Oral Cancer News

Source: www.wsoctv.com/health
Author: staff

Tongue cancer accounts for about 25 percent of all oral cancers. According to the National Cancer Institute, about 10,530 cases of tongue cancer will be diagnosed in the U.S. this year. Although the cancer can occur at any age, it’s most commonly diagnosed in older people, with a median age at diagnosis of 61. Men are affected about twice as often as women.

Two important risk factors for tongue cancer are smoking and drinking. For people who smoke and drink, the risk may be up to 100 times that of those who neither smoke nor drink. Another risk factor for tongue cancer is HPV (human papillomavirus) infection. Douglas Chepeha, M.D., Microvascular Reconstructive Surgeon with the University of Michigan, says doctors are also seeing cases of tongue cancer in young and older women who neither smoke nor drink. The reasons for these cases are not clear.

Overall five-year survival rates for tongue cancer are about 59.5 percent. However, the cancer has the potential to spread fairly quickly. If the cancer is detected when the condition is still localized, 5-year survival rates are over 77 percent. Once the cancer spreads regionally, survival rates drop to about 55 percent. Thus, early diagnosis is important. Patients who develop a sore on the tongue that doesn’t heal or bleeds easily should see a physician for evaluation.

Treating Tongue Cancer: Reconstruction After Surgery

Tongue cancer typically occurs on one side of the tongue. The main treatment is surgery, which can require removal of a significant amount of tissue. Chepeha says doctors typically allow the remaining portion of the tongue to heal or place a skin graft over the area. But that can leave patients with trouble speaking, eating and swallowing.

Chepeha and his colleagues are using a reconstructive technique, using a graft from the patient’s own body, to improve the aesthetics and function of the tongue. The natural tongue contains areas of thin and thick tissue. So doctors take tissue from areas of the body that best match the varying degrees of thickness. The most common donor site on the body is the forearm. For very skinny or overweight patients, the abdomen may provide a better match in tissue thickness.

To create the tongue graft, the surgeons look for the area that best matches the size and shape of the original section of tongue. Chepeha compares it to using a fabric pattern to cut out material for a piece of clothing. Once the ideal area is selected, surgeons carefully cut away skin, fat and piece of nerve (no muscle is removed). Then blood vessels and nerve in the graft are connected to those in the mouth. Chepeha says the first 72 hours are the most critical time after the transplant. If the blood vessels are not connected precisely, a clot can form and the transplanted tissue will die.

After the surgery, the nerve in the graft provides some sensation in the transplanted tissue. However, the graft doesn’t have enough muscle control to move on its own. Therefore, patients need to learn how to maneuver the remaining natural half of the tongue for speaking and eating. Taste is not affected much by the surgery because taste buds on the remaining half of the tongue and those located in other areas of the mouth continue to function.