Tongue cancer is one type of oral cancer that begins with abnormal growth of cells on the tongue. Oral cancers are relatively common and highly treatable IF FOUND AND TREATED EARLY.
Tongue cancer is relatively rare, representing nearly 1 percent of newly diagnosed cancer cases in the United States, according to the National Cancer Institute (NCI). However, it’s one of the more frequently diagnosed forms of head and neck cancers (25% of oral cancer cases are found on the tongue)
Several types of cancer grow in the tongue, but squamous cell carcinoma is the most common. Squamous cells are thin, flat cells that line the mouth (and other organs.)
There are two types of tongue cancer:
- Cancer of the oral tongue. The front two-thirds of the tongue that you can stick out is called the oral tongue.
- Cancer of the base of the tongue. The base is the back one-third of the tongue that extends down the throat.
It most often begins in the thin, flat squamous cells that line the tongue’s surface. The type of cells involved in your tongue cancer helps to determine your diagnosis and treatment. Where it occurs also affects your treatment.
It can occur:
- In the mouth, where it may be more likely to be seen and felt (oral tongue cancer). This type of tongue cancer tends to be diagnosed when the cancer is small and more easily removed through surgery.
- In the throat, at the base of the tongue, where tongue cancer may develop with few signs and symptoms (hypopharyngeal tongue cancer). Cancer at the base of the tongue is most often diagnosed at an advanced stage, when the tumor is larger, and the cancer has spread into the lymph nodes in the neck.
Increasingly, cancers at the base of the tongue are associated with human papillomavirus (HPV), which has a profound effect on the prognosis and treatment of the cancer.
Who is most at risk?
- Smoking, or tobacco use (in any form) is the number one risk factor (Historically, 75% of those diagnosed have been tobacco users.)
- Alcohol use. (When combined with smoking, the risk is 15x greater.)
- Age: People *over the age of 40. (*15% are in people between the ages of 40-55 and 62% are in people between the ages of 55 and 75), although it can occur in younger people.
- Gender: Men are 6 times more likely to have this cancer overall, but only 2 times more likely to have it in the anterior (front) region of the mouth.
- Occurs twice as often in African Americans than in Caucasians.
- HPV viral infections (particularly HPV16) have been shown to greatly increase the risk and is being seen more in younger people.
What are the symptoms?
One of the biggest dangers of this cancer is that it often goes unnoticed. You might not notice any symptoms in the early stages, especially with cancer at the base of the tongue. The most common early sign of tongue cancer is a persistent sore or ulcer on your tongue. In contrast, a non-cancerous ulcer should naturally heal within two to three weeks.
The presence of pain from the sore or ulcer is another way to differentiate if it is worrying. Most regular (benign) ulcers are painful due to inflammation. On the contrary, cancerous (malignant) ulcers may be painless at the beginning creating a higher index of suspicion.
- Red or white patch or lump on your tongue that persists.
- Experiencing pain and difficulty swallowing.
- Mouth numbness.
- Persistent sore throat.
- Bleeding from your tongue with no apparent cause.
- A lump on the side of the tongue that touches the teeth.
- The lump often looks like an ulcer and is grayish pink to red.
- The lump bleeds easily if bitten or touched.
- There are few symptoms in the early stages.
- In later stages, the cancer may cause pain, a sense of fullness in the throat, difficulty swallowing, the feeling of a lump in the neck or throat, voice changes or ear pain.
Because there are so many benign tissue changes that occur normally in your mouth, and some things as simple as a bite on the inside of your cheek may mimic the look of a dangerous tissue change, it is important to have any sore or discolored area of your mouth, which does not heal within 14 days, looked at by a professional.
How is tongue cancer diagnosed?
To make a diagnosis, we take a medical history and ask specific questions about symptoms. Then, we examine the tongue and neck, and a small, long-handled mirror will be used to look down the throat.
Several tests are used to aid in the diagnosis. These tests can include:
- X-rays of the mouth and throat, including CT scans.
- Biopsy: A small sample of tissue that is removed from a tumor to diagnose cancer. After the biopsy is taken, a pathologist will examine the cells under a microscope.
- PET scans (positron emission tomography), which use radioactive materials to identify excessive activity in an organ. This may indicate if the tumor is growing.
How is tongue cancer treated?
Surgery, radiation therapy and chemotherapy are used to treat tongue cancer. Sometimes, targeted drug therapy may also be recommended.
Key Points
- People can get cancer in the oral tongue — the part you can stick out — and the base of the tongue, which extends down the throat.
- This cancer is more common in people 40 and older.
- Tongue cancer can be treated with surgery, radiation therapy and chemotherapy.
Next Steps
An Oral Cancer screening can identify tongue and other oral cancers. We routinely perform oral cancer screenings during your annual exam and/or cleaning appointments. If you notice any of these signs or symptoms, see us as soon as possible for a comprehensive exam.
Treatment for advanced tongue cancers can greatly impact your ability to speak and eat. Working with a skilled rehabilitation team can help you deal with changes that result from tongue cancer treatment.
If you have noticed any unusual lesions or are experiencing any of the symptoms mentioned above, see your dentist as soon as possible for an evaluation. If you’re in the Dallas/Ft. Worth area and would like to be seen in our office, fill out our contact form and we will contact you, or call us at 214-956-9100 to schedule an appointment.
Sources: https://oralcancerfoundation.org/facts/
https://www.cedars-sinai.org/health-library/diseases-and-conditions/t/tongue-cancer.html
https://seer.cancer.gov/statfacts/html/tongue.html
https://seer.cancer.gov/statfacts/html/tongue.html
