Cancer of the tongue

Cancer of the tongue is a group of oncological diseases in the oral cavity, which are formed most often from cells of squamous epithelium - flat epithelium. According to statistics, the cancer of the language is not more than 2% of all cancer, but this pathology is characterized by aggressive development and serious complications due to the anatomical structure and location of the affected organ. More often, cancer cells are found in men of mature age (after 50-55 years), in women, the cancer of the tongue is diagnosed 5-7 times less often.

The onco-process is differentiated according to the following criteria:

1. Localization:
   • The root (18-20%).
   • Lateral surfaces of the tongue (65%).
   • The tip (3%).
   • Back of tongue (3-5%).
   • Sublingual zone (5-7%).
2. Types (histological):
   • Adenocarcinoma is a very rare species.
   • Squamous cell carcinoma is in 90-95% of cases.
3. Forms:
   • Ulcerous (bleeding ulcerated tumor).
   • Infiltrative.
   • Papillary form of cancer.
4. On development and growth:
   • Exophytic tumor protruding into the oral cavity.
   • Endophytic, diffuse tumor that grows into deep layers of the tongue, mouth cavity.
5. On the way of metastasis proliferation:
   • Lymphogenous pathway (into the lymph nodes).
   • Hematogenous pathway (into internal organs).

[1], [2]

Causes of Language Cancer

The exact causes and etiology of oncological pathologies of the language have not yet been established, the generally accepted version is the effect of external carcinogenic factors on the DNA structure of the language cell. These can be polycyclic hydrocarbons, ethyl compounds and other pathogenic irritants.

Also, the causes of cancer of the tongue are associated with chronic traumatization of the epithelium, which gradually contributes to its hyperplasia, dysplasia and development of oncoprocess. Any ulceration, erosion, growths, especially long-term non-healing and spreading in the oral cavity, can be considered precancerous signals.

Risk factors and causes of cancer of the tongue:

• Nicotine addiction - smoking, the use of tobacco mixtures, tobacco.
• Alcohol addiction.
• HPV - papillomas.
• Plain lichen is a hyperkeratotic or ulcerative form.
• Systemic lupus erythematosus.
• Herpes virus.
• HIV.
• Plummer-Vinson Syndrome.
• Leukoplakia - simplex (simple), erosiva (erosive) or verrucosa (verruzovaya).
• Inside the epidermal cancer, Bowen'S Disease is Bowen's disease, an obligate precancerous disease.
• Syphilitic glossitis.
• The professional factor of harmful production is contact with salts of heavy metals.
• Chronic diseases of the oral cavity that develop as posttraumatic conditions when wearing dentures.

One of the most dangerous factors are obligate, precancerous diseases, the probability of their malignancy is this:

• Leukoplakia - 5-15%, depending on the species.
• Erythroplasty - 30-35%.
• Dysplasia - 30-35%.

Any pathogenic systematic effect on the oral mucosa, on the epithelium of the tongue, can be an onco- provoking factor - from chronic stomatitis to harmful, addictive habits such as smoking or alcohol abuse.

[3], [4], [5]

Symptoms of cancer of the tongue

The clinical manifestations of cancer of the tongue are conventionally divided into three stages - the initial stage, the development of the process and the period of neglect of the cancer. Symptoms of cancer of the tongue in the initial stage are not obvious and can manifest as small cracks, ulcers, in the form of small foci of plaque. Most often, the cancer of the tongue is localized along its sides, where the tongue is in contact with the teeth, rarely the oncoprocess touches the root or the lower zone. Primary symptoms in 90% of cases are not diagnosed as oncoprotein, rarely they can be accurately determined only by histological examination in case of suspected oncopathology. If the cancer is not detected, the tumor continues to develop and is intensely ulcerated. Ulcers look like a depression with a pronounced thickening at the edges (crater ulcer). Painless erosion soon turns into a painful formation, bleeds and thus signals a pathology. As a rule, at this stage signs of cancer are already manifested, and the patient seeks help from a doctor. Less often, the diagnosis is carried out at the 3rd or 4th stage of the process, when the tumor grows all over the tongue, affects the soft tissues of the face, the muscles of the tongue, and has metastases in the lymph nodes (under the chin, in the intralesive and submandibular nodes). Remote metastases, including bone tissue, are found only in adenocarcinoma of the tongue, squamous cell carcinoma does not metastasize into the liver and lungs.

Oncologists distinguish the following symptoms of cancer of the tongue:

• Primary signs are white focal plaques, ulcers, cracks, compaction in the form of nodes, papillomas.
• Pain when eating, burning or numbness of the tongue.
• Constant sore throat, not associated with other diseases (angina, acute respiratory disease, influenza).
• Pain in the ear zone, not associated with ENT diseases.
• Bleeding of the tongue.
• Pain in the teeth, loosening of the teeth.
• Gum bleeding, not associated with dental diseases.
• Increased salivation.
• The growing laziness of the language, the difficulty in pronouncing words, certain sounds.
• Enlarged lymph nodes.
• Extremely unpleasant odor from the mouth, not associated with gastrointestinal diseases.
• Signs of exhaustion, weight loss.
• Signs of general intoxication.
• Secondary inflammatory diseases of the respiratory system, including the clinic of aspiration pneumonia.

Symptoms of cancer by localization and involvement of the lymphatic system can be presented in the form of a table:

Tumor localization	Signs, Symptoms	Lymphonoduses
Tip of the tongue	Ulceration, exophytic tumors. Pain and bleeding can begin at the end of stage II	5-10%
The bottom of the oral cavity, the localization of cancer under the tongue	Infiltrative tumors that proliferate in muscle tissue. Pain in the lower jaw, under the chin, in the neck	T1 - up to 15% T2 - up to 30%
Lateral surfaces of tongue	Ulceration, squamous cell carcinoma. Pain when eating, bleeding, pain in the face. Beginning with Stage III, immobility of the tongue, total ulceration of the oral cavity, exhaustion	From 30 to 70%
The root of the tongue	Aggressive, rapid development, dysphagia, bleeding, sore throat, regional lymph nodes. The tumor affects the auditory nerve, so the ear hurts. The last stage is characterized by intoxication symptoms, cachexia develops	65-80%

First signs of cancer of the tongue

Unfortunately, the first signs of cancer of the tongue in 90% of cases are missed not only by the patients themselves, but also by the doctors, when a cursory examination of the oral cavity diagnoses glossitis, stomatitis or other, not such dangerous diseases.

Most often, the tongue tumor develops from squamous epithelial cells, that is, it has the form of squamous cell carcinoma. The epithelial tissue of the tongue is in principle adapted to various stimuli - mechanical, flavor, temperature, therefore conditionally considered to be sufficiently dense, adapted to traumatic effects. Most likely, the first signs of cancer, therefore, do not feel as alarming, especially if the language does not show atypical formations.

