Cancer of the Tongue

Cancer of the tongue occurs when a group of cells on the tongue become abnormal and start to grow out of control. Most of the time, tongue cancer starts in very thin, flat cells that cover the surface of your tongue (squamous cells). Cancer cells can spread and form a mass of cells called a tumor. The tumor may spread deeper into the tongue, or it may spread to other areas of the body (metastasize).

RISK FACTORS

The exact cause of cancer of the tongue is not known. However, some risk factors make this more likely:

  • Use of tobacco products, including cigarettes, pipes, cigars, smokeless (chewing) tobacco, and snuff. This is the number one risk factor of cancer of the tongue.

  • Male gender.

  • Age of 50 years or older.

  • Poor oral hygiene (not brushing or flossing your teeth regularly).

  • Frequent use of alcohol.

  • Human papillomavirus (HPV) infection.

  • Family history of tongue cancer.

SYMPTOMS

Tongue cancer can start in 1 of 2 places. It can start at the front part of the tongue or at the base of the tongue at the back of your throat. Symptoms of cancer at the front part of your tongue may include:

  • A lump or sore on your tongue that may be painful (especially when you eat or speak) and may not heal. It also may bleed easily if you bite it or touch it.

  • Numbness on your tongue.

  • Difficulty moving your tongue.

  • Pain when chewing.

  • Difficulty pronouncing or saying certain words or making certain sounds.

  • A bad odor in your mouth.

  • A lump on your neck.                                                        

Cancer at the base of the tongue is harder to see. Symptoms may not show up as soon as they do for cancer at the front part of your tongue. Symptoms may include:

  • A feeling in your throat that you are choking (especially when you are lying down).

  • Difficulty swallowing or pain when you swallow.

  • A muffled voice.

  • Ear pain.

  • Pain when you try to open your mouth or difficulty opening your mouth.

  • A lump on your neck.

DIAGNOSIS

To diagnose tongue cancer, your caregiver may perform the following exams:

  • A physical exam of your mouth, throat, and neck for a sore or lump. Your caregiver may use a mirror with a long handle or a thin, flexible tube with a tiny light and camera at the end (fiberscope) to see the back of your mouth.

  • Removal and exam of a small number of cells (biopsy) from your tongue or a lump on your neck. The cells are checked for cancerous formations under a microscope.

  • Imaging exams, such as X-rays of your mouth and neck. The images can show if there is an abnormal mass.

If you do have cancer, your caregiver will stage your cancer. Staging provides an idea of how advanced your cancer is. The stage will depend on how much your cancer has grown and if it has metastasized. The meaning of the stage depends on the type of cancer. For tongue cancer:

  • Stage I means the cancer is the size of a peanut or smaller. It has not metastasized.

  • Stage II means the cancer is larger than a peanut, but not larger than a walnut. It has not metastasized.

  • Stage III means the cancer has grown larger than a walnut. It may have spread to a lymph node or lymph gland on the same side of your neck as the cancer. (Lymph is a fluid that carries white blood cells all over your body. White blood cells fight infection.)

  • Stage IV means the cancer has spread to nearby areas. It may have spread heavily into your lymph glands.

TREATMENT

Treatment for tongue cancer can vary. It will depend on the stage and location of your cancer and your overall health. Treatment options may include:

  • Radiation therapy. This uses waves of nuclear energy to kill cancer cells on your tongue. It may be used for stage I and II cancers. It often is used for cancers at the base of your tongue.

  • Surgery:

  • Surgery is done if your tumor is small, has not spread, and is at the front of your tongue.

  • Surgery may be done to remove tumors that have spread into your neck or lymph nodes.

  • A combination of surgery, radiation, and drugs that kills cancer cells (chemotherapy). This may be done for stage III and stage IV cancers.

SEEK MEDICAL CARE IF:

  • Your tongue hurts or is numb.

  • The way you speak changes.

  • The way you swallow changes.

  • You notice a lump on your neck.

  • You have an oral temperature above 100.5° F (38.1° C).

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have pain that gets worse.

  • Your tongue or mouth bleeds.

  • Your lip, mouth, or neck swells.

  • You have trouble swallowing.

  • You have trouble breathing.

  • You have an oral temperature above 102° F (38.9° C).