The cancer type that begins in the cells under the tongue is called the floor of the mouth cancer. It usually starts to grow in the small and flat cells in the mouth lining (also known as squamous cells). When it occurs, it is called squamous cell carcinoma and causes different changes in the feel and look of the tissue under the tongue. These include a sore that does not heal or a lump.
Treatment options for this cancer type usually include radiation therapy, chemotherapy, and surgery.
Symptoms
People with this cancer type may experience the following symptoms. For example:
- Sores in the mouth that do not heal
- Loose teeth
- Moving tongue problems
- Mouth pain
- Weight loss
- Difficulty swallowing
- Ear pain
- Swelling in the neck
- White patches in the mouth that do not disappear
If any of the previous symptoms occur, immediately contact your doctor.
Causes
The abnormal cells begin to multiply and grow fast when DNA changes occur in those cells. In such cases, it happens under the tongue. The instructions on how the cells should grow, multiply, and when to die are in the DNA. When DNA changes (mutations) occur, cells get different instructions, which make them grow and multiply abnormally and form tumors. Moreover, cancer cells may continue living while healthy ones die, resulting in too many malignant cells.
If the cancer is not detected, it grows until it breaks and spreads to other body tissues and organs (also known as metastatic cancer).
Risk Factors
Check below the most common factors that increase the risk of the floor of the mouth cancer:
- Tobacco products – All tobacco types increases significantly the risk of this cancer type. For example cigarettes, cigars, pipes, chewing tobacco, and snuff.
- Alcohol – If you are drinking alcohol frequently and in high amounts, it elevates the risk of floor of mouth cancer. The risk of this cancer increases more if alcohol and tobacco products are used together.
- Human papillomavirus – Sometimes called HPV is a virus that spreads among people through sexual contact. Many people do not have any problems but sometimes, HPV may cause changes in the cells that lead to different cancer types.
- Weakened immune system – The body’s immune system may become weakened due to medicines or certain health conditions. For example, medicines that prevent organ transplant rejection, HIV infection, and others.
How to Prevent the Floor of the Mouth Cancer?
The following tips may help reduce the risk of this cancer type. For example:
- Quit smoking or never begin and if you face problems with smoking cessation, discuss it with your healthcare professional.
- Limit or avoid alcoholic beverages
- Vaccination against human papillomavirus is recommended
- Have regular dental and health examinations with your healthcare providers
Diagnosis
The following tests are usually involved in the floor of the mouth cancer diagnosis. Examples include:
- Mouth and neck examination – During this procedure, doctors will check for lumps in the mouth or neck, swollen lymph nodes, and other abnormalities.
- Biopsy – This is a test in which doctors remove a small sample of the tissue and send it to the laboratory for testing. Thus, they look for cancer cells.
- Imaging tests – For example PET (positron emission tomography), CT (computerized tomography), and MRI (magnetic resonance imaging) scans. These tests help doctors get detailed images of different body structures and determine the exact size and location of the tumor.
Treatment
Commonly, the treatment for this cancer type begins with surgery and may be followed by chemotherapy, radiation therapy, or both at the same time.
However, there are different factors that your doctor will consider before making a treatment plan. These include how fast the cancer is growing, its location and size, existing health problems, and others. Check below treatments for the floor of the mouth cancer in detail:
Surgery
This is the primary treatment for people with this cancer type and surgery usually involves the following steps. For example:
- Cancer removal – During this surgery, doctors will remove the tumor and some healthy cells around it. Healthy cells usually are removed to ensure all cancerous cells are removed. However, if cancer grows too much and involves the tongue or jaw, surgeons may remove a part of the previous structures, which may lead to swallowing and speaking problems. As a result, you may need physical therapy or other procedures to overcome these changes.
- Neck lymph node removal – In most cases, when the cancer begins to spread, it goes to the lymph nodes first. Therefore, doctors may recommend surgery to remove affected lymph nodes (a procedure known as neck dissection). Moreover, surgeons may remove some lymph nodes even if there are no cancer symptoms as a precaution. Commonly, to get to the lymph nodes, surgeons make an incision in the neck and remove them through this cut. Thereafter, they decide whether you need other treatments or not.
- Reconstructive surgery – It is usually used when people get out some body parts including the neck, face, jaw, or others. The healthy bone may be taken from other body parts and placed where it missing. Commonly, this procedure is done at the same time as surgery to remove the cancer.
Other Treatments
The following treatment options may be recommended by doctors either before or after surgery to remove the cancer. For example:
- Radiation therapy – This treatment option uses powerful energy beams that come from X-rays, protons, and other sources to destroy cancer cells. During this therapy, the patient is lying down on a table while a specific machinery delivers energy right to the cancer cells. In some cases, doctors may recommend radiation therapy along with chemotherapy.
- Chemotherapy – This includes strong medications that are given often intravenously (IV) to kill cancer cells.
- Targeted therapy – It involves medications that target specific proteins in the cancer cells. Thus, medications block these substances, which cause cancer cells to die. Your doctor may perform some tests to determine if this treatment option will be effective for you.
- Immunotherapy – Cancer cells produce some chemicals that help them hide from the immune system. Hence, doctors will prescribe some medications that boost the immune system and help fight cancer cells. Immunotherapy is usually prescribed when other treatment options do not work.
- Photodynamic therapy – This therapy involves medications that make cancer cells sensitive to light. Therefore, doctors will shine high-intensity light on the cancer cells that activate the medicine and cause cancer cells to die.
Additionally, treatment options for people with an advanced form of the floor of the mouth cancer usually negatively affect speaking and swallowing. However, there are some procedures available that help cope with changes after surgery.
Frequently Asked Questions
What are the symptoms of the floor of the mouth cancer?
- Severe ear pain
- A lump of ulcer in the mouth that does not heal
- Red, dark, or white patches inside the mouth
- Jaw-moving problems
- Loose teeth
If you experience any of the previous symptoms, immediately visit a doctor.
What health condition can be mistaken for mouth cancer?
These include:
- Cold sores
- Canker sores
- Thrush
- Torus
- Fibroma
- Mucocele
- Warts
- A benign tumor that does not spread to other body parts
Consult with your doctor for more details.
What are the complications of the floor of the mouth cancer?
People with this cancer type may experience some treatment complications. For example:
- Mucositis (inflammations of the mucosa)
- Pain, bleeding, and dry mouth
- Dysphagia
- Speaking problems
- Neutropenia
- Vocal cord paralysis
- Dysarthria
- Trismus
- Nerve damage
The previous list does not contain all possible complications. For more details, discuss it with your healthcare professional. If you have additional questions, ask your doctor.
