Table of contents:
- Tongue cancer
- What are the causes?
- What are the symptoms of tongue cancer?
- How is the diagnosis made?
- How is tongue cancer treated?
- Whom can I ask?
- How are the costs going to be covered?
Tongue cancer (tongue carcinoma) is a rare, malignant tumor from the group of head and neck tumors. The back third of the tongue is particularly affected, less often the front tongue areas and the lower surface of the tongue. The chances of recovery are relatively good in the early stages of the disease.
Tongue carcinomas are mostly squamous cell carcinomas and come in different shapes, e.g. flat or cauliflower-like. As they grow, they also affect neighboring structures, such as the lymph nodes of the neck, the lower jaw or the larynx.
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What are the causes?
The causes of development have not yet been precisely clarified. Risk factors include:
- high alcohol consumption (especially high-proof spirits),
- Viral infections (especially HPV),
- chronic inflammation of the lining of the mouth and tongue,
- poor oral hygiene.
The risk of tongue cancer can be reduced by quitting smoking and consuming little alcohol. Good oral hygiene and, for example, correcting poorly fitting dentures to avoid inflammation are also beneficial.
What are the symptoms of tongue cancer?
At first, tongue cancer hardly causes any symptoms. In the further course, the following symptoms, among others, can occur:
- Foreign body sensation in the mouth or throat,
- Burning of the tongue or mouth,
- Sore throat radiating to the ear,
- Difficulties swallowing,
- increased salivation,
- Bad breath,
- Speech problems,
- bleeding spots on the underside of the tongue,
- enlarged lymph nodes on the neck and lower jaw.
How is the diagnosis made?
First of all, there is an anamnesis and a thorough examination of the oropharynx, either with the naked eye or with the help of a mirror. If tongue cancer is suspected, the doctor will take a tissue sample (biopsy) from the changed skin areas. An endoscopy prevents additional changes in the deeper sections of the upper airway. With the help of imaging methods such as ultrasound, computer tomography or magnetic resonance tomography, it is possible to check to what extent the tumor has already spread.
How is tongue cancer treated?
The treatment depends on the size and extent of the tongue carcinoma and its spread (metastasis). The functionality of the tongue and other affected structures should be preserved as much as possible. The following options are available:
- Operation: The aim is to surgically remove tumors as completely as possible. This is possible, for example, by using a laser. If there is a possibility of metastases in the cervical lymph nodes, these are usually removed as part of the operation (neck dissection).
- Radiation therapy or combined radiation and chemotherapy: This is usually only used for very advanced or surgically not completely removable tumors. Depending on the extent of the tumor or the involvement of the lymph nodes, a combination of surgery and radiation therapy can also be useful.
- Targeted therapy: Modern drugs (e.g. monoclonal antibodies such as cetuximab) target specific cell structures of the tumor tissue in order to destroy it or at least to slow down growth.
- Plastic reconstruction: In advanced cases with swallowing disorders or speech problems, damaged or removed structures can be surgically replaced. This allows functions such as speaking, chewing or swallowing to be restored to a large extent - often with speech therapy support.
- Psychological support: can support those affected in dealing with the illness and the associated problems, complaints and impairments.
Rehabilitation & aftercare
Rehabilitation can follow immediately or promptly after the treatment is completed. There are special aftercare clinics that are familiar with both the physical and psychological problems of cancer patients. For more information, see Rehabilitation & Cure.
Regular check-ups are also necessary after treatment in order to identify and treat recurrences at an early stage.
Whom can I ask?
If you have complaints in the mouth or tongue area, you can contact the following offices:
- Specialist in ear, nose and throat medicine,
- Specialist in oral and maxillofacial surgery.
How are the costs going to be covered?
All necessary and appropriate diagnostic and therapeutic measures are taken over by the health insurance carriers. For certain services (e.g. medication, inpatient stays), patient co-payments are provided. Your doctor or the outpatient clinic will generally settle accounts directly with your health insurance provider. However, you may have to pay a deductible with certain health insurance providers (BVAEB, SVS, SVS, BVAEB).
The costs will not be charged directly if you use a doctor of your choice (ie doctor without a health insurance contract) or a private outpatient clinic. For more information, see Costs and Deductibles.
When hospitalization is required
Hospitalization may sometimes be required for treatment. The hospital costs are billed for. The patient has to pay a daily contribution to the costs. Further medication treatment at home takes place by prescription by the general practitioner or specialist.
For more information, see What does a hospital stay cost?