What Is Tongue Cancer? Symptoms, Causes, Diagnosis, Treatment, and Prevention

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Tongue cancer is a type of head and neck cancer that begins in the tongue, the muscular organ in your mouth that helps you speak, chew, and breathe. Your tongue extends from the middle of your neck to the roof of your mouth. The tongue is one of the most common sites for head and neck cancer. However, tongue cancer is relatively rare overall, making up less than 1 percent of all new cancer diagnoses annually in the United States. As with most cancers, early diagnosis and treatment of tongue cancer lead to better outcomes.
Types of Tongue Cancer Types There are two main types of tongue cancer: Oral Tongue Cancer This type affects the front part of the tongue that you can stick out of your mouth. Oropharyngeal Tongue Cancer This type occurs in the base of the tongue that extends down your throat. Oropharyngeal cancer may be harder to diagnose because it’s not always clearly visible. The majority of tongue cancers, whether they occur in the front of the tongue or the back of the throat, start in the squamous cells, which are thin, flat cells that line the surface of the mouth. In fact, Moffitt Cancer Center says that squamous cell carcinoma accounts for 90 percent of all tongue cancers. Other types, such as lymphoma and sarcoma, can develop on the tongue but are extremely rare.
Causes and Risk Factors for Tongue Cancer Causes Researchers don’t know exactly what causes tongue cancer, and the disease can affect anyone, according to Memorial Sloan Kettering Cancer Center . However, certain risk factors may increase a person’s chance of developing tongue cancer, according to the American Cancer Society : Smoking or Other Tobacco Use Smokers are 5 times more likely to develop tongue cancer than nonsmokers. Alcohol Use Heavy drinkers have a higher chance of having tongue cancer. Using alcohol and tobacco together further accelerates the risk. Having the Human Papillomavirus (HPV) HPV is a sexually transmitted disease. HPV type 16 is the subtype of HPV that’s most commonly linked to tongue cancer. Being Older Most people with tongue cancer are older than age 55 at diagnosis. However, tongue cancer is on the rise among younger people. Being Male Men are twice as likely to have tongue cancer as women. Poor Oral Hygiene Some studies have suggested that poor oral hygiene and dental care may contribute to tongue cancer.
Signs and Symptoms of Tongue Cancer Symptoms Tongue cancer may include these symptoms: Red, white, or dark patches on the tongue that don’t go away A persistent sore throat A sore spot or lump on the tongue that doesn’t go away Pain when swallowing Mouth numbness Burning or pain on the tongue A lump in the neck or back of the throat Problems with speaking, chewing, or moving the tongue Unexplained bleeding from the tongue Ear pain When tongue cancer occurs in the mouth, the first symptom is often a sore on the tongue that doesn’t heal, according to the Mayo Clinic . When the cancer affects the throat, the first sign is frequently swollen lymph nodes.
How Is Tongue Cancer Diagnosed? Diagnosis To diagnose tongue cancer, doctors might first ask about your symptoms and medical history. Then they might perform a physical examination of the tongue. Dentists often discover tongue cancers during routine exams. To make an accurate diagnosis, the following tests may be performed: Imaging Scans of the Mouth and Throat This could include X rays, computed tomography scans, or positron emission tomography scans. Endoscopy Doctors insert a thin tube with a light and camera on the end down your throat to look for signs of tongue cancer. Biopsy Surgeons remove a small piece of tissue from the suspicious area of the tongue. A pathologist examines the tissue in a lab, looking for cancer cells. This is the only way to confirm a tongue cancer diagnosis.
Stages of Tongue Cancer Stages After doctors diagnose tongue cancer, they will attempt to determine its stage, or the extent of the cancer in your body. Distinguishing the stage can help doctors recommend effective treatments and provide an accurate prognosis. The American Cancer Society explains that doctors commonly use the American Joint Committee on Cancer’s system called TNM (tumor, node, metastasis) to stage tongue cancer. TNM helps describe the tumor’s size and location, whether it has spread to lymph nodes, and if it has metastasized to other areas of the body. Numbers or letters are also added after T, N, and M to provide more details about each of these descriptions.