Initial alarm signals are the appearance of local foci of plaque, which does not disappear within a month, ulcers, cracks, outgrowths. If such manifestations increase, develop, there is periodic discomfort, therefore, there is a direct indication of the need for examination. Severe pain is a sign of an already developed process that is not only difficult and difficult to treat, but also fraught with menacing consequences, up to disability and death.

For any form of the cancer of the tongue is characterized by a rapid and aggressive course of the process, so uncontrollable ulcers, cracks in the tongue, should be entrusted to a specialist. It is better to prevent risk and to be reinsured than to undergo a long, very painful and traumatic treatment of the tumor of the tongue.

[6], [7], [8], [9]

What does cancer of the tongue look like?

Most commonly, the visible symptoms of the cancer of the tongue appear with precancerous (obligate) conditions, such as Bowen's disease, leukoplakia, HPV (papilloma), stomatitis caused by chemotherapy, flat red lichen.

1. Cancer in situ is Bowen's disease. In the oral cavity, one spot appears on the tongue, which rapidly grows to large sizes (up to 5-6 centimeters). The spot has a smooth surface, uneven contours, a hollow in the middle. It is in the zone of the cavity that erosion is formed, then the entire ulcer is ulcerated.
2. Leukoplakia in Latin means a white growth, a plaque, which determines the appearance of the trait. Leukoplakia as a process is a chronic, gradual total keratinization of the cells of the epithelium of the oral cavity, of the tongue. There are three studied types of leukoplakia:
   • Simple, which is visible as a small white spot, with clear contours, a flat and removable toothbrush. The stain does not hurt, does not cause discomfort.
   • Keratosis, which is a consequence of simple leukoplakia. The primary spot is covered with a plaque in the form of a wart. The plaque is sensitive to irritants, therefore it is often damaged, cracks and ulcers appear on it. Such phenomena already bring discomfort in the form of a sensation of rough edges in the mouth. Verrux sprouting does not hurt, but can bleed with cracks and ulceration.
   • Erosive leukoplakia, in turn, is a pathogenetic consequence of the two previous forms. Verrux sprains begin to ache while eating, especially hot or spicy, acidic.
3. Papilloma is noticeable due to the fact that this is an obvious epithelial outgrowth. Papillomas usually have a white hue, have a foot, less often a broad base. The dimensions of papillomas can reach 2-3 cm, they can be quite dense in structure and can be felt as a foreign language formation.
4. Glossitis is an inflammation of the tongue, the most dangerous form of the rhomboid inflammatory process is when the tongue gradually forms a seal in the form of a geometric figure. Salivation increases, the tongue periodically hurts.

The launched form of the cancer of the tongue looks like a continuous, total erosive process affecting not only all parts of the tongue, but also the mucous membrane of the mouth, soft facial tissues and even bones.

How does cancer of the tongue manifest?

The first alarming signs of a tumor of the tongue are the white spots or cracks that last for several weeks. How does cancer of the tongue manifest?

At the initial stage, warning signs should become seals on the epithelium of the tongue, sores, even painless nodules or erosion. As a rule, atypical formations progress rapidly, increase and do not lend themselves to domestic methods of disposal. The first painful sensations, bleeding and enlarged lymph nodes are signs of the development of cancer, when its treatment is most likely to occur under stationary conditions. Possible pains are not in the area of the tongue, but near the ear, in the throat, in the occiput, under the jaw, which speaks of enlarged lymph nodes and developing metastases. Cancer of the tongue is characterized by an aggressive course and the initial stage is quickly transformed into the process of the IInd III and final, terminal stage.

How does the cancer of the tongue manifest in these stages?

• Severe pain when eating.
• Total ulceration of the oral cavity, visible erosion and lesions of the mucous membrane.
• Hyperemia of the oral cavity.
• Limitation of language mobility, difficulty in pronunciation of words.
• Weight loss, exhaustion.
• General intoxication of the body.
• Bad, unpleasant odor from the mouth due to the decay of the epithelium and soft tissues.
• Headache.
• Puffiness and pain in regional lymph nodes.

Cancer of the tip of the tongue

Cancer of the tip of the tongue is extremely rare and is diagnosed, as a rule, in the early stages due to the appearance of clinical signs. According to statistics, the cancer of the tip of the tongue is no more than 4% among all the varieties of tumors of this zone of the oral cavity. For this localization process is characterized by metastasis in the chin lymph nodes, when the tumor is diagnosed at the III or IV stage. From the chin zone, metastases quickly expand into the submandibular region, and then into the neck. Metastasis proceeds according to the bilateral type and is fraught with serious complications. In this process, the prognosis of the tumor process is unfavorable, a five-year remission is possible only in 30-35% of patients.

Primary symptoms are usually missed by the patient, as they look like symptoms of stomatitis, but the tip of the tongue has a high sensitivity, so permanent erosions, cracks force the patient to see a doctor when the process can be considered reversible. Early diagnosis with biopsy helps not only to correctly and accurately establish the diagnosis, but also to determine the therapeutic strategy of curing cancer of the tip of the tongue. As a rule, this part of the language is affected by squamous keratinized cancer, which is quite successfully treated with combined therapy, including radiotherapy and surgical methods.

[10], [11]

Cancer of the mouth and tongue

Malignant processes in the oral cavity, including the tongue, are most often caused by obligate precancerous pathologies, poor environmental conditions and in 50% of cases by harmful habits such as smoking, alcohol abuse, as well as STDs, sexually transmitted diseases.

Statistically, the cancer of the oral cavity and the tongue is localized in this way:

• 60-65% - a cancer of the tongue.
• 13-15% - swelling of the mucous membrane of the cheek.
• 8-10% - the bottom of the oral cavity, cancer under the tongue.
• 6-7% - cancer of the mucosa of the alveoli of the upper jaw, palate.
• 3-4% cancer of the soft palate.
• 2-3% cancer of the mandibular alveoli.
• 1% soft skin of the palate.
• 1% - anterior palatine arches.

To date, statistics have changed in the direction of increasing diagnosed cases of cancer of the tongue. 90-93% of all oncology processes in the oral cavity are squamous cell carcinoma, in other cases, lymphoma, adenocarcinoma, melanoma are defined.

Cancer of the oral cavity, including the tongue, is classified according to ICD-10 in the range from C00 to C09, starting from malignant neoplasms of the lip and ending with malignant formations of the tonsils. Cancer of the tongue is defined as C01 - malignant neoplasm of the base of the tongue (root of the tongue) and C02 - malignant neoplasm of other and unspecified parts of the tongue.

The diagnosis of the oncology process in the oral cavity and language is confirmed by histology, the characteristic clinical manifestations are characteristic for the late stages, when there is pain and lymph nodes increase. Metastasis occurs in 45% of patients with squamous cell carcinoma of the anterior zone of the tongue, and 55% with tumors of the bottom of the oral cavity (sublingual zone).

