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In a recent move by Health Canada to address the severe health risks associated with smoking, tongue cancer has taken center stage.
The federal agency has released its latest update to mandatory warning labels on cigarette packs in Canada, adding tongue cancer as a risk.
On the label, Health Canada warns cigarettes cause tongue cancer, adding "36 per cent of mouth cancer victims die within five years. Even if you survive, you may lose part of your tongue."
But what exactly is tongue cancer and what symptoms should you look out for? To find out, Yahoo Canada spoke with Dr. John Waldron, a radiation oncologist and the head and neck cancer group leader at the Princess Margaret Cancer Center in Toronto.
Here's everything you need to know.
What is tongue cancer?
Dr. Waldron explains tongue cancer is a malignancy that arises in the tongue; part of a group of oral cavity cancers that are associated with smoking risk.
The majority of tongue cancers develop in the front two-thirds of a tongue, and the most common type of oral cancer is squamous cell carcinoma. As the Canadian Cancer Society notes, the carcinoma starts in the "flat, thin cells" that make up the oral mucous membrane.
What risk factors increase chances of tongue cancer?
Waldron underscores traditional culprits linked to tongue cancer include:
oral products like betel nut (or areca nut)
According to Waldron, approximately 70-80 per cent of people who develop tongue cancer are cigarette smokers. The specialist highlights that when alcohol use is added to the equation, "it increases the risk even more."
It's estimated 5,400 Canadians will be diagnosed with oral cavity cancer in a year, and 1,500 Canadians will die from it.
Men are more susceptible to developing it. However, "the ratio of incidence of oral cancer was six to one for men compared to women," in the past, and now it's closer to two to one.
What are the symptoms of tongue cancer?
Waldron outlines key symptoms are visible on the tongue, including:
pain or discomfort
"Those experienced with it can more or less conclude it is a tongue cancer by its appearance," Waldron claims, adding early detection is key.
Dentists and dental hygienists play a crucial role in screening for potential lesions, he notes. Diagnosis involves visual inspection and biopsy confirmation by a pathologist.
What is the prognosis and treatment of tongue cancer?
Waldron emphasizes the tight link between cancer extent and prognosis when navigating the stages of tongue cancer. Early-stage cancers, often less than a centimeter in size, boast high cure rates, while advanced stages present greater challenges. There are five stages of oral cancer.
"The key message here is that the cancer starts in the tongue and slowly gets bigger," Waldron explains. The bigger the cancer gets, the later the stage.
The outcome is very tightly correlated with the extents of the cancer — and largely, that means the size of the cancer.
Oral cancer can spread from the tongue to the floor of the mouth, the jaw, lymph nodes and beyond. In that extent of the cancer, Stages 3 and 4, less than half of patients are cured, Waldron says.
Treatment options include surgery, radiation therapy and chemotherapy.
Can I lower my risk of tongue cancer?
To lower your risk factors, Waldron advocates for lifestyle changes. These include quitting smoking and avoiding the use of oral products like betel nut. Moderation in alcohol intake is crucial as well, he says.
While dietary influences on tongue cancer are less clear, maintaining a healthy diet, good oral care and regular dental check-ups are recommended preventive measures.
Do warning labels on cigarettes matter?
In the wake of Health Canada's recent inclusion of tongue cancer in cigarette pack warning labels, Waldron says it's important to educate individuals about associated risks. More specifically, naming each individual risk may send a clearer message to the public.
"Where you're saying 'tongues' specifically, is probably a good thing. I think it allows the average consumer to focus more on the consequences... If you say, 'you can get cancer of your tongue,' now, that's something they can really understand," he said.
"Everybody knows how important their tongue is, [for] managing food, articulation, for speech... I think it is probably a step in the right direction."
Health Canada assures smokers, "You can quit. We can help." Resources for smokers who want to quit are available online or by calling 1-866-366-3667.