What is Tongue Cancer?
Tongue cancer is a type of oral cancer that forms in the front two-thirds of the tongue. Globally one person dies every six seconds due to tobacco use, which accounts for one in 10 adult deaths.This type of cancer usually develops in the squamous cells, the thin, flat cells that cover the surface of the tongue.Tongue cancer is also present as non-healing ulcer on the sides or tip of tongue.It can also cause pain in the ear also and difficulty in eating. It is usually affects people who consume tobacco in the form of smoking or chewing (Guthka, khaini, paan etc.) It can affect people with no tobacco habits also, especially ladies with sharp tooth causing longstanding tooth biteCancer that forms in the back one third of the tongue is considered a type of head and neck cancer.
Sign and symptoms of Tongue Cancer
Symptoms of tongue cancer are very similar to symptoms of other types of oral cancer. It can often be mistaken for a cold that won’t go away, or a persistent sore in the mouth. Other tongue cancer symptoms and signs may include:
- Ulcer in the mouth which has not healed within 4weeks
- Development of white(Leucoplakia) and red patches(Erythroplakia) which are precancerous ( i.e. stages before development of cancer)
- Persistent heaviness or change in the voice.
- Persistent tongue and/or jaw pain
- A lump or thickening in the inside of the mouth
- A white or red patch on the gums, tongue, tonsil, or lining of the mouth
- A sore throat or feeling that something is caught in the throat that does not go away
- Difficulty swallowing or chewing
- Difficulty moving the jaw or tongue
Tongue cancer can occur:
In the mouth, where it may be more likely to be seen and felt (oral tongue cancer). This type of tongue cancer tends to be diagnosed when the cancer is small and more easily removed through surgery.
In the throat, at the base of the tongue, where tongue cancer may develop with few signs and symptoms (hypopharyngeal tongue cancer). Base of tongue cancer is usually diagnosed at an advanced stage, when the tumor is larger and the cancer has spread into the lymph nodes in the neck.
Also base of tongue cancers are associated with human papillomavirus (HPV), which has a profound effect on the prognosis and treatment of the cancer.
Persistent difficulty in chewing or swallowing, speaking, or moving the jaw or tongue.The movements of the tongue can get affected with the cancer at advanced stage.
Endoscopic neck dissection (surgery) is a technically feasible and safe technique for treating early-stage oral cancer. Any incision in the neck gives a scar which is visible so technological advancement has led to more pragmatic and safe surgery by placing the incision behind the ear and along the hairline (retro auricular). Through this incision, endoscopic camera and instrument are put, surgery is performed and then incision is sutured. This operation is performed for doing thyroidectomy (thyroid removal operation), parathyroidectomy (parathyroid gland adenoma removal) and neck dissections for head neck cancer. The cosmetic outcome is very good with surgical removal of the tumor.
Treatment for advanced tongue cancers can impact your ability to speak and eat. Working with a skilled rehabilitation team can help you cope with changes that result from tongue cancer treatment.
Salivary Gland Cancer
What is Salivary gland cancer?
Salivary gland cancer is a type of head and neck cancer. It is a rare disease in which malignant (cancer) cells form in the tissues of the salivary glands.Being exposed to certain types of radiation may increase the risk of salivary cancer.Signs of salivary gland cancer include a lump or trouble swallowing.
The salivary glands make saliva and release it into the mouth. Saliva has enzymes that help digest food and antibodies that help protect against infections of the mouth and throat. There are 3 pairs of major salivary glands:
- Parotid glands: These are the largest salivary glands and are found in front of and just below each ear. Most major salivary gland tumors begin in this gland.
- Sublingual glands: These glands are found under the tongue in the floor of the mouth.
- Submandibular glands: These glands are found below the jawbone.
Of all the above, PAROTID TUMOR is most common, In fact as many as 80% of salivary gland tumors begin in the parotid glands.
Parotid glands are salivary glands which are situated in the area in front of ear. It produces saliva to keep our mouth wet, if you see or think about delicious food it starts producing saliva and opens in the mouth via a duct, adjacent to upper 2 molar teeth or upper 2nd last tooth.
Parotid gland can get affected by tumors or lump which in 80% times is not cancerous. These Benign parotid tumors tend to grow but do not spread to other parts of the body. As they grow, they may push on the surrounding tissue or wrap around them; if the nerve is immediately next to the tumor then the nerve can in time be either pressed on or engulfed by the salivary gland tumor making surgery more difficult. The benign tumor of the parotid gland is Pleomorphic adenoma also called Benign Mixed Tumor. They will usually been seen as swelling which keeps on growing with time slowly and will usually not cause any pain. If there is pain or recently it has rapidly increased in size then we suggests cancerous conversion of the benign tumor.
To diagnose it one needle test is done called FNAC by which it is confirmed that swelling is cancerous or not cancerous. Surgeon will require CT scan or MRI for looking inside the nature of lump and likely any extension.
Surgery is challenging as there is nerve called Facial nerve which runs deep to the tumor so this nerve and its branches needs to be preserved. This nerve controls the facial expressions. Its damage during surgery leads to inability to close the eyelid and deviation or mouth to while smiling and in worst cases it may lead to permanent facial paralysis of the patient. In order to avoid this we take utmost care in identifying the facial nerve prior to the removal of Parotid Gland. Surgery is the only successful way by which it can be removed. Surgeon’s experience and use of adjunctive instruments like nerve stimulator to help in identifying the finer branches with large tumours are the key points of successful removal of tumor.
Patients are able to go home on same day or day after surgery, depending on the overall health and other parameters. After 1-2 weeks of surgery they are allowed to eat everything but forbidden from taking Pan Masala, Gutkha and are also refrained from heavy lifting exercises.