By Dr Akshay Kudpaje

Recently, a 36-year-old IT professional came to us with a non-healing ulcer in his tongue. A clinical examination and CT scan revealed that he had stage II tongue cancer. Incidentally, he was a non-smoker.

This has been a distressing trend of late. While tobacco use has been considered to be the number one risk factor for all types of head and neck cancer, there has been a surge in a number of youngsters who do not consume any tobacco and are diagnosed with tongue cancer. In such cases, the culprit could have sharp teeth, a high level of pesticides, adulteration, and pollution in the environment.

The importance of early detection and timely treatment cannot be underscored enough. The IT professional underwent a surgery to remove the tumor through the mouth, without scarring the face or lip. The lymph nodes in his neck were operated on through a small incision, which healed naturally. Using plastic surgery, tissues from his forearm were used to reconstruct his tongue. In less than three weeks, he recovered. Within a month, he was able to eat, drink and speak normally and was in his office.

About Mouth Cancer:

Oral cancer or mouth cancer is the most common cancer among Indian men and the fifth most common among women in India. It can develop on the tongue, the tissue lining the mouth and gums, under the tongue, at the base of the tongue, and at the back of the mouth.

Usually, tongue cancer manifests as a sore or growth in the mouth that refuses to heal. It could be a lump or ulcer that does not go away, or pain while swallowing, or difficulty in speaking or moving the tongue. When it is advanced it may cause hoarseness of voice, and, sometimes, inexplicable weight loss.

In 80% of the cases, tongue cancer is caused due to smoking, alcohol consumption, and tobacco use. Smokeless tobacco contains carcinogens as well and is not a safe alternative to smoking.

A change in sexual behaviour, has increased the oropharyngeal cancer cases caused by the sexually transmitted human papillomavirus 16 or HPV16. This is usually observed among non-smokers and is more pronounced among men.

The other risk factors are diet, a weak immune system, and the habit of chewing betel quid (areca nut and lime wrapped in a betel leaf). Genetics and family history can also play a role in oral cancer.

A stitch in time

Diagnosis of tongue cancer includes clinical examination, biopsy and CT scans. The doctor checks the back of the throat with a small mirror that is held in the patient’s mouth during an examination. For a biopsy, the tissue from the affected area is sent to a laboratory for examination using a microscope. This confirms whether the tumor is cancerous or benign. The CT scan helps to measure the tumor’s size, extent and how far it has spread before deciding the best treatment modality.

Depending on how extensive the cancer is, which part of the tongue is affected, and whether the cancer has spread to the lymph nodes in the neck or other areas, the treatment may include surgery, radiotherapy and/or chemotherapy. While tongue cancer is curable when it is detected early, it can be life-threatening if not diagnosed and treated on time. An early diagnosis means the five-year survival rate exceeds up to 80%. However, it’s less than 20-30% for the advanced stages. Not to mention, the higher cost and duration of treatment.

As always, prevention is better than cure. To avert the risk of tongue cancer, avoid smoking; those who do must quit smoking; stop consuming smokeless tobacco such as ghutka; avoid inhaling snuff; abstain from drinking alcohol; limit exposure to pesticides and pollution; maintain high levels of oral hygiene; and ensure you eat a diet with healthy portions of fruits and vegetables.

Diligent annual dental check-ups and regular oral cancer screenings are strongly recommended as they are the best tool available for early diagnosis of successful treatment.

(The author is a Senior Consultant & Director – Head & Neck Oncology, Cytecare Cancer Hospitals, Bengaluru. The article is for informational purposes only. Please consult medical experts and health professionals before starting any therapy, medication and/or remedy. Views expressed are personal and do not reflect the official position or policy of the

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