The tongue consists of two parts. The front two-thirds, visible when the mouth is open, is where cancer development is called oral cavity cancer. The base of the tongue, making up about one-third of its length, is near the throat. Cancer cells forming here are referred to as oropharyngeal cancer.

Doctor Do Tuong Huan, Head of Surgical Oncology, Oncology Center, Tam Anh General Hospital Ho Chi Minh City, stated that while the exact causes of tongue cancer are not fully understood, several factors can increase the risk of developing the disease.

Smoking

Tobacco products, including cigarettes, cigars, e-cigarettes, chewing tobacco, and snuff, are high-risk factors for tongue cancer. Tobacco smoke contains over 60 toxic substances. These toxins directly and continuously contact the mucous membrane lining the tongue's surface. Over time, they can damage cellular proteins, injure the DNA structure of tongue lining cells, and cause DNA mutations, ultimately leading to tongue cancer.

Doctor Huan and his team performing surgery on a patient. Photo: Tam Anh General Hospital

Doctor Huan and his team performing surgery on a patient. Photo: Tam Anh General Hospital

According to Doctor Huan, both active and passive smoking increase the risk of tongue cancer generally, and head and neck cancers specifically. The risk is higher for individuals who have smoked for extended periods, consumed large quantities, or combined smoking with smokeless tobacco use, alcohol consumption, or both. Continuing to smoke after tongue cancer treatment raises the risk of developing a second cancer in the mouth and increases the likelihood of recurrence.

Alcohol Consumption

Heavy and prolonged alcohol consumption increases the risk of tongue cancer. Alcohol acts as a solvent, thinning and irritating the mucous lining of the tongue and mouth. Furthermore, the liver metabolizes alcohol into acetaldehyde, a substance capable of damaging DNA and epithelial cells in the oral cavity.

Combining alcohol and tobacco use further elevates the risk of developing tongue cancer compared to using either substance alone.

Human Papillomavirus (HPV) Infection

HPV is a group of over 100 related viruses spread through sexual contact, including oral sex. Specific HPV types, especially type 16 and type 18, can infect the penis, vulva, vagina, cervix, rectum, anus, mouth, and throat. HPV-related tongue cancers are more common at the base of the tongue rather than the mobile front two-thirds.

Frequent sore throats, bleeding gums, and chronic infections can also increase the risk of tongue cancer.

Tongue cancer is curable if diagnosed and treated early. Doctors advise the following preventative measures: thorough oral hygiene, brushing teeth at least two times daily, practicing safe sex, avoiding smoking, and limiting alcohol consumption.

Individuals noticing any oral abnormalities should consult an oncologist or head and neck specialist for the most suitable treatment plan. The doctor may recommend CT or MRI scans to clearly visualize any irregularities in the mouth.

Treatment options, including surgery, radiation therapy, or chemotherapy, depend on the patient's specific condition. Surgeons perform wide excisions of the cancer, using frozen sections during the operation to ensure clear margins free of cancer cells. Reconstructive microsurgery helps patients maintain essential functions like eating, speaking, and aesthetics for daily life and social interaction.

Khai Minh