Tongue Cancer

Tongue cancer occurs when cells on your tongue start to grow and divide uncontrollably. Several types of cancer can affect your tongue, but the most common is squamous cell carcinoma (SCC).

When cancer affects the front part of your tongue (the part you can see), healthcare providers call it oral cancer or oral tongue cancer. If you develop cancer on the back portion of your tongue (the part you can’t see), providers call it oropharyngeal cancer or base of tongue cancer.

This condition is rare overall, making up less than 1% of new diagnoses in the United States. But it’s one of the most common types of head and neck cancers. It’s twice as common in males. It’s also more common in people age 40 and over.

Symptoms of tongue cancer

Signs of tongue cancer aren’t always apparent. What cancer looks like depends on the location of the tumor and how far the disease has progressed.

The most common symptoms you can see include:

• Red or white patches on your tongue
• A lump on the side of your tongue that bleeds easily
• A red or grayish ulcer on your tongue that doesn’t go away

Additional tongue cancer symptoms may include:

• Thickening of the skin in your mouth
• A long-lasting sore throat or hoarseness
• Pain in your ears or neck
• Feeling like there’s something stuck in your throat
• A burning sensation or numbness in your tongue
• Difficulty or pain chewing or swallowing
• Jaw swelling
• Loose teeth or sudden changes in the way your dentures fit

Tongue cancer causes

This disease occurs when abnormal cells grow out of control. But experts are still learning why some people get tongue cancer and others don’t — and why these cells grow out of control in the first place. Many researchers believe that DNA changes (mutations) that affect your tongue can cause tongue cancer.

Risk factors

Experts have found several risk factors for tongue cancer. A risk factor is something that increases your chances of getting a certain condition. The two biggest risk factors include heavy smoking and high alcohol consumption (alcohol use disorder). Your risk goes up drastically if both pertain to you.

Other tongue cancer risk factors include:

• A history of HPV (human papillomavirus), a leading cause of base of tongue cancer (less commonly, it can cause oral tongue cancer)
• Chewing tobacco or betel nut
• Biological family history of oral or oropharyngeal cancers
• Personal history of cancer (especially squamous cell carcinoma)

How doctors diagnose this condition

Dentists are often the first to detect tongue cancer during routine exams or oral cancer screenings. Or your primary care physician (PCP) may notice signs during an exam for another condition.

To gather more information, your provider may:

• Shine a light into your mouth to look for abnormal tissue
• Use an endoscope (a thin, flexible tube with a camera and light) to look at your mouth and throat
• Check for swollen lymph nodes

If a healthcare provider sees signs of tongue cancer, they’ll recommend a biopsy. During this procedure, they’ll take a small sample of affected tissue and test it for cancer cells.

Your provider may also order imaging tests like:

• CT scans
• MRIs
• PET scans

How is tongue cancer treated?

Treatments depend on a few factors. These include the size and location of the tumor, as well as how far the cancer cells have spread. Tongue cancer treatments include:

• Tongue cancer surgery: This usually includes removing all or part of your tongue (glossectomy). Your surgeon may remove lymph nodes in your neck to reduce the risk of the cancer spreading.
• Radiation therapy: Most often, healthcare providers use radiation therapy after surgery to kill any remaining cancer cells. Sometimes, they use it before surgery to shrink a tumor. Or they may use it as a stand-alone treatment, especially if cancer has already spread to other areas.
• Drug therapies: These may include chemotherapy, immunotherapy and targeted therapy.

When should I see my healthcare provider?

Schedule an appointment with your provider any time you notice a new lump, bump, spot, ulcer or discoloration on your tongue. This is especially the case if symptoms last for more than two weeks.

Also, visit your dentist regularly for cleanings and checkups. For most people, that means every six months. But your dentist will tell you how often you should come in based on your needs. If there’s something suspicious going on, they’re likely to detect it during a routine appointment.

What’s the outlook for people with tongue cancer?

This condition can be curable with early diagnosis and treatment. That’s why it’s so important to tell your healthcare provider if you develop any new lumps, spots or sores on your tongue that don’t go away.

Speech therapy and reconstructive surgery can help you redevelop language skills and swallowing function after tongue cancer surgery.

Tongue cancer survival rate

The survival rate depends on whether the cancer has