, which makes up about two-thirds of the organ. The lateral and ventral sides of the tongue are particularly common sites for the formation of oral cancers.

Squamous cell carcinoma usually starts with a precancerous lesion on the tongue's surface caused by dysplasia. Dysplasia is a condition in which healthy squamous cells begin to divide rapidly and uncontrollably due to gene alterations in their DNA or external stimuli.

The most common precursor to tongue malignancy is a condition called leukoplakia. This is a pathological change in the mucosa tissue that causes a white plaque to form on the tongue's surface. Leukoplakia starts as a painless stain that can’t be rinsed or scraped away. Over time, the plaque may grow thicker, develop bumps or wart-like structures, turn into an ulcer, and eventually escalate to tongue cancer.

2. Hypopharyngeal Tongue Cancer

This is a rare type of cancer that starts in the hypopharynx region. The hypopharynx is the lowest part of the throat, just behind the larynx. Hypopharyngeal cancer affects the base of the tongue—the one-third part of the tongue located in the throat.

Hypopharyngeal cancer is much harder to detect than cancers of the anterior part of the tongue. In most cases, the disease is diagnosed in its advanced stages when it has already spread to the lymph nodes and other areas of the throat and neck.

The underlying cause of hypopharyngeal tongue cancer is unknown, but its incidence is closely associated with human papillomavirus (HPV) infections. According to the Centers for Disease Control and Prevention (CDC), HPV is believed to be responsible for 70% of all hypopharyngeal cancer cases in the U.S.

How Common and Dangerous Is Tongue Cancer?

Tongue cancer is not a particularly common malignancy, but it's not considered rare either. In the U.S., only about four new cases of tongue cancer are diagnosed annually per 100,000 individuals. And approximately 0.4% of adults will be diagnosed with the disease in their lifetime. The survival rate is pretty good at nearly a 70% 5-year survival rate. Additionally, tongue cancers diagnosed in the early localized stages have an even better 5-year survival rate of 84.2%. However, the disease can be fatal once it reaches the final metastatic stage.

Who Is at Risk of Tongue Cancer?

Most oral cancers, including tongue cancers, are co-carcinogenetic, meaning that it takes more than one carcinogen or risk factor to trigger the disease. Common risk factors of tongue cancer, and oral cancer in general, include:

• Smoking and chewing tobacco
• Heavy alcohol consumption
• HPV and oral herpes infections
• Poor oral hygiene and dental sepsis
• A diet low in fresh fruits and vegetables
• Hereditary genetic factors
• Prolonged or excessive exposure to UV radiation
• Immune deficiencies

What Are the Signs and Symptoms of Tongue Cancer?

You can tell if you have tongue cancer by the various signs and symptoms of the disease. Here are the common symptoms of precancerous developments and cancers of the tongue you should watch out for:

• Numbness and changes in texture or sensation on the tongue
• Unexplained discolored or pale patches on the tongue that won’t wash off
• Painless or painful lumps, ulcers, or sores on the tongue that won’t heal
• Bleeding from the tongue that’s not caused by physical injury
• Difficulty or pain when chewing and swallowing food
• Trouble speaking and hoarseness of voice
• Unexplained bad breath
• Lumps on the neck from swollen lymph nodes
• Pain or discomfort in the throat and jaw

How Doctors Diagnose and Grade Tongue Cancer

Early detection is key to effective treatment of any cancer. While most symptoms of squamous cell carcinoma are quite easy to detect, the biggest problem lies in differentiating malignant tumors from the multitude of similarly occurring non-cancerous tongue lesions. Hypopharyngeal tongue cancer, on the other hand, often goes unnoticed until it starts causing problems around the throat and neck.

An accurate diagnosis of tongue cancer is essential in order to determine suitable treatments. The most effective way of diagnosing tongue cancer is by testing tissue samples from tongue lesions for dysplasia, neoplastic biomarkers, or other evidence of malignancy. Imaging tests such as MRI, CT, and PET scans may also be done to check for widespread or regional metastasis.

Once the disease has been identified, it is staged using the tumor-node-metastasis (TNM) staging system. The TNM system has five main stages:

• Stage 0 – Carcinoma in situ (Tis); the cancer is only present in the tongue’s epithelium.
• Stage I – The tumor is no larger than 2 cm across.
• Stage II – The tumor is between 2 cm and 4 cm across.
• Stage III – The tumor is larger than 4 cm and may have spread to the epiglottis and one lymph node.
• Stage IV – The cancer has started spreading to the surrounding oral cavity and throat structures.

Holistic Tongue Cancer Treatment

Early-stage cancer contained within the tongue is treated through targeted methods such as surgery and localized radiation therapy. Such procedures are usually followed by rehabilitative treatments and care to restore the tongue's normal functioning, structure, and appearance. Metastasized tongue cancer is addressed through a combination of chemotherapy and radiotherapy.

At Brio-Medical, we take a different but better approach to treating cancer. Our tried-and-true holistic cancer treatments stimulate the body’s own defenses and physiology to fight the disease by pulling the malignancy by the roots. Best of all, natural remedies barely have any side effects. If anything, many of our treatments are used integratively with traditional medicine to ease the side effects of chemotherapy and radiotherapy.

Brio-Medical’s broad range of natural cancer treatments includes:

• Natural immunotherapy
• Hormonotherapy
• Localized and whole-body hyperthermia
• Nutrition therapy
• Mind-body, wellness, and behavioral therapy
• Detoxification and antioxidation therapies with mistletoe, curcumin, glutathione, and other organic compounds
• Pain therapies
• Cellular rejuvenation therapies with oxygen, ozone, and various vitamins

References

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3. Mohammed F, Fairozekhan AT. “Oral Leukoplakia.” In: StatPearls [Internet]. Treasure Island (FL). Updated July 18, 2022. Accessed September 21, 2022.
4. Sanders O, Pathak S. “Hypopharyngeal Cancer.” In: StatPearls [Internet]. Treasure Island (FL). Updated January 29, 2022. Accessed September 21, 2022.
5. Division of Cancer Prevention and Control, Centers for Disease Control and Prevention. “HPV and Oropharyngeal Cancer.” HPV and Cancer. Page last reviewed: December 13, 2021. Accessed September 21, 2022.
6. National Cancer Institute. Surveillance. Epidemiology and End Results Program (SEER). “Cancer Stat Facts: Tongue Cancer.” Accessed September 19, 2022.
7. Ram, Hari et al. “Oral cancer: risk factors and molecular pathogenesis.” Journal of Maxillofacial and oral surgery vol. 10,2 (2011): 132-7. doi:10.1007/s12663-011-0195-z.
8. Moffit Cancer Center. “What Are the First Signs of Tongue Cancer?” Oral Cavity or Throat Cancer. Accessed September 21, 2022.
9. The Oral Cancer Foundation. “Early Detection, Diagnosis, and Staging.” CDC Oral Cancer Background Papers. Accessed September 21, 2022.