Understanding Tongue Cancer
- “Top Chef” alum Shirley Chung has completed radiation and chemotherapy treatments amid her stage four tongue cancer, a type of oral cancer that is also referred to as a head and neck cancer. She admitted in a recent social media post that the journey certainly hasn’t been easy but she’s maintained hope and resilience throughout the past few months.
- Tongue cancer may be hard to spot in its early stages, however, when the cancer develops, patients may experience trouble with swallowing, voice changes, pain in the ear, pain in the throat, or a feeling of fullness in the throat. Be sure to see your doctor if you notice any lingering symptoms.
- Chemotherapy stops cancerous cells from growing, dividing, and spreading to other organs. It travels through the bloodstream, killing cancerous cells. However, the process also impacts healthy cells, leading to side effects.
- Radiation therapy uses ionizing energy, which travels through the body and essentially damages DNA. Normal tissue can repair that damage, while cancer cells can’t.
- To better manage chemotherapy side effects, experts recommend exercising and eating a nutritious diet with enough fruits, vegetables, and protein. Getting enough sleep helps with fatigue and allows you to recover quicker. Your doctor may also recommend medications to help with side effects.
Chung, who owns a Chinese restaurant called Ms. Chi Cafe with her husband Jimmy Lee, took to social media this week to inform her fans that she’s doing well and living life to the fullest as best as she can on her “tough” road to recovery.
She then explained how just 2 weeks after undergoing treatment, she suffered major discomfort as a side effect from radiation and chemotherapy all across her body.
Chung explained, “My neck, lips and jawline were covered with blisters from the radiation, my tongue and throat were peeling & bleeding all the time. I couldn’t sleep through the night, was waking up every 2 hours coughing up blood and mucus.
“My days were filled with clean and rinse my mouth, clean and change dressing on my neck, self inject pain meds every 3 hours, tube feed nutritional shakes and water. My pain finally got better 3 weeks ago. The first sip of water was glorious, it was still super painful, but after 3 months of not being able to swallow anything, it was a small win!”
The Chinese-American chef revealed she has since been able to learn how to drink smoothies again, as well as eat soups, ice cream and egg custard.
After noting her taste buds are slowing returning to normally, she added, “I can taste 50% of sweet and savory and all the warm spices.”
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The resilient lover of cooking also recounted having an emergency surgery to replace her “G tube,” otherwise known as a gastrostomy tube, which is surgically placed in one’s body through the abdomen to the stomach to bring in nutrition, fluids, and medicine.
She concluded, “Since I have been feeling better, I got to enjoyed Chicago a little bit, trips to museums and a play. I even played in the snow with Baxter. As I am getting ready to go back home for the holidays, I can’t thank my team @uchicago , Dr Vokes and Dr Juloori enough for treating and taking great care of me.
“My friends and family who visited and texted and checked on me. Everyone’s prayer, donations,gifts and love, warmed my soul, pushed me forward on this tough road of cancer recovery. I appreciate YOU. Next step, come back to Chicago in January for my final checkup. I GOT this.”
Shirley Chung’s Tongue Cancer Diagnosis
Chung, who made the difficult decision to close her L.A. restaurant while she focuses on her recovery, first announced her diagnosis in July.
“I have some personal news to share with you. Since last year December, I had a series of dental issues, I bit my tongue severely; I fractured my tooth and had to extract it and get an implant… we thought it was because I am a heavy teeth grinder,” she said in an Instagram post.
“And I was too busy to see a EMT specialist. The end of May, ulcers erupted in my mouth and my oral surgeon discovered a hidden tumor under my tongue. A few days later, I was diagnosed, stage 4 tongue cancer, as cancer cells also spread into my lymph nodes.”
While receiving her diagnosis, all Chung said she heard was “‘option 1, surgery, 100% removal of your tongue’ … Jimmy was holding it together for both of us, asking if we have any option that I can keep my tongue and the survival rates.”
Thankfully, Chung and her husband’s curiosity and determination to find another treatment option led her doctor to tell them about a special case that took place at the University of Chicago. It was there they were told about how another person battling tongue cancer was cured through chemotherapy and radiation in Chicago, something she described as a “unicorn case.”
