'Regeneration' of tongue after cancer patient's removal

A team of doctors at the Ho Chi Minh City Oncology Hospital used skin from the forearm or thigh to regenerate the tongue, helping cancer patients restore 60-90% of this part.

More than a year ago, Mr. Le Thanh Minh (73 years old, Phu Giao district, Binh Duong ) had pain in the right oral cavity. Thinking it was a normal toothache, Mr. Minh bought western medicine to take. He thought the disease would go away when the pain subsided, but after a while, the mouth and tongue area swelled, accompanied by severe pain as he described "unbearable". Part of his tongue was ulcerated, making it very difficult to eat and drink, he could only drink water and milk. In July, his family took him to the Ho Chi Minh City Oncology Hospital (Thu Duc City facility). Doctors diagnosed him with tongue cancer and had to surgically remove part of it and use reconstructive techniques to restore the function of this part.

After the surgery a week ago, Mr. Minh can now talk to his family, and the pain has significantly reduced. Although speaking is more difficult than before, he said he will practice to get used to it. "Up to now, I feel my tongue has recovered 60-70%," he said.

Doctor Nguyen Anh Khoi asked about patient Le Thanh Minh's health after surgery on the morning of September 13. Photo: Ha An — Doctor Nguyen Anh Khoi asked about patient Le Thanh Minh's health after surgery on the morning of September 13. Photo: *Ha An*

Mr. Minh is one of more than 300 patients who have had successful tongue reconstruction surgery at the Ho Chi Minh City Oncology Hospital in the past 3 years. According to Dr. Nguyen Anh Khoi, Head of the Department of Head and Neck Maxillofacial Surgery, tongue cancer is one of the 20 most common types of cancer. The cause is due to the patient's heavy use of alcohol and tobacco, poor oral hygiene, and trauma caused by sharp teeth rubbing against the skin in the mouth.

Currently, to treat early-stage tongue cancer when the tumor is still small, doctors can choose surgery or radiation therapy depending on the condition and needs of the patient. However, surgery is still the main technique used.

Dr. Khoi said that during surgery, depending on the severity of the disease, the doctor will remove part or all of the tongue and remove lymph nodes to prevent metastasis. If less than 1/3 of the tongue is removed, the patient will not need reconstruction because the tongue function is still relatively good. If more than 1/3 is removed, reconstruction is needed to restore function with the principle of being as close to the tongue as possible, helping the patient swallow and speak more easily.

To create a tongue, the doctor will take a piece of skin from parts of the body such as the patient's forearm, thigh or abdomen. Depending on the location and aesthetic requirements, the appropriate skin area will be selected for reconstruction. The surgery lasts 8 - 12 hours, the team will simultaneously take skin from the patient's body and cut the cancerous part of the tongue. The skin when removed will be grafted to the defect.

According to Dr. Khoi, when they first operated on their first patients, the entire surgical team was quite nervous. "Once they gained experience, the blood vessel connection process was shortened from 2 hours to 40 minutes, helping the doctors feel less pressured," Dr. Khoi said.

The research team said that with a defect of less than 50% of the tongue, the patient will recover almost completely the tongue within 2 years if there is no recurrence, with a rate of over 90%. With a more severe defect of 2/3 or the entire tongue, the patient can recover about 60% of the tongue's function and can only eat liquid foods such as milk and porridge for life.

In the group's study, the rate of recurrence of fatal tongue cancer in the late stages was about 60%. Before this technique, the recurrence rate was 100%. In addition, this technique helps patients reduce pain, reduce bad breath, and partially restore speech and swallowing functions.

Currently, the cost of a tongue reconstruction surgery is about 18 million VND, many times cheaper than treatment abroad. The research team said that in the near future, they will develop 3D modeling technology to shape the tongue before surgery, helping the tongue simulation to be as realistic as possible to replace the current manual measurement method.

According to the research team, the trend of tongue cancer is getting younger. Previously, the disease was mainly found in people over 60 years old. However, nowadays, people aged 20 - 30 have the disease with increased factors and the possibility of recurrence is higher than before. Most patients are subjective, hospitalized in the late stages, making treatment difficult. In the world , a study in Nordic countries showed that the trend of tongue cancer rejuvenation increased 6 times in 30 years. Therefore, this technique brings hope to many tongue cancer patients.

The group's work was awarded first prize in the medical field at the 27th Ho Chi Minh City Science and Technology Innovation Award on September 26.

Ha An

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