Patient Guide

Oral Tongue Cancer

Introduction

The diagnosis of cancer in a patient is often accompanied by disbelief, and feeling of helplessness. The feeling of helplessness is partly due to fear of cancer, lack of knowledge and little awareness of the many treatment options available.

This series of pamphlets aims to educate the reader about common head and neck cancers - how the condition presents in patients, symptoms they may experience, investigations that are required and treatment options available. For more specific information, you are advised to seek a head and neck cancer specialist’s opinion for a face to face discussion of the condition.

Oral Tongue Cancer

Oral Tongue Cancer is a relatively uncommon cancer. The main causes of tongue cancer are that of smoking and excessive alcohol consumption. However we do sometimes see patients with no previous history of smoking or excessive alcohol intake. Common symptoms include a tongue ulcer, a growth on the tongue, bleeding from the growth or ulcer on the tongue, pain in the tongue, difficulty eating and lymph gland enlargement in the neck.

Examination and Tests

Your doctor will examine you - paying particular attention to the growth/ ulcer on the tongue and whether there is any involvement of adjacent structures like the floor of mouth and the jaw bone.

Two types of investigations are required:

  1. Biopsy of the lump on the tongue to determine the presence of cancer.
  2. Scans to determine the extent of the disease. Commonly-performed scans include Magnetic Resonance Imaging (MRI) scan of the tongue and neck, to determine local extent of disease and whether or not it has spread to the neck. Your doctor will also order either a Computed Tomography (CT) scan of the chest and liver or a Positron Emission Tomography (PET) scan. These scans determine if the cancer has spread to any other organs.

Treatment

The treatment of tongue cancers depends on the stage of disease. Early stage tongue cancers require surgery only, which would involve removing the tongue cancer and in certain situations removing lymph glands from the neck. Advanced stage tongue cancer requires surgery and radiotherapy and sometimes even chemoradiotherapy on top of surgery.

Surgical removal of a tongue tumour affects speech and eating. The degree of impairment depends on the size of the tumour and the amount of tongue that has to be surgically removed. Your doctors may recommend reconstruction of the tongue if necessary and will also refer you to our speech and swallowing therapist to improve speech and swallowing after treatment.

Cancer Patient Services

The Department of Otorhinolaryngology (Ear, Nose, Throat) in Tan Tock Seng Hospital offers the following services in relation to head and neck cancers:

  1. Diagnosis of whether or not the patient has a head and neck cancer.
  2. Appropriate staging of the cancer.
  3. Treatment of the cancer. Every patient with cancer is discussed at our multidisciplinary tumour board to work out the best possible treatment for you based on the latest clinical evidence for each condition.
  4. Long term follow up and surveillance to ensure the cancer does not return.

Cancer Care Management

We work closely with other medical specialists and allied health professionals to ensure the best possible outcome for our cancer patients.

Our radiologists provide their expertise in interpreting scans and aiding us in the exact staging of patients.

Our radiation oncologists and medical oncologists also provide expertise to our patients who may need radiotherapy and chemotherapy in the treatment of their cancers.

Patients who undergo surgery may sometimes need reconstruction of defects left by tumour removal. We have a team of reconstructive plastic surgeons who can reconstruct the defect to restore form and function.

The speech and swallowing therapy team will work rigorously with you to obtain the best possible outcome for speech and swallowing. Additionally, you will also meet our dietician who will provide dietary advice before, during and after treatment. We also collaborate with the dental team to ensure your teeth are in optimal condition before embarking on radiotherapy.

Our aim is the same as yours: to fight off the cancer and to return you to an optimal quality of life.

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