• 9/18/2006
  • Sweden
  • staff
  • Newswise.com

The tongue, a large collection of skeletal muscles found on the floor of the mouth, manages our food for chewing and swallowing, acts as one of the organs of taste in that its surface is covered in taste buds, and assists in forming our speech. One can stick out their tongue as part of a diagnostic examination or to show contempt.

Injury or discomfit to the tongue is generally caused by accidental biting or irritation by certain foods or drugs. Medical disorders include a common infection known as “thrush” in which an overgrowth of fungi forms a white film covering the tongue. Intense pain of the entire mouth can also be caused by burning mouth syndrome.

Tongue cancer on the other hand does exist and although its incidence is low, the result can be deadly. Tongue cancer begins as a small lump or thick white patch on the tongue that may be painful or tender. With time the lump turns into an ulcer with a firm, raised rim and a center that bleeds easily. If untreated the tumor will grow causing the tongue to become rigid and hard making swallowing and speech difficult.

The American Cancer Society tabulated 7,320 new cases for tongue cancer in the United States in 2004, a rate of one in 37,158. Males were afflicted with this disease in two of three cases. For the same year there were an estimated 1,700 estimated U.S. deaths for tongue cancer, with two male deaths for every female death. Accordingly, in this country, each day will find 20 new diagnosed cases of tongue cancer and four deaths from the disease.

What is the clinical future for one diagnosed with this form of oral cancer? A noted Swedish otolaryngologist—head and neck surgeon has completed a retrospective study of patients presenting with tongue cancer. The author of “Prognostic Factors in Early Cancer of the Oral Tongue,” is Anders Westerborn MD, Chair, Department of Otolaryngology, Örebro University Hospital, Örebro, Sweden. Dr. Westerborn’s will present his findings at the 110th Annual Meeting & OTO EXPO of the American Academy of Otolaryngology—Head and Neck Surgery Foundation, being held September 17-20, 2006, in Toronto, Canada.

Methodology
From 1988-2004, 105 patients with small tongue cancers (T1 and T2) less than four cm in size, received treatment at the Örebro University Hospital. Forty-eight (46 percent) of the subjects were male, 57 (54 percent) were female. The media age of the subjects was 61 years old.

Fifty-patients were patients were treated primarily with surgery, 51 with external beam radiotherapy. Thirty-six patients had one treatment; the rest received additional treatment.

Results
Dr. Westerborn found the following with his retrospective review of the subject patients:

– Sixty-five percent of the subjects survived two years without the disease. Twenty-nine percent died within five years from disease.
– The prognosis for patients age 60 and older was worse than the outcomes for younger victims of the disease. Thirty-seven percent of patients 60 and older died of disease as compared to 20 percent younger.
– Forty-five specimens of the cancer were retrospectively investigated. Two of every three specimens had a pattern of invasion characterized by cancer cells well delineated or infiltrating the tongue’s cords, bands or strands. One third of the specimens displayed small groups or strands of less than 15 cells or marked, widespread small groups or single cells.
– Pattern of invasion and depth of the cancerous growth were more than likely an indicator of cancer recurrence.

Conclusions
Dr. Westerborn suggests that older patients with a cancerous growth on the tongue with greater pattern of invasion and depth are more likely to have recurrence of tongue cancer. Mortality is higher for the older patients. Gender was not found to be a factor.

These findings confirm the need for early diagnosis and treatment for tongue cancer. Despite its low rate of incidence, tragic consequences are likely if symptoms of this disease are ignored.

Source:
American Academy of Otolaryngology Head and Neck Surgery (AAOHNS)