Treatment Options for Tongue Cancer Treatment Treatment for tongue cancer might depend on the cancer’s location, how fast it’s growing, and whether it has spread to other areas. Surgery Surgery is the most common treatment for tongue cancer. Surgeons may perform different procedures: Glossectomy With this surgery, all or part of the tongue is removed. Surgeons cut out the cancer and some healthy cells around it. If the whole tongue is removed, it’s known as a total glossectomy. Neck Dissection This procedure involves making a cut in the neck and removing lymph nodes. Surgeons may perform a neck dissection if the cancer has spread to the lymph nodes. Or they may take out lymph nodes as a precaution. Reconstructive Surgery A reconstructive procedure may be needed if parts of the jaw, face, or neck are removed or disfigured during tongue cancer surgery. Doctors often take healthy tissue or bone from other parts of the body to rebuild areas of the tongue, palate, lip, jaw, face, throat, or skin. This procedure can be done at the same time as surgery to remove the cancer. Radiation Therapy Radiation uses beams of high energy to kill cancer cells. When it comes to tongue cancer, radiation therapy can be used on its own or with other treatments, like chemotherapy. Often, doctors will recommend radiation after surgery to destroy any remaining cancer cells. Chemotherapy Chemotherapy involves delivering powerful drugs to kill cancer cells in the body. Chemo can be used before or after surgery, or it may be given at the same time as radiation therapy to help boost the effects. Targeted Therapy Targeted treatments home in on specific proteins that control how cancer cells divide and grow, according to the National Cancer Institute . These therapies may be used to treat tongue cancer that spreads or recurs Immunotherapy With immunotherapy, your body’s own immune system is harnessed to help fight cancer cells. Immunotherapies might be used to treat tongue cancer if the disease is advanced or other therapies have failed. Clinical Trials Clinical trials are research studies that offer patients an opportunity to test new treatments that aren’t yet available to the public. Your healthcare provider can help you determine if you’re a good candidate for participating in a clinical trial.
Complications of Tongue Cancer Complications Complications of tongue cancer commonly occur as a result of the treatments received. According to Cancer.Net , oral surgery can lead to these problems: Speech problems Difficulty swallowing Problems with chewing Dehydration or malnutrition Disfigurement Changes in taste Lymphedema (a condition that causes lymph fluid to build up in the fatty tissues just under the skin) Emotional issues Radiation therapy can pose some of the same complications as surgery while also potentially causing the following issues: Mouth sores Dry mouth Skin irritation Fatigue Nausea Sore throat Bone pain The American Cancer Society says that cancer medicines, such as chemotherapy, can cause these side effects: Infection Fatigue Nausea Diarrhea Hair loss Loss of appetite Some patients may benefit from undergoing rehabilitation methods, such as speech therapy, physical therapy, or nutritional counseling, to help manage complications. Prognosis of Tongue Cancer The outlook for someone with tongue cancer depends on the stage of the cancer, a person’s overall health, the treatments received, and other factors. The National Cancer Institute provides relative survival rates to compare people with the same type and stage of cancer to those in the overall population. The five-year relative survival rate for someone with tongue cancer is: 85 percent for tongue cancers that haven’t spread beyond the tongue 70 percent for tongue cancers that have spread to only the lymph nodes 41 percent for tongue cancers that have spread to distant areas of the body
Research and Statistics: Who Has Tongue Cancer? Research and Statistics About 18,040 new diagnoses of tongue cancer are made each year in the United States. Roughly 2,940 people will die from the disease. The lifetime risk of developing tongue cancer for adults is around 0.4 percent. However, age-adjusted rates for new tongue cancer cases have been increasing in recent years. Researchers believe that this upward trend could be partially due to more people contracting the HPV virus. Some research has also suggested that altered lifestyle habits during the COVID-19 pandemic — including poor oral hygiene, increased use of alcohol and tobacco, and missed dental appointments — may have contributed to a rise in tongue cancer cases.
Screening and Prevention of Tongue Cancer Prevention Though there are currently no recommendations for routine screening for tongue cancer, the American Cancer Society recommends undergoing regular dental checkups that include an exam of the entire mouth to spot these cancers early. While there’s no way to completely eliminate your risk of developing tongue cancer, the Mayo Clinic says that you can help prevent the disease with these actions: Refrain from smoking and using other tobacco products. Limit your alcohol intake. Get an HPV vaccine (if you are a candidate to receive one).

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