[12]

Squamous keratinizing cancer of the tongue

Among all malignant neoplasms of the oral cavity, squamous, squamous cancer is most often diagnosed, including language in 90-95%.

Cancer of the tongue is histologically divided into 4 types:

1. Carcinoma in situ - intraepithelial carcinoma, which is extremely rare.
2. Ploskokletochny kerbstone cancer of the tongue - a tumor that grows into the nearby connective tissue in the form of a verrucous carcinoma. The tumor is characterized by large zones of keratinization, similar to the so-called "cancer pearls". The process develops rapidly, destroying all neighboring structures.
3. Ploskokletochny kerbstone cancer, characterized by the growth of atypical epithelium.
4. Low-differentiated tumor with specific spindle-shaped cells - sarcoid cells.

Cancer planocellulare cornescens (squamous keratinizing cancer of the tongue) is clinically divided into superficial and deep, which develops from the glands of the mucous tissue. The course of the process is characterized by aggressiveness, the appearing ulcers quickly overgrow with dense, keratinized margins. The affected area of the tongue appears prominently above the entire surface, has a grayish hue, feels dense, painless. The perruchnic form of the cornificating cancer is divided into a plaque and a warty appearance. The most dangerous is the warty variety due to the high likelihood of malignancy.

Differentiate squamous squamous keratinizing cancer with tumor basal cell, which in case of ulceration retains an even smooth surface of peripheral zones. Exophytic squamous cell carcinoma of the tongue grows papillary, without any smooth, even areas. Often a purulent infection in the central part of the plaque is attached to the miniapapillomas, which provokes a characteristic fetid odor from the mouth.

Treatment of corneal cancer depends on the location and degree of neglect of the process, but in most cases, excision of cancers within the healthy tissue is performed. Before the operation, close-focus radiation therapy is performed, after excision it is repeated to stop the oncoprocess. Currently, laser technologies are used in squamous cell carcinoma surgery, which helps to avoid severe consequences and prolongs the period of remission. The prognosis in patients with squamous cell cancer in the I - II stage is 90% of five years of remission and survival, if there are metastases to the lower jaw, the survival rate is halved.

Cancer under the tongue

Cancer under the tongue is a swelling of the bottom of the oral cavity, which is about 15% of all cases of malignant processes in this area. The bottom of the cavity is formed by a set of different structures that are located between the hyoid bone and the tongue. The main support of the bottom of the oral cavity is the maxillo-hyoid muscle. This zone is most often affected by the tumor under the influence of carcinogenic factors - smoking, heavy metal salts, permanent mechanical or temperature trauma. Also, the causes of cancer under the tongue can be HPV - papilloma, leukopenia and other precancerous diseases. Most often, the tumor is localized near the frenum of the tongue, rarely at the mouth of the salivary duct. Cancer under the tongue is defined in men, on average, there are 4 male patients over 55 for a female patient. The initial stage of the process proceeds without symptoms and signs of tumor development. The patient turns to the doctor already with pain in the third stage. Pain in case of cancer of the bottom of the mouth is a signal of tumor germination into deep structures and most often a symptom of metastasis. If the metastases penetrate into the bone tissue, they localize in the lower jaw, provoking a significant limitation of the mobility of the tongue, its root. In addition, the tumor obturates the salivary glands, which is accompanied by their inflammation, increase and violation of salivation.

How is cancer diagnosed under the tongue?

• The first examination is performed visually - the oral cavity is examined.
• Palpation of submandibular zone and neck.
• Finger examination of the oral cavity, including tongue, tonsils and bottom.
• Ultrasonic examination of the neck.
• Radiography of the cervical zone, lower jaw.
• Orthopantomography.
• Tumor biopsy.
• A smear from the throat.
• Tomography according to indications.
• UAC (general blood test).
• Determination of the Rhofactor.

Forecast cancer treatment under the tongue is unfavorable. Five-year remission is possible in 85% of patients, provided that the tumor is detected at an early stage. Unfortunately, the rest of the patients live no more than a year and a half.

[13], [14], [15]

Squamous cell carcinoma of the tongue

Ploskokletochny cancer - a malignant neoplasm, formed from cells-keratinocytes. The development of cancer is provoked by carcinogenic factors:

• Effects of carcinogenic resins.
• Heavy metals salts, ethyl.
• Inorganic compounds of arsenic.
• Ionizing radiation.
• Permanent traumatic mechanical factor.
• Overgrowth of scar formation.
• Obligatory precancerous diseases.

Squamous cell carcinoma of the tongue has many synonyms - squamous epithelioma, epidermal form of squamous cell carcinoma. Such a variety of definitions is due to the fact that squamous cell tumors can in principle develop in those parts of the body where there is squamous epithelium. Plane epithelial cells cover the internal organs that have a serous membrane, performing a unique protective function.

Symptoms of squamous (squamous) cancer of the tongue:

• The first stage of tumor development is asymptomatic.
• Initial clinical signs - white foci of attack, growths, erosion, less often - cracks in the tongue.
• Pain when swallowing food, liquids.
• Periodic sensation of numbness of the tongue, which, with the development of cancer, increases and completely immobilizes the tongue.
• Bleeding ulcers, cracks, accretions on the tongue.
• Severe pain when eating, talking.
• As a consequence of the pain of eating and communication, exhaustion, dysphagia develops.

Most often, patients turn to the doctor. In the second or third stage of the disease, when the symptomatology becomes obvious. Treatment of squamous cell carcinoma of the tongue depends on the location of the tumor and the period of seeking medical help.

The main zone of the tumor is the lateral parts of the tongue, here the cancer develops in 70% of cases. In 15-20%, the tumor forms at the base of the tongue (oropharynx), under the tongue - in 5-8%, at the tip of the tongue very rarely - in 2-3% of all diagnosed pathologies of the oral cavity. At the time of receiving oncological care, more than 50% of patients have all the symptoms of regional metastasis, distant metastases are not characteristic of squamous cell tumors, metastases to the liver, lungs provoke carcinomas and other cancers of the tongue.

Upon examination, the tumor appears as a small plaque of grayish hue, which has a small-hummocky structure, in the form of expanding papilloma. The tumor is clearly limited, visibly protruding above the surface of the epithelium of the tongue. Neoplasm can also be in the form of a nodule or erosion of irregular shape. If the process proceeds according to the ulcerative type, the formations have a reddish-gray hue, the borders of the ulcer are surrounded by pronounced infiltrates.

A squamous cell cancer of the tongue is difficult to treat, and the prognosis is most favorable when a tumor is detected in the first stage. As a rule, the standard purpose is radiotherapy in the form of an independent treatment method or as part of a comprehensive strategy, the palliative method. Also, in the initial stages, contact gamma-therapy is effective, at later stages it is applied remotely (DHT). Radiation therapy is performed until the tumor is reduced by more than half, if this tactic does not work out, the question of using other more radical measures of treatment is being solved.

