The first reaction of many people to a tongue ulcer is a fire. However, experts warn that if the ulcers on the edge, tip, back or belly of the tongue do not heal after half a month, and white spots, red spots and flat moss that do not feel painful appear, it is not just a simple case of “fire”, because it may be a precursor of tongue cancer.
Older people are the most common group of tongue cancer, but there is a trend of younger people. The cure rate of early tongue cancer reaches 80%, and the earlier the treatment, the better the result. It is worth noting that smoking is positively correlated with the incidence of tongue cancer, and people who smoke two packs of cigarettes a day are 12.4 times more likely to develop tongue cancer than non-smokers.
Case Study.
A “painless” ulcer developed into tongue cancer. 62-year-old Uncle Hu initially found an ulcer on his tongue and didn’t feel any pain, so he didn’t take it seriously. However, the ulcer slowly expanded and later spread to half of his tongue. Only then did Uncle Hu come to Guangzhou Medical College Dental Hospital for treatment. Once he was investigated, he was in the middle and late stage of tongue cancer and needed immediate surgery, and half of his tongue was finally removed. Fortunately, the technology of “mending” half of his tongue is now available, so his pronunciation function was not seriously affected.
It is not uncommon for patients like Uncle Hu to have oral ulcers or lumps protruding from their mouths, but when they finally go to the hospital, they are often in the middle or late stage.
Among cancers, oral cancer accounts for 5%. In recent years, the incidence of oral cancer has been on the rise. According to the location of disease, oral cancer can be divided into tongue cancer, gum cancer, cheek cancer, floor of mouth cancer, jaw cancer, lip cancer, parotid malignant tumor, maxillary and mandibular malignant tumor, submandibular gland malignant tumor, etc.. Among them, tongue cancer accounts for 45.9 percent.
”Tongue cancer is mainly prevalent in the elderly and slightly more in men, but what is worrying is that the trend of youthfulness is becoming more and more obvious.” Zhou Miao introduced that in recent years, young cases of tongue cancer have been common in outpatient clinics, “and there is no shortage of tongue cancer patients in their 20s and 30s.” Zhou Miao said that in Germany, patients suffering from tongue cancer are usually over 60 years old. “This is mainly related to the increased nightlife of our young people nowadays and the excessive consumption of pickled foods, spicy and stimulating foods and barbecue foods. There are also young people who like to chew betel nut, which also increases the chances of developing tongue cancer.”
Identification.
Most ulcers at risk of cancer are not painful How do you distinguish ordinary ulcers from those at risk of cancer? Zhou Miao pointed out that, in general, ordinary inflammatory ulcers and traumatic ulcers will feel pain in the early stage, and the disease will not last too long, and the ulcers can generally heal within 1 to 2 weeks.
”Therefore, if the ulcer cannot heal after treatment for more than two weeks, then it may be an ulcer with cancer risk and pathological examination is needed to rule out the possibility of cancer.” Zhou Miao said there are three main symptoms of precancerous tongue lesions: first, white spots; second, red spots; and third, lichen planus.
White spots are mainly flat or slightly elevated white lesions, which usually do not cause pain, and “5% of white spots will become cancerous”; red spots are mainly velvety or granular red patches, which also do not cause pain; and flat moss has a broken, flushed, white striped or reticulated surface. “If you notice one of these three symptoms on your tongue and don’t feel painful for a longer period of time, you should be alerted.”
Treatment.
Early tongue cancer has a cure rate of 80% Park Jung-kook introduced that tongue cancer is prone to early cervical lymph node metastasis and has a high metastasis rate. “This is mainly because the tongue body has richer lymphatic vessels and blood circulation, plus the mechanical movement of the tongue is more frequent, all of which are factors that contribute to the metastasis of tongue cancer.”
For early-stage tongue cancer, he said, surgical radical treatment is generally advocated, with stage I or II neck clearing in the neck; for advanced cases, generally speaking, induction chemotherapy is done first, followed by surgery, and then radiation therapy after surgery. For tongue cancer that affects the floor of the mouth and the mandible, a combined tongue, mandible and cervical lymphatic clearance is also performed on one side, and if there is metastasis on the opposite side, bilateral cervical lymphatic clearance is required.
”The earlier tongue cancer is treated, the better.” In the past, he said, there was no way to repair the tongue after tongue removal surgery, so many patients lost their speech function after surgery. “Now, the repair of the tongue can be done at the same time as the tongue is removed, and after the repair, it is similar to a normal tongue.”
It is also reminded that since tongue cancer has a high recurrence rate, it is recommended to review every 3 months for one year after surgery; every 6 months for 2 to 3 years after surgery; and after 5 years, it is also necessary to review once a year.
Reminder.
Two packs of cigarettes a day have a much higher chance of tongue cancer Zhou Miao introduced that smoking and alcoholism, long-term periodontitis, poor oral hygiene, frequent late nights, frequent high tension, and family history …… are all high risk groups of tongue cancer.
How to prevent tongue cancer? First of all, rotten teeth and worn dentures should be treated in time. Because rotten teeth, sharp teeth, residual roots and crowns will stimulate and wear the oral mucosa and tongue, which will easily lead to ulcer malignancy; at the same time, we should brush our teeth diligently, preferably after each meal, change the toothbrush once every 3 months, and do not use mouthwash frequently; in terms of diet, do not eat food that is too hot, and also try to eat less fried food and pickled food; in addition, elderly people wearing dentures, those with dental caries, those with family history In addition, elderly people who wear dentures, those with dental caries, those with a family history of cancer, and those in areas with a high incidence of cancer are advised to have regular checkups.
”It is especially important to note that smoking is positively correlated with the incidence of tongue cancer.” Zhou Miao said that smoking, like drinking, can easily lead to tongue cancer. “According to statistics, smoking 10 to 19 cigarettes a day is six times more likely to develop tongue cancer than non-smokers; smoking 20 cigarettes a day is 7.6 times more likely to develop tongue cancer than non-smokers; smoking 40 cigarettes a day is 12.4 times more likely to develop tongue cancer than non-smokers.”