“Higher survival rate, or keep my tongue? I chose to keep my tongue, I am a fighter, I am a chef, I can be that unicorn too,” Chung said at the time.
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Managing Chemo & Radiation-Related Side Effects
Chemo patients almost universally experience fatigue, often alongside gastrointestinal side effects, such as nausea. Doctors have many effective medications to combat chemo-induced nausea. “But mitigating that fatigue often depends on the patient,” Dr. Renata Urban, gynecologic oncologist at the University of Washington, previously told SurvivorNet.
“Neuropathy is probably one of the most challenging side effects,” Dr. Urban continued.
Neuropathy results from damage to the peripheral nerves. It usually resolves after chemotherapy treatment, but sometimes symptoms can persist. While it’s typically characterized by numbness or a pins-and-needles sensation in the hands and feet, neuropathy can have several different symptoms, including:
- Weakness in the hands or feet
- Stabbing or burning pain in the hands or feet
- Difficulty gripping, such as when holding a fork
- Difficulty with fine motor skills, such as writing or buttoning a shirt
- Nausea and vomiting are common side effects of chemotherapy. When chemotherapy affects the rapidly dividing cells in the stomach lining, the resulting cellular havoc in the gastrointestinal tract can lead to side effects such as nausea and vomiting. However, doctors can help patients mitigate the hit with various medications before, during, and after treatment.
“Part of the chemotherapy prescription includes a set regimen of anti-nausea medications…We also ensure patients have medications at home that they can use should they develop nausea after treatment,” Dr. Urban added.
Skin Care: Dealing With the Side Effects of Radiation
Meanwhile, Radiation Oncologist Dr. Subhakar Mutyala also spoke with SurvivorNet, explaining, “Radiation therapy is actually ionizing energy, where energy goes through your body, essentially causes DNA damage.
“It is a treatment where you don’t feel the treatment itself. Now, sometimes, you might feel the place where we place the tumor. If we’re placing applicators in the cancer, you might feel that. Or if you’re lying on a table and we’re holding you still, you might feel that. But the actual treatment is just ionizing energy.”
“Radiation is in some way advantageous because it is relatively straightforward. It has been established for some time. On the other hand, it’s five days a week, Monday through Friday for seven weeks,” Dr. Allen Ho, director of the head and neck cancer program at Cedars-Sinai Medical Center, previously told Survivor Net.
There are of course side effects said Dr. Ho, including:
- Sensitive or painful teeth and gums
- Burning, peeling, or swelling of the tongue
- Dry mouth
- Taste bud alterations
- Infection
Why Radiation Makes It Difficult to Taste, Swallow Food
Unlike other forms of the disease, these side effects are common in patients with tongue cancer. Those patients are also apt to develop mouth ulcers, which make eating, drinking, and even brushing teeth a painful experience.
Dr. Christina Wood, a dentist at Station Dental in Colorado, also told SurvivorNet that she recommends all radiation and chemo patients visit a dentist before treatment.
In addition to a regular check-up, individuals should also request a fluoride treatment, said Dr. Wood.
“These provide a high dose of fluoride for your teeth to help increase mineralization of the enamel [strengthen the teeth] and prevent mucositis [painful mouth inflammation],” she explained.
Tips to Navigating Chemo Side Effects
Doctors don’t have an arsenal of prescription medications to combat fatigue. However, you can do several things to help minimize the hit and restore your energy.
- Exercise: While it may be counterintuitive, physical activity can help alleviate side effects, especially fatigue. “Although ovarian cancer is not common, we often draw upon the experience of patients with breast cancer and colon cancer that have shown that physical activity can not only improve quality of life but may also have beneficial impacts on cancer outcomes,” Dr. Urban says.
- Eat well: Even though nausea may interfere with your ability to eat a healthy diet, it’s essential to ensure you’re eating appropriately, getting enough protein, and not losing weight. Not only will nourishing your body support your recovery, but it may also help you feel more energized.
