An estimated 17,110 people received a tongue cancer diagnosis in 2018, meaning this type of cancer will account for 1% of all new cancer cases.
As a rarer type of cancer, tongue cancer also has a more positive 5-year survival rate (65.8%) than other types of cancer, e.g. lung cancer (18.6%) and pancreatic cancer (8.5%).
Below, we’ll explore tongue cancer in more detail, covering the most common type, the symptoms, diagnosis, treatment, and outlook.
What Is Tongue Cancer?
Your tongue consists of two parts: the base of your tongue and the oral tongue. Cancer may develop in either of these parts. The base of your tongue is the third of your tongue at the back of your mouth. Located near to your pharynx (your throat), cancers found here are known as “oropharyngeal cancers.”
The oral part of your tongue is the bit that’s visible when you stick your tongue out of your mouth – the two-thirds at the front. When cancer develops here, medical doctors call it “oral cancer” or “mouth cancer.”
Therefore, when you hear people referring to tongue cancer, they are typically talking about oral cancer. Cancer in the one-third at the back of your tongue is treated differently. Medical doctors categorize them as a separate type of head and neck cancer.
How Is Tongue Cancer Diagnosed?
First, your doctor will run through your medical history, discussing any personal or family history with cancer; whether you drink or smoke, and if so, how much; and whether you have ever tested positive for HPV.
They’ll then do a thorough physical examination to look for signs of cancer in your mouth, e.g. ulcers that aren’t healing. They’ll also check for swelling in nearby lymph nodes.
Should your doctor find any signs of cancer, they’ll want to do a biopsy of the area. The most common is an incisional biopsy which involves removing a piece of the tongue that they suspect is cancerous. This can be done in your doctor’s office under local anesthesia.
Alternatively, a newer method known as a brush biopsy may be done. This involves rolling a small brush over the affected area to cause minor bleeding. Your doctor is then able to collect the cells they need to test for cancer.
However your cells are collected, they will be sent for analysis at a specialist lab. If cancer is detected, you may be referred for an MRI or CT scan to check how deep the cancer is and if it’s spread and where.
What Are the Stages of Tongue Cancer?
As with all types of cancer, doctors categorize cancer of the tongue using grades and stages. This will give an indication as to whether or not the cancer has spread and what size the tumor is.
The grade of cancer indicates how aggressive it is and what the likelihood of it spreading is. The grades are as follows:
- Low – This is unlikely to spread as it is slow-growing
- Moderate – This could spread as it is growing at an average rate
- High – This is highly likely to spread as it is a very aggressive form
And the stages are:
- T – This refers to the size of the tumor, with T1 being a small tumor and T4 being a large one
- N – This indicates whether the cancer has spread to the lymph nodes in the neck. The cancer has not spread if tests classify it as N0 but it has spread to numerous lymph nodes if it’s deemed N3
- M – This specifies whether there are any further growths in other areas of the body
Being aware of the symptoms of this type of cancer (and others, of course) can help with early detection and treatment.
Who Is at Risk of Developing Tongue Cancer?
There are a number of factors that may increase your risk of developing tongue cancer, despite the exact cause of this cancer being unknown. These include:
- Chewing or smoking tobacco.
- Heavy drinking. Studies show that the risk of mouth cancer is increased with drinking alcohol, particularly when someone’s a smoker too. 30% of oropharyngeal and mouth cancers are caused by alcohol consumption
- A family history of mouth cancers
- Being infected with the sexually transmitted disease, the human papillomavirus (HPV)
- A personal history of specific types of cancers, e.g. those that develop in the squamous cells
- Chewing betel (something that’s common in southeast and south Asia)
- Weak immune system. If you are undergoing treatment for AIDS or HIV or you’re taking immune suppressants, you’re at more risk
- Certain mouth conditions. Red patches (erythroplakia) and white patches (leukoplakia) are caused by cell changes and these may eventually develop into cancer
- Poor oral hygiene. For example, ill-fitting dentures or jagged teeth that cause constant irritation may increase your risk
- Poor diet. One study suggests that the risks of oral cancers may be increased by diets low in fruit and vegetables
What Are the Signs and Symptoms of Tongue Cancer?
The symptoms in these cases are often very similar to those of other types of oral cancer, which include a sore in the mouth that’s persistent and a cold that you can’t get rid of. Equally, if the cancer is developing on the base of your tongue, early symptoms may not be apparent.
Other common symptoms include:
- A white or red patch on your tongue that doesn’t go away
- A persistent sore throat
- A lump or spot (ulcer) on your tongue that doesn’t go away
- Numbness in the mouth that doesn’t seem to disappear
- Pain when you swallow
- Difficulty swallowing or chewing
- Difficulty moving the tongue or jaw
- Pain in your tongue and/or jaw
- Unexplained bleeding, which isn’t caused by an injury, e.g. biting your tongue
- Pain in your ear (this is a rarer symptom, however)
Some of these symptoms may be an indication of something far less sinister, but it’s always good to check with your local doctor or dentist.
Equally, even if none of the aforementioned symptoms relate to you but you feel as though there’s something abnormal happening in your mouth/on your tongue, you should seek medical advice.
How Is Tongue Cancer Treated?
The treatment required for this type of cancer depends on how far the cancer has spread and what size the tumor is.
Some may only need a single treatment while others may receive ongoing care.
For cases where the cancer is small, surgery is often effective at removing this. But if the tumor is larger and has spread to lymph nodes located in the neck, a combination of surgery and radiotherapy may be recommended.
This means you’ll need to undergo an operation to remove both the cancer in your tongue and the affected lymph nodes. Depending on how many of the lymph nodes are affected will depend whether they’re removed from one or both sides.
Known as a “neck dissection,” this operation reduces your risk of developing cancer again in the future. And to ensure any cancer cells that are left behind are removed completely, a course of radiation may be required.Add
> Glossectomy and Reconstruction
Should a large part of your tongue need removing, you may have what’s known as a glossectomy. This is quite an invasive type of surgery and may lead to severe side effects, such as changes in how you swallow, talk, breathe, and eat. However, certain therapies, e.g. speech therapy, can help you manage these changes.
You may also need some reconstruction to help rebuild your tongue. This involves taking a piece of skin from another area of your body to reconstruct the missing part.
This tends to be combined with radiation therapy with the chemotherapy using drugs to get rid of cancer cells around your body. This may be recommended if the cancer has spread to other parts of your body or tissues.
What Is the Most Common Type of Tongue Cancer?
The most common type of cancer of the tongue is squamous cell carcinoma (SCCA). This cancer can grow:
- On the surface of your skin
- In the lining of your digestive and respiratory tracts
- In the lining of the throat, thyroid, larynx, nose, and mouth
Squamous cells cover each of these parts. This includes the flat, thin cells that cover the surface of your tongue.
How Can You Prevent Tongue Cancer?
While doctors continue to try and find the exact cause of cancer, there aren’t any clear-cut ways that you can definitely prevent its onset. However, there are numerous steps you can take to try and reduce your risk of developing cancer of the tongue.
These include avoiding all of the aforementioned risks mentioned earlier while also visiting your dentist for routine six-monthly checkups, cleaning and flossing your teeth , using water soluble vitamins every day, and being vigilant for the signs and symptoms of cancer.