As a surgical method for diagnosing a primary tumor of the third stage, resection is shown, its form is determined by the localization of the process. Squamous cell carcinoma is characterized by deep invasive sprouting along the fibers of muscle tissue and vessels, therefore, a radical removal of all muscular tissue affected by metastases is quite often used.

Cancer of the root of the tongue

Anatomically, the language is divided into two main zones - the base (root) and the body.

The body of the tongue can be seen by everyone, if the tongue protrudes in front of the mirror, the root is harder to see, more often the doctor determines his condition during the examinations. The base of the tongue is located near the pharynx, therefore the cancer of the root of the tongue is considered to be a process of the oropharynx. Statistically, the cancer in this zone is less common than the cancer of the lateral surfaces, but this localization is more difficult to treat due to inaccessibility and connection with the nasopharynx, yawn, sky.

Clinical manifestations of root cancer:

• The initial stage of cancer is characterized by a languid, unmanifested symptomatology.
• The first signs appear 2-3 months after the beginning of the development of the tumor process.
• Feeling of sore throat when eating.
• Difficulty in swallowing food, liquids.
• Pain in the depth of the mouth, in the pharynx.
• Increased salivation due to the germination of the tumor in the masticatory muscles.
• Increased regional lymph nodes.

Early manifestations of the root cancer of the tongue are periodic discomfort in the form of food impairment, if the initial symptoms are diagnosed in time as a malignant process, the prognosis and the timing of remission can be quite favorable. Later detection of clinical manifestations is fraught with a lethal outcome.

[16], [17]

Symptoms of root cancer

Cancer of the root of the tongue is defined as a tumor of the oropharynx. There are the following main symptoms of root cancer:

• Small areas of erosion, nodules, cracks.
• Lack of pain in the early stages.
• Pain when eating, swallowing during the third stage of the process.
• Pain in the tongue, in the throat.
• Pain in nearby organs, zones - in the area of the ear, neck, under the jaw.
• Trismus of masticatory muscles (spasm).
• The increasing immobility of the tongue.
• Defects of speech.
• Fetid smell from the mouth.
• Enlargement of lymph nodes - neck, submandibular nodes, occiput, less often clavicular region.
• Exhaustion, weight loss.

Cancer of the root of the tongue progresses very quickly, it is characterized by infiltrative growth, rapid metastasis by lymphogenous pathway. In clinical practice, there are adenocarcinomas of the root of the tongue, which develop from the salivary glands, accompanied by a clear sign of this form - immobility of the tongue.

Treatment of cancer of the base of the tongue is performed with the help of radiotherapy, further treatment is shown, including brachytherapy, tracheostomy, with metastases - lymphadenectomy. If after 4 weeks the dynamics is negative, excision of the affected area of the tongue is carried out to the epiglottis, the area of the neck affected by the tumor is simultaneously excised. Prognosis of root cancer:

• 5-year survival at I and II stage (up to 70%).
• 3-5 years of life after surgery in 50% of the III stage.
• Less than 30% of survival in stage IV.

Stages of cancer of the tongue

Almost all oncological pathologies develop at certain stages - from the initial, most often asymptomatic to the final, metastasizing and ending with a lethal outcome. The prognosis - the period of remission and survival of patients depends on the stage of the cancer of the tongue and the initiation of treatment.

Clinical stages of cancer of the tongue are determined in this way:

• I stage, when the tumor does not manifest itself with symptoms, has small dimensions (up to a centimeter) and does not develop beyond the boundaries of the tongue. The tumor is clearly localized in the epithelial tissue, is not metastasized and is rarely diagnosed at this stage.
• II stage, when the process begins to develop into the depth of the muscle tissue, the tumor grows in size and can give rise to initial metastases, usually in the zone under the chin or under the jaw. There are primary signs of the process - burning tongue, ulceration or nodular formation on it.
• III stage. The tumor develops and occupies more than half of the entire tongue and part of the hyoid zone. There are obvious clinical symptoms in the form of periodic numbness of the tongue, limiting its mobility and visible to the naked eye neoplasm. Metastases grow into the lymphatic system of the occipital zone, behind the ears, into the region of the armpits.
• IV stage, when the tumor metastasizes into many internal organs and bone tissue First of all metastases appear in regional lymph nodes, then they affect the brain, lungs and liver, and later - bone tissue.

The stages of the cancer of the tongue are classified according to the generally accepted TNM system:

1. T - tumor, its size (tumor).
2. N - presence of nodes (nodus), lymphatic lesions.
3. M - the presence of metastases (metastases).

The aggressive course of the process is due to the constant impact on the tongue, abundantly supplied with lymph and blood. A person takes food daily, including hot, acute, sour, contributing to trauma, activation of existing erosions, cancer development. In addition, smoking and alcohol are considered almost the main culprits, trigger factors that accelerate the transition of cancer from the initial stage to the next, complicated by metastases.

The initial stage of the cancer of the tongue

It is believed that the most favorable in terms of treatment prognosis and survival statistics is the initial stage of the exophytic cancer of the tongue, the endophytic process develops faster and more aggressively. Like the other oncology processes, at the first stage of development, the cancer of the tongue does not appear clinically, the initial stage does not cause disturbing symptoms or unpleasant sensations. The only signs are small ulcers in the mouth, focal patches, cracks in the tongue, which have no clear boundaries, with palpation, the identified nodules can be felt as small seals. Often to damage the epithelium of the tongue, secondary infections are added in the form of stomatitis, an atypical odor from the oral cavity appears. Salivation increases, teeth can bleed or your throat hurt. The initial stage is characterized by three ways of development, it is most manifested in exophytic form, when the signs of cancer are noticeable by careful examination of the outer cavity of the mouth

Anatomical forms of development of the initial stage of the cancer of the tongue:

1. Ulcerous, erosive form.
2. Nodular form.
3. Papillary shape.

Unfortunately, the asymptomatic character of the initial stage of the cancer of the tongue is the cause of the further development of the process that extends to the sky, the alveolar processes, to the muscle tissue. Therefore, if there are white spots, seals, cracks, papillomas and other atypical signs in the mouth, you should immediately consult a doctor - the therapist, the dentist who will carry out the primary diagnosis, will be sent to clarify the information to a specialist for a more thorough examination of the cavity mouth. It should be noted that surface examinations reveal only about 7% of the symptoms that the cancer of the tongue demonstrates in the initial stage, therefore, timely diagnosis depends on the care of the patient himself and the doctor conducting the diagnostics.

Cancer of the 3rd degree

Cancer of the language of the third degree is manifested by severe symptoms that it is difficult not to notice or feel:

1. Pain, periodically intolerant, localized in the affected part of the tongue. Pain can irradiate upwards - into the ear, the occipital part, into the temples.
2. The tongue becomes numb, loses mobility, there are problems with eating, with communication (it hurts to talk).
3. Periodically my throat hurts.
4. Symptoms of general intoxication appear.
5. The decay products of the epithelial and muscular tissue of the tongue provoke hypersalivation - increased salivation.
6. There is an unpleasant smell from the mouth.