- Sleep: Want to mitigate fatigue? Be sure to maintain your regular sleep-wake cycle while on treatment. Sticking to a set sleep schedule helps reduce fatigue by ensuring enough hours for your body to heal and restore itself each night. It may also help you recover more quickly by keeping energy levels high during the daytime.
How to Deal With the Side Effects of Chemotherapy
Tongue Cancer: Understanding the Cause of Head & Neck Cancers
According to Cedars-Sinai, several types of cancer develop in the tongue, with the most common being squamous cell carcinoma. The two types of tongue cancer are:
- Cancer of the oral tongue, which consists of the front two-thirds of the tongue that you can stick.
- Cancer of the base of the tongue, the area which is the back one-third of the tongue that extends down the throat.
Although some people may be diagnosed with tongue cancer and have no risk factors, Cedars-Sinai says this type of cancer is most commonly found in adults 40 years old and up. Men are also twice as likely to be diagnosed with tongue cancer.
Other risk factors, as per Cedars-Sinai include:
- Smoking and drinking alcohol [smokers are 5x more likely to develop tongue cancer than nonsmokers]
- Human papillomavirus (HPV)
- African-American men have a greater risk than caucasians
It’s unclear what led to Shirley Chung’s diagnosis, but it’s important to understand that symptoms of tongue cancer can include:
- An unusual lump on the side of the tongue
- An ulcer-like lump, of a grayish-pink to red color
- A lump that bleeds easily when touched
Tongue cancer may be hard to spot in its early stages, however, when the cancer develops, patients may experience trouble with swallowing, voice changes, pain in the ear, pain in the throat, or a feeling of fullness in the throat.
HPV and Cancer Risk: The Basics
As for how throat cancer is diagnosed, it’s usually done through X-rays, CT scans, and PET scans. A diagnosis often requires a biopsy.
For tongue cancer treatment, surgery, chemotherapy and radiation therapy are usually done.
It’s much more common to know someone who has a head or neck cancer, like tongue cancer, now-a-days than it was several decades ago. And that’s because of its strong connection to the human papillomavirus, also known as HPV, which is the most common sexually transmitted infection in the United States.
“From the 1980s to the 2010s, the rate of HPV-related head and neck cancers has gone up by 300 percent,” Dr. Ted Teknos, a head and neck cancer specialist, and president and scientific director of University Hospitals Seidman Cancer Center in Cleveland, Ohio, told SurvivorNet during a previous interview.
The vast majority of humans in the United States both men and women will eventually get infected with HPV, according to Dr. Allen Ho, a head and neck surgeon at Cedars-Sinai.
Expert Resources on HPV-Related Cancers
- Get the Facts: What Do We Know About HPV-Linked Throat Cancer?
- Majority of Throat Cancer Diagnoses Are Caused by HPV – Here’s What You Need to Know
- HPV-Related Cancers Are on the Rise And More Than 70 Cancer Centers Call for Urgent Action to Increase Vaccinations; What You Need to Know to Protect Your Child’s Health
- The HPV Vaccine Gardasil Now Approved For Prevention of Head & Neck Cancers– As Cases Rise in Men
- Millions More Americans Now Eligible to be Vaccinated Against HPV-Related Cancers
“The important thing to know about HPV is that there are many different strains, and only a couple of them tend to be more cancer-inducing,” he told SurvivorNet.
“Probably less than 1 percent of the population who get infected happen to have the cancer-causing virus that somehow their immune system fails to clear, and over 15 to 20 years it develops from a viral infection into a tumor, and a cancer.”
It’s unclear whether HPV alone is enough to trigger the changes in your cells that lead to head and neck cancers, or whether this happens in combination with other risk factors like smoking.
Of course, some people who develop head and/or neck cancers have no known risk factors for the condition. Genetics can play a role in this cancer, too.
Head and neck cancers are unique in that they’re usually preventable with the HPV vaccine. And that’s why those eligible should get vaccinated against HPV, SurvivorNet experts have told us.
Why the HPV Vaccine is so Important in Preventing Cancer
Contributing: SurvivorNet Staff
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