Tongue cancer starts in cells of the tongue. Cancer cells grow out of control and form a tumor. They can invade and damage nearby tissue. Tongue cancer happens most often in squamous or surface cells. It may be seen as a patch or lump in the tongue.
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Cancer occurs when cells grow and develop without control or order. It is not clear exactly what causes these cells to develop. A combination of genetics and environment probably play a role.
Tongue cancer is more common in men. It can happen at any age but is most common in people aged 40 years and older. Other factors that may increase your chances of tongue cancer include:
- Smoking cigarettes, cigars, or a pipe
- Use of chewing tobacco, snuff, or other tobacco products
- Heavy alcohol consumption
- Poor oral and dental hygiene
- History of mouth ulcers
- Family history of head, neck, or oral cancers
Tongue cancer may cause:
- A lesion, lump, or ulcer on the tongue
- Mouth sores and mouth pain
- Numbness or difficulty moving the tongue
- Pain when chewing and speaking
- Bleeding from the tongue
- Difficulty swallowing
- Change in speech
- Ear pain—may be caused by large tumors on base of tongue
Changes may start in a part of the tongue that sits in the mouth or in the throat. Cancer that starts in the mouth may be easier to see. This may lead to an earlier diagnosis than those that develop in areas further back in the throat. In late stages, cancer can spread to other areas of the body.
Tongue cancer may first be spotted during a routine dental visit. The doctor may also see it in a physical exam.
The doctor may ask about your symptoms and medical history. A physical exam will be done. A scope may be used to see areas further down the throat. A sample of the area may be removed for testing. The test, called a biopsy, will confirm if cancer is present.
Images may need to be taken to see where tumors are. This can be done with:
The care team will use lab tests and images to determine the specific type and stage of cancer you have. Staging is used to guide your treatment plan. Like other cancers, tongue cancer is staged from 1 to 4. Stage 1 cancer has not spread far. The higher the stage the further the cancer has spread. Stage 4 cancer has spread to other parts of the body
Tongue cancer treatment may include one or more of the following:
- Surgery—to remove as much of the cancer as possible. Cancer that reaches nearby lymph nodes can spread to other areas of the body. Lymph nodes in the neck may be removed for testing or treatment.
- Chemotherapy—medicine that targets fast growing cells like cancer. The medicine travels throughout the body. May be used:
- In combination with radiation, if surgery is not an option
- After surgery to decrease risk of cancer coming back
- To ease symptoms if tumor cannot be removed or cured
- Radiation therapy—beam of radiation is directed at tumor. It can destroy cancer cells and shrink tumors. Radiation may be used
- As main treatment
- In combination with chemotherapy
- To ease symptoms caused by large tumors that cannot be removed or cured
Exact treatment will depend on the stage of the cancer and overall health.
To help reduce your chance of tongue cancer:
- Do not smoke or use tobacco products. If you do smoke or use tobacco products, talk to your doctor about how you can quit.
- Drink alcohol in moderation. Moderate drinking is a maximum of 2 drinks per day for men and a maximum of 1 drink per day for women.
Rehabilitation and Follow-up
Reconstructive surgery may be needed if large areas were removed. Therapy will also help to regain movement for speech and swallowing.
- Head and neck cancer. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/head-and-neck-cancer.
- Head and neck cancer—for patients. National Cancer Institute website. Available at: https://www.cancer.gov/types/head-and-neck.
- Tongue cancer. Cancer Research UK website. Available at: http://www.cancerresearchuk.org/about-cancer/mouth-cancer/stages-types-grades/tongue-cancer.
- Mohei Abouzied, MD, FACP
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