Cancer of the language of the third degree is already clearly manifested by anatomical signs, which are divided into the following forms:

1. Exophytic - papillary, verruzed or ulcerative (most often).
2. The endophytic form is often ulcerative-infiltrative.

It is the endophytic development of the tumor of the tongue that is considered to be the most malignant and is classified in this way:

• IIIА, when the tumor reaches a size of more than 2 centimeters, infiltration extends beyond the middle of the tongue and affects the mucous membrane of the mouth. Primary regional metastases can be detected (in 5-7% of cases).
• IIIB, when the tumor has obvious multiple metastases - collateral or regional.

[18], [19]

Cancer of the 4th stage

Cancer of the tongue in the IVth stage is clinically very difficult. The tumor extends almost to the entire tongue, capturing nearby and distant soft tissues, including the bones of the face. When the process is running during the diagnosis, multiple metastases are visible, immobile regionally and distantly, including in bone tissue.

Cancer of the tongue of the 4th stage is classified as follows:

• IVA, when the tumor is localized throughout the anatomical zone of the tongue, metastases are rarely detected.
• IVB stage, when the tumor has clinically manifested distant metastases and extends not only to the language, but also to neighboring structures - skin and face tissues, facial bones, maxillary sinus, deep muscles of the tongue.

Cancer of the tongue develops in three clinical stages and, if in the initial period it can proceed without signs and symptoms, and in the advanced stage is accompanied by secondary clinically pronounced manifestations, the neglected period (IV stage) proceeds aggressively and is characterized by such symptoms:

• Tumor infiltrative formation is totally covered with ulcers.
• There are strong painful sensations when eating, often making this process impossible in principle.
• The patient loses weight, there are signs of cachexia.
• The complete immobility of the tongue develops because of the growth of the tumor and its germination into the masticatory muscles (trisus of the masticatory muscles).
• Constant bleeding gums, tongue.
• Progressive necrosis of tissues causes an extremely unpleasant odor from the mouth.
• Secondary inflammatory processes in the respiratory organs may develop as a result of aspiration of infected saliva.

Cancer of the tongue in the 4th stage as the process is characterized by an aggressive malignant course and has an extremely unfavorable prognosis.

[20], [21], [22]

Classification according to ICD-10

С002.0-С002.9 - Malignant neoplasms of the tongue

[23], [24],

Metastasis with cancer of the tongue

For cancer of the tongue is characterized by metastasis in the III and IV stage of development. Metastases begin to appear even in the early stages, 3-4 months after the beginning of the formation of the tumor, but do not manifest clinically and, as a rule, are not detected in diagnosis. Distribution of regional metastases in 99% of cases occurs through the lymphatic drainage, the hematogenous path of metastasis to internal organs and bones is extremely rare. Metastases in linguistic cancer are spread with the help of lymphatic outflow, the centers of which are nodes in the neck region (the zone of the carotid artery). Significantly increases the number of lymph vessels in the base area of the tongue, the glomerular cancer of the oropharynx is localized, this type of tumor gives an aggressive growth of metastases.

The exophytic form of the cancer of the tongue gives metastases less frequently and much later than endophyte tumors that affect regional lymph nodes in 70% of cases. In addition, oncological practice has already accumulated information that low histological differentiation of the tumor is characterized by early and very extensive development of metastases. The frequency of involvement of regional nodes with specific localization of cancer is:

• The lateral surfaces of the tongue are 43.5%.
• The root of the tongue, the bottom of the oral cavity - 44,5%.
• The tip of the tongue is 15-20% (submandibular nodes).

Clinicians believe that about half of patients may not have metastases, which is confirmed by years of observations and statistics. However, the complexity of detection of lesions of lymph nodes, due to both anatomical specificity and late diagnosis, leads to the fact that in some cases there may be diagnostic errors both in the direction of hyperprognosis and in the direction of hypodiagnosis. Such errors are present, despite cytology and histological studies.

How does metastasis develop in cancer of the tongue? General stages of diagnostics look like this:

• Careful palpation of the neck and submandibular zone from both sides.
• Visual inspection of the oral cavity.
• Finger examination of the oral cavity, including the bottom, tongue, tonsils.
• Ultrasound examination of the cervico-brachial girdle.
• Radiography of the chest.
• Radiography of the lower jaw.
• Orthopantomography.
• CT scan.
• Indirect lymphoscintigraphy.
• Biopsy of a neoplasm.
• A smear from the throat for cytology.
• Analyzes of blood, urine, saliva.

The main informative method, which helps to detect metastases at early stages of development, is ultrasound and indirect lymphoscintigraphy. If the tumor is already diagnosed and is subject to surgical excision, regional lymphadenectomy of the neck is used during the procedure, which allows to determine the presence or absence of metastasis in intact lymphatic zones.

Diagnosis of cancer of the tongue

The detection of a tumor in most cases is already in the late stages of oncoprocess development in the oral cavity. Very rarely are situations where the diagnosis of cancer of the tongue determines the I or II stage, which is asymptomatic. The main indicative and informative method in clarifying the nature, form and type of cancer is histology. A biopsy of tumor neoplasm is carried out, lymph nodes, both nearby and distant, for example, axillary ones, are necessarily examined.

Diagnosis of cancer of the tongue includes such activities:

1. Physical methods:
   • Visual inspection.
   • Internal examination - palpation of the tongue, the bottom of the oral cavity, including the tonsils.
   • Palpation of the neck and the area under the lower jaw.
2. Instrumental examination of the tumor and the whole organism:
   • Ultrasound of the cervical zone.
   • Ultrasound of the abdominal cavity organs.
   • Chest X-ray.
   • X-ray of the jaw, including orthopantomography.
   • Biopsy of a neoplasm.
   • Smears for cytology.
   • MRI or computed tomography of the skull.
   • Positron emission tomography according to indications.
   • Radioisotope method of neoplasm research.
   • Laryngoscopy.
   • Nasopharyngoscopy according to indications.

Not all of the above methods are used in the diagnosis of cancer, as the late stages of the disease are so developed that it is enough to conduct a cytology or take a scraping from the epithelial part of the tongue. The most important action is the differentiation of the tumor from similar on external symptoms of other oncopathologies. It can be epithelial dysplasia, hemangioma, language tuberculosis, syphilitic gum, myoma of the oral cavity, leukoplakia. Often, the cancer of the tongue is similar to erythroplasty, which is a precancerous condition, but not a full-fledged tumor process. In addition, diagnostic difficulties are possible with differentiation of the tumor and mixed tumor processes, characteristic of the oropharynx. Mixed tumors are most often formed from the salivary glands, localized at the back of the base of the tongue, less often laterally. Atypical tumors develop slowly, have a round shape, a dense uneven consistency, such formations include mucoepidermal formations, Abrikosov's tumor, and cylinders. Diagnosis of cancer of the tongue is confirmed or eliminated by morphological studies - cytology and biopsy.

