Dysphagia+and+tongue+cancer


 * Cancer of the tongue **

Most patients with tongue cancer will have some difficulties in swallowing (Groher & Crary, 2010; Nguyen et al., 2004). Dysphagia will be due to either the cancer itself or its treatment. (2;a)


 * Cancer **

Cancer “is the result of cell growth that is out of control” (Groher & Crary, 2010; p.100).

The New Zealand Cancer society [|here] has more information about cancer in general. Some of the general side effects of cancer that will affect your patient’s treatment are:

· Pain

· Weight loss

· Fatigue

· Decreased autoimmune system

Weight loss is especially common in head and neck cancers with 30-50% of patients being malnourished due to reduced intake and digestion of food and liquids (Groher & Crary, 2010). Malnutrition also leads to other confounding problems for the patient such as:

· Increased susceptibility to infection

· Reduced immune function

· Respiratory failure

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 * Staging of Cancer **

Before treatment can begin the cancer is staged using different systems, although the TMN system shown below is used most often (Groher & Crary, 2010).

(Groher & Crary, 2010)
 * || Primary Tumor (T) ||
 * TX || Primary tumor cannot be evaluated ||
 * T0 || No evidence of primary tumor ||
 * Tis || Carcinoma in situ (early cancer that has not spread to neighboring tissue)5 ||
 * T1 || Tumor < 2cm in greatest dimension ||
 * T2 || Tumor > 2cm but < 4cm in greatest dimension ||
 * T3 || Tumor > 4cm in greatest dimension ||
 * T4 || Tumor invades adjacent structures ||
 * || Regional Lymph Nodes(N) ||
 * NX || Regional lymph nodes cannot be assessed ||
 * N0 || No regional lymph node involvement (no cancer found in the lymph nodes) ||
 * N1, N2, N3 || Involvement of regional lymph nodes (number and/or extent of spread)55 ||
 * || Distant Metastasis (M) ||
 * MX || Distant metastasis cannot be evaluated ||
 * M0 || No distant metastasis (cancer has not spread to other parts of the body) ||
 * M1 || Distant metastasis (cancer has spread to distant parts of the body) ||

T (tumor) explains the size of the tumor and if it has spread into near tissue (Groher & Crary, 2010).

N (nodes) states whether the cancer has spread into any close by lymph nodes.

M (metastasis) explains whether the cancer has spread to other organs.

An increase in size of the primary tumor (T3 - T4) and number of neck nodes affected (N2 – N3) are correlated to an increase of severity of Dysphagia (Nguyen et al., 2008).

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