Tongue cancer is a type of oral cancer that starts in the cells of the tongue or can cause lesions or tumors on the tongue. Tongue cancer can be categorized into 2 types: tumors that are located in the front two-thirds of the tongue, located in the mouth, and oral tongue cancer. This type of cancer can also occur at the base of the tongue, the rear third located in the throat, or the oropharynx, making up the second type of tongue cancer known as oropharyngeal cancer.
Risk Factors For Tongue Cancer
The two biggest risk factors for the development of tongue cancer include cigarette smoking and alcohol usage. Cigarette smoke contains carcinogens, primarily nitrosamines and polycyclic hydrocarbons, which increase the risk factor for tongue cancer. Along with this, alcohol metabolizes into acetaldehyde, and this substance affects DNA repair. Apart from smoking and alcohol consumption, some other lesser-known factors that can contribute to the development of tongue cancer include the use of betel nuts, radiation exposure, immunocompromised states, poor oral hygiene, and even genetic factors. Along with this, the Human Papillomavirus (HPV) has also been noted to play a role in the development of tongue cancer.
Epidemiology
Historically, carcinoma of the tongue is a condition that is linked to older males with a history of smoking or drinking alcohol. The disease is mostly seen in males in comparison to females, and the frequency of the disease varies significantly with geographic location. However, new studies show that there has been an alarming increase in the incidence of both oral and base of the tongue squamous cell carcinoma during the last decade, especially in women and younger patients without any history of traditional risk factors. This increase can be attributed to a dramatic spike in HPV associated oropharyngeal squamous cell carcinoma.
Signs and Symptoms of Tongue Cancer
Many early signs and symptoms of tongue cancer can also be early signs of other conditions. It is imperative to consult your primary care physician if you have the following symptoms:
- Red or white patches in your tongue.
- Sores, lumps, or mouth ulcers that don’t heal.
- A painful, swollen, or bleeding tongue that doesn’t get better.
- Difficulty in moving your tongue or jaw.
- Persistent hoarseness.
What is Immunotherapy ?
Emerging as the fourth modality in cancer treatment, immunotherapy is a line of treatment that activates the immune system to identify, recognize, and attack cancer cells in the body. Cancer immunotherapy aims to overcome the mechanisms tumors use to evade and suppress immune responses. This resets the immune system’s protective balance and enhances or restores its capacity to identify and eliminate cancer cells from the body. When used in combination with conventional lines of treatment, immunotherapy can show positive results for patients diagnosed with throat cancer.
Treatment for tongue cancer today is not just focused on removing the cancer. Doctors and experts have also diverted their efforts towards developing treatments that limit side effects and the possibility of a recurrence. Immunotherapy is one such line of treatment that can help attain these outcomes.
Checkpoint Inhibitors For Tongue Cancer
Emerging as a reliable form of treatment over the last decade, checkpoint inhibitors have been employed to treat a wide range of cancers. These drugs operate by blocking the checkpoint proteins found on the surface of the cells and by giving permission to the healthy cells of the body to continue fighting cancer. The primary function of the immune system is to differentiate between foreign agents and the healthy cells of the body. The immune responses then get rid of these foreign agents while sparing the healthy cells of the body. To make the distinction between healthy cells and any harmful pathogen, the immune system uses checkpoint proteins that are found on the surface of the cells. These checkpoint proteins are similar to a switch that needs to be turned “on” or “off” to trigger an immune response. However, when it comes to malignant cancer cells, the immune system fails to recognize them as foreign agents since cancer cells are the body’s own cells that have attained mutation and have proliferated at a rapid rate. The cancer cells use these checkpoints to evade immune responses and proliferate in the body.
PD-1 Inhibitors
Pembrolizumab and Nivolumab are two checkpoint inhibitor drugs that target the PD-1 protein. By blocking this protein, checkpoint inhibitors allow the immune response to recognize and ultimately attack the cancer cells in the body. These drugs can be used when chemotherapy stops working for patients with oral cavity or oropharyngeal cancer that has returned (recurrence) after initial treatment. It can also be used when the cancer has attained metastasis or spread to other parts of the body. These drugs are administered through an IV infusion and are generally given for a period of 2, 3, 4, or 6 weeks.
Pembrolizumab, alone or in combination with chemotherapy, can also be used as the primary form of treatment in patients whose cancer has returned, is metastatic, or cannot be removed with surgery.
Side Effects Of Checkpoint Inhibitors
Some of the most common side effects of checkpoint inhibitors include –
- Fatigue
- Cough
- Nausea
- Diarrhea
- Skin Rash
- Constipation
- Joint Pain
While these side effects are usually mild, there may also be some serious side effects. These include:
- Infusion Reactions: In rare cases, patients may also experience infusion reactions because of checkpoint inhibitors. These infusion reactions can be similar to an allergic reaction and may result in fever, chills, flushing of the face, wheezing, and difficulty breathing.
- Autoimmune Reactions: Sometimes these drugs may result in the immune responses working in overdrive and may start affecting the healthy cells of the body. This can cause some serious or even life-threatening situations for a patient and it is imperative that patients consult their doctors about these symptoms as soon as possible.
DENVAX: Dendritic Cell Therapy For Cancer
DENVAX, a groundbreaking therapy in the realm of cancer treatment, focuses on harnessing the potential of dendritic cells. DENVAX can seamlessly integrate into existing treatment plans without causing significant disruptions to daily life of a patient.
While cancer cells may evade the immune system and its responses, DENVAX boosts these responses by deploying activated dendritic cells. These specialized immune cells then trigger strong immune responses that traverse the body, effectively targeting and eliminating the malignant cells. A form of adjuvant therapy, DENVAX harmoniously complements surgery, radiation, and chemotherapy, contributing to a comprehensive, multi-disciplinary approach.
Noteworthy benefits of DENVAX include its role in enhancing the quality of life, extending lifespan, and improving clinical outcomes for patients with throat cancer. Its user-friendly nature and compatibility with other modalities make it an ideal choice for personalized cancer care. In cases of advanced stage IV cancer, DENVAX serves as palliative therapy, providing comfort to patients while maintaining safety and minimal toxicity.
Final Note
Tongue cancer is one of the leading malignancies in the world today, and while the traditional modalities, namely surgery, radiation therapy, and chemotherapy, have had success in treating this disease, there is still a need for new innovative lines of treatment to improve cancer outcomes. Immunotherapy is one such line of treatment that has considerably improved cancer outcomes in the past decade. When used in combination with traditional modalities, immunotherapy can significantly improve outcomes for tongue cancer.