[25]

Cancer Treatment

Tactics and the definition of a treatment strategy are directly related to that stage. In which is the development of the tumor and with how extensive and profound is the metastasis. The main method, which involves the treatment of cancer of the tongue, is radiation therapy. It is used as an independent stage in the process control, and in conjunction with other ways of treating the tumor. The choice of the regime and the number of procedures necessarily take into account the degree of neglect of the oncoprocess. For example, at stages I and II shows the conduct of contact radiation therapy, at later stages, accompanied by metastases, remote methods of irradiation are used. The first 3 sessions of radiotherapy show the effectiveness and necessity of continuing the application of this method. If the observation does not show positive dynamics, radiation therapy is canceled and other combined therapies are prescribed. With persistent positive dynamics, the dose of radiotherapy can be increased up to 2 times and the course is continued. Treatment of cancer of the tongue is carried out for a long time, with the help of many modern techniques, but the most effective combined strategy, including surgery. The scope of surgical intervention is determined by the oncology process and can be as follows:

• I and II stage - resection of the tongue, as a rule, half.
• III stage - volumetric expanded operation.
• After the resection of the primary tumor, the neck tissue is excised.
• With multiple metastases, Krylya's method is used when the fascia of the cervical, supra-lingual, supraclavicular lymph nodes are removed together with the removal of part of the submandibular salivary gland.
• Also, with extensive metastasis, a Vanaha surgery or cervical lymphadenectomy can be performed. The essence of surgical intervention consists in the facial removal of the lymph nodes located under the jaw, under the chin together with part of the salivary gland. The Vanaha method is indicated for cancer of the anterior third of the tongue surface in stages III and IV.

Treatment of cancer of the tongue also includes chemotherapy as a palliative method, which helps to improve the effectiveness of previously used methods. Combination therapy is much more effective than monotherapy and allows to increase the percentage of survival, remote remission results to 55-60%. The most favorable predictions for the treatment of exophyte neoplasms, which are located in the anterior zone of the tongue, especially in the early stages. Despite the complications, after radiation therapy in the form of purulent inflammation in the oral cavity, aesthetic deformation problems, speech impairment, the forecast of five-year survival is close to 60%. Those patients who were diagnosed in the late, neglected period, live no more than 12-18 months after the surgical intervention, they are imposed gastrostomy.

The recovery period also enters into the treatment of the tumor of the tongue, it is quite difficult and prolonged. Since the process of food intake is a serious problem after resection of the body, it is possible to perform a plastic surgery. It is also very difficult to restore normal speech and general psycho-emotional state. At this time the patient needs moral support not only of the attending physician and medical staff, but also of people close to him.

[26], [27], [28], [29]

Methods of treatment of cancer of the tongue

Modern methods of treatment of cancer of the language are developing rapidly due to the latest achievements in the study of atypical cells, their pathogenetic mechanism of development and developments in the field of equipment for the management of oncopathologies. Early stages of tumors of the tongue are subject to radiation therapy and organ-preserving operations. Today, the method of burning neoplasms with the help of focused ultrasound is successfully used, resection is performed with a gamma knife, excision of affected tissues is carried out by thermocoagulation or using a laser. All these methods are low-traumatic and allow maximum preservation of the functions of the language, including without damaging the speech device in principle. Operations last a short period, much more time is required to restore and rehabilitate the patient. Late stages of cancer of the tongue are subject to more extensive operations, when a significant area of the organ is removed, the tumor is less often excised and the tongue and lymph nodes are removed completely. After such radical measures, the functions of the tongue are partially restored by plastic surgery, when donor material is used from the patient's own tissues. Also, after removal of metastatic lymph nodes, the patient is shown reconstructive therapy, which helps to regulate the process of food intake, speech. Correction of appearance defects is not so significant in the treatment of cancer of the tongue, but after several years of remission, it is possible to carry out facial plastic surgery, provided the organism is ready for another surgical intervention.

In addition to surgical intervention, the cancer of the tongue is treated with radiation and chemical therapy. Primary stages are subject to a contact gamma method (2-5 centimeters from the body), more advanced stages are treated with remote radiation therapy - a radioactive method that destroys not only tumor cells but also healthy cells. Chemotherapy may be prescribed, which helps to speed up the reduction of tumor growth and is well combined with radiation methods as a palliative element. In general, the methods of treatment of the new growth of the oral cavity are planned jointly, the oncologist closely cooperates with dentists, orthodontists, physiotherapists, speech therapists, plastic surgeons and nutritionists.

Treatment of root cancer

Malignant neoplasms of the oropharynx begin to be treated, as a rule, in the late stages. More than 80% of patients enter the hospital with an already developed oncology and extensive metastases. This type of cancer of the tongue is considered the most unfavorable, a five-year remission is possible only in 10-15% of patients. Perhaps such a low survival rate is associated not only with the neglect of pathology, but also with the lack of a single standardized, optimal therapy regimen. Also, the difficulty of treating the root cancer of the tongue consists in the total spread of the tumor by extensive damage to the tissues of the oral cavity, which makes it impossible to carry out a radical operation. There is one more obstacle: the anatomical and physiological specificity of the localization of the base of the tongue, for the arrest of cancer, extensive excision of the deep layers of tissues is necessary, as a result, almost all functions of the tongue are broken and multiple serious complications are possible.

The main method, which involves the treatment of root cancer of the tongue, is considered radiation therapy, which is shown as an independent stage, but is also used in combination with cytotoxic drugs. Gamma-therapy is very effective at stages I and II of cancer development, especially in combination with X-ray radiation, conducted in a close-focus method. The left treatment is applied and at advanced stages, both preoperative preparation, and a postoperative course. Wide block excision of the tumor and metastasis in the lymphatic apparatus is carried out in any case, regardless of the presence or absence of metastases. Surgery is shown even in the initial period of tumor formation, since it is the removal of atypical cells that helps to stop the process and prevent it from spreading to nearby tissues. Lymphadenectomy is currently shown to 90% of patients with cancer of the root of the tongue, this contributes to prolongation of the terms of remission and increase the chances of survival in principle.

Methods of treatment of cancer of the base of the tongue:

• Radiation therapy.
• Cryotherapy, laser.
• Thermocoagulation.
• Surgical intervention.
• Chemotherapy.
• Radiotherapy.
• Assignment of cytostatic drugs in tableted form.
• Biotherapy, the appointment of drugs containing monoclonal antibodies, inhibitors of growth of atypical cells.

Operation in cancer of the tongue

The type and extent of surgical intervention in language cancer directly depend on the stage of the process, the size of the tumor, the degree of spread of metastases and their localization. If atypical cells do not affect adjacent tissues, the operation is carried out as sparingly as possible, such interventions are called organ-preserving. More serious stages of the process require volume operations involving excision of the nearby lymphatic apparatus, as well as soft tissues of the face or neck. As a rule, the beginning of treatment is a radiotherapy, which shows the prevalence of the tumor and the curability of the oncoprocess in principle. If the tumor continues to grow, it recurs, the operation is unavoidable and contributes not only to neutralizing the growth of squamous cell carcinoma, but also to some relief of symptoms. The number and sector of tissues that are subjected to excision are determined by the localization of the neoplasm. It is also necessary to remove some of the healthy tissue, because the anatomical location of the tongue is very specific and does not allow for radical intervention within the boundaries of normal tissue structure.

Surgery for cancer of the tongue can be local and performed with a laser or thermocoagulation (moxibustion), as a rule, such sparing interventions are indicated for early detection of a tumor and the absence of metastasis in regional lymph nodes. Endophilic deep neoplasms require more radical measures, such as resection of a larger half of the tongue, excision of lymph nodes affected by metastases. Why can not you do without an operation? Arguments in favor of surgical intervention:

1. To date, surgical treatment of the oncology process in the oral cavity is the most reliable and effective way to stop the process. Surgical intervention is rarely shown as a monomethod, more often it is used in combination with radiotherapy, chemotherapy and other methods of curing cancer.
2. Surgery for cancer of the tongue can provide the highest percentage probability of persistent remission and prolongs life expectancy to 5 years. This is not only prolongs the life of the patient, how much gives him hope for a cure, because every year there are new, modern methods of treating cancer. It is likely that in five years scientists will finally be able to defeat cancer.
3. It is incorrect to compare the effectiveness of radiotherapy and surgery in the treatment of cancer of the tongue. The first method is affective in exophytic tumors of small size, but are ineffective in infiltrative neoplasms, especially in later stages.
4. At the III and IV stage of the neoplasm of the tongue, treatment without surgery is simply impossible.
5. Modern surgical technology allows today to perform surgical intervention in the most gentle ways, in addition, after resection, excision, the probability of complete reconstructive recovery of musculoskeletal complexes tends to 95%.

Radiation therapy of cancer of the tongue

Radiation therapy is considered one of the most reliable methods of treating the initial stages of malignant processes in the oral cavity. The effect of radiation on the tumor is ionizing X-ray irradiation of atypical cells, most often multilayered planar epithelium. However, in addition to effectively neutralizing tumor growth, radiotherapy for cancer of the tongue can be accompanied by a number of complications, as it destroys not only cancerous tumors, but also a part of healthy tissues. Therefore, the therapeutic strategy takes into account the age, the patient's condition, the location of the neoplasm and the appropriateness of using the gamma method. Usually, the I and II stages of cancer are treated by a contact method, when the rays are exposed to a close distance (interstitial irradiation). The more advanced stages III and IV are subjected to remote radiation therapy.

Radiation therapy for cancer of the tongue can be called radiotherapy and conditionally divided into a radical, that is, an independent method of treatment, but also conducted as an adjuvant method that helps reduce the risk of relapse after surgery. Also, radiation therapy is used in conjunction with chemotherapy (chemoradiotherapy), which activates and speeds up the process of stopping the tumor and developing metastases.

Radiotherapy of tumors of the tongue is shown in different versions and regimens, doing procedures with the help of special equipment that is able to focus the radiation beam in accordance with the contours of the tumor, called the method - RMR (radiotherapy with modulated intensity). This property of new devices helps to minimize damage to healthy tissue cells.

Very effective radiation treatment for patients after surgery, which included cervical lymphadenectomy. Indications for the radiation method in such patients can be the following conditions:

• Multiple foci of metastasis in the cervical region.
• A large node (more than 3 centimeters), affected by metastases.
• A low-grade type of cancer of the tongue.
• Development of metastases beyond the borders of the lymph node.

Complications and consequences of radiation therapy in the treatment of cancer of the tongue:

• Inflammatory process in the mucosa of the oral cavity (mucositis), xerostomia.
• Pain in the throat when eating, liquids.
• Sensation of dryness in the mouth.
• Ulceration of the mucosa.
• Disturbance of taste sensations, smell.

As a rule, complications after radiotherapy are neutralized by additional treatment, all symptoms disappear after a maximum of 6 months after the course.

Chemotherapy for cancer of the tongue

Chemotherapy helps suppress the activity of the proliferation of abnormal squamous cell epithelium. Chemotherapy for cancer of the tongue is carried out by intravenous administration of cytostatics. Cytotoxic drugs are a category of antitumor drugs, they are capable of breaking and damaging the nucleus, the membrane of the atypical cell and provoking its necrosis. The chemotherapeutic method is rarely used as an independent course in the treatment of malignant neoplasms of the oral cavity, more often it is prescribed in conjunction with radiation therapy and surgery. Like many other methods of oncology, chemotherapy has its pros and cons. Adverse complications after the chemotherapeutic course concern the bladder, nervous system, skin, kidneys. The patient can feel such symptoms:

• Periodic nausea, vomiting.
• Hair loss, temporary alopecia.
• Disorder of the digestive system.
• Constipation or diarrhea.
• General fatigue.
• Pain in the oral cavity.

In what regimen can chemotherapy be carried out in case of language cancer?

• As a preliminary treatment before the start of the course of radiotherapy.
• Before surgery.
• After radiation therapy.
• After surgery for resection of the tumor.
• With a vast, generalized metastatic process involving internal organs and bone tissue.

Treatment of cancer of the tongue by alternative means

At first glance, it seems that treating cancer of the tongue with alternative means is a myth and useless actions. Nevertheless, even oncologists do not mind the use of herbal remedies as an auxiliary therapy, provided that alternative means are agreed with them.

Certainly, the treatment of cancer of the tongue, and other oncological processes by alternative means is always a risk. The reasons for the ineffectiveness of such therapy:

• Uncontrolled reception of vegetable broths, tinctures.
• Non-compliance with the formulation of the preparation, it is especially dangerous to use those plants that are toxic. Having a history of swelling, any folk prescription should be agreed with the attending physician.
• False hope for a vegetable panacea. When a person is sick, the more he is diagnosed with cancer of the tongue, hoping for some herbs or homeopathy, at least silly, often such experiments only tighten and aggravate the pathological process, and lead to the loss of precious time.
• Acquisition of herbal fees in places not intended for the sale of medicines (markets, online stores). If the plant product is agreed and approved by a doctor, you should buy it in a pharmacy.
• Phytotherapy can not replace any conventional method of treating oral cancer. Treatment with alternative means should only be an auxiliary element in the whole complex of therapeutic actions.

All collection of herbs should be made taking into account the peculiarities of the patient's health condition. Typically, in the treatment of tumors used potent plants containing alkaloids - celandine, labaznik, Icelandic cetrarium, chaga.

Herbs are mixed in strictly defined proportions and the broth is prepared exactly according to the instructions. It should be remembered that sometimes the use of vegetable infusion can lead to more serious consequences than a course of radiotherapy or chemotherapy.

The most safe is the following recipe for rinsing the mouth, this procedure will reduce the sensation of dryness and inflammation after carrying out radiation or chemical therapy:

• Take a teaspoon of sage, calendula, thyme and nettle.
• A mixture of herbs pour a liter of boiling water and insist in a thermos for 6 hours.
• Decoction to filter.
• The resulting broth diluted with boiled cold water in a ratio of 1/1.
• Rinse your mouth three times a day after each meal (can be more often).
• Rinse as a procedure should last at least 3 minutes.

It also effectively removes irritations in the tongue of the mucous decoction of flax seeds.

1 tablespoon of seeds is poured in 0.5 liters of chilled boiled water, infused for 10 hours, filtered, but not mixed. At the bottom of the tank, where flax was infused, there must be a slimy residue, which is what is needed for rinsing. A teaspoon of sediment is placed in the mouth and held there for at least 5 minutes, the procedure should be repeated 3-4 times, so that the entire period of stay of linseed in the mouth is about 20 minutes.

It is very important to remember that treatment with alternative means, recipes read in a dubious quality press, regarding cancer processes is very dangerous. Any recipe that promises immediate healing should be categorically rejected, only the attending physician will be able to choose the course of herbal medicines.

Nutrition for a cancer of the tongue

Given that the cancer of the tongue flows with pain symptoms that interfere with taking food and liquid, the diet should be specific.

Nutrition for a cancer of the tongue should be as much as possible fractional and sparing, categorically unacceptable hot, acute, acidic, pickled, fried dishes. Alcohol and smoking should be forgotten forever, as they are one of the most important tumor-provoking factors.

Food should have a consistency of mashed potatoes, the meat should be cooked steamed in the form of stuffed meat. Solid products, including those containing bones, are excluded from the menu, but make changes in the direction of vitaminized, high-calorie, but at the same time easily assimilated food.

Often after the conducted courses of radio and chemotherapy, the patient develops a digestive disorder, if the patient is still lying, constipation is almost inevitable. Help in solving this problem can boiled vegetables on the water, containing coarse fibers - zucchini, cabbage, carrots, beets, pumpkin. Actually, these products can be a base for any side dish, but potatoes and pasta are better to postpone until better times, as starchy food does not help to strengthen immunity and normal digestion. In boiled vegetables it is useful to add raisins, prunes, chopped walnuts.

List of prohibited foods that should be excluded from nutrition in case of language cancer:

• Animal fats, margarine.
• Meat half-finished products, smoked and boiled sausage.
• Mushrooms.
• Filled broths.
• Molok with a high percentage of fat.
• Hard grades of cheese.
• All smoked meat, marinades.
• Products cooked in aluminum cookware.
• Limit salt, replace conventional salt with sea salt.
• Limit sweets.
• Excluded are all artificial soluble and carbonated beverages, including instant coffee.
• All canned products.
• Beans.
• Potatoes (can be replaced with Jerusalem artichoke).
• All products containing soda.
• Vinegar.
• Yeast bread.
• Alcoholic beverages.

What can be done with a tumor in the mouth?

• Boiled vegetables, excluding potatoes.
• Freshly squeezed juices (not acidic).
• Liquid porridge on the water from buckwheat, oatmeal, rice.
• Broth of dogrose and mountain ash.
• Dried fruits compote.
• Boiled artichoke.
• Low-fat pork, veal in boiled powdered form.
• Boiled sea fish.
• Fried and baked cottage cheese.
• Natural low-fat yogurt.
• Mashed fruits (not acidic).

Forecast of cancer of the tongue

The prognosis of cancer of the tongue depends on the stage at which the process was detected and how successfully the treatment was carried out. Complete recovery of health in this disease is almost impossible due to the nature of the tumor, the anatomical location of the affected organ and the consequences of radiation therapy, chemotherapy. Obviously, prolonged remission is possible with the initial stages of the cancer of the tongue, according to statistics it is about 80% of cases at stage T1 and 55-60% at stage T2. If the cancer is diagnosed in stage III or IV, five-year remission is not more than 35% of patients who underwent combined therapy. The prognosis of cancer of the tongue is directly related to the presence and amount of metastases in the lymphatic system, this is the most significant prognostic criterion. If the regional nodes are affected by metastases, the survival and duration of remission is reduced by at least 2 times.

In general, the prognostic information can be given by a doctor only after six months of treatment and dynamic follow-up. It is very important to follow all the prescriptions and not lose faith in healing, then the chances of persistent remission and survival in principle increase many times, an example of this is the fate of many people who are not losing their spirit.

[30], [31], [32], [33]

Prognosis for cancer of the root of the tongue

An indicator that can refine the prognosis for cancer of the root of the tongue is the stage and prevalence of the process. Cancer of the root of the tongue or oropharyngeal cancer is considered one of the most difficult for both radiotherapy and surgery.

The prognosis for cancer of the root of the tongue is directly related to the period of detection of the tumor, the earlier it was diagnosed and the treatment started, the more favorable the outcome of therapeutic efforts

In general, the prognostic information is determined by the classification of the root cancer of the tongue. The following systematization of oropharyngeal tumors is common:

• Tis is a carcinoma.
• T - tumor up to 2-cm.
• T2 - tumor size from 2 to 4 cm in diameter.
• Т3 - a tumor more than 4 centimeters.
• T4 - a tumor more than 4 centimeters with growth deep into the soft tissues of the root of the tongue, the neck of the jaw bone.

Five-year remission and survival in patients with cancer of the root of the tongue is noted in the range of 50-60% of all cases described, especially favorable for the stage T, when the tumor is small. If the patient has stage T4, the prognosis is no more than 20% remission within 3-5 years.

It is believed that the deeper the tumor of the tongue is localized, the more likely the adverse outcome is, the cancer of the lateral surfaces of the tongue or its tip has a better prognosis than the tumors in the root zone. The most dangerous is the infiltrative-ulcerative form with aggressive course and extensive metastasis.

Cancer of the tongue occupies a rather large sector among all oncology processes in the oral cavity - up to 70%, however, among the entire list of malignant tumors, its frequency is noted only 3%. Nevertheless, tumor neoplasms of the tongue are serious and threatening pathologies, which at least lead the patient to disability, and in neglected cases - to a lethal outcome. You can avoid a deadly disease, you just need to get rid of harmful, cancer-provoking habits, regularly monitor oral hygiene, undergo regular check-ups. Early diagnosis of cancer always has a favorable prognosis, you just need to consult a doctor at the first alarming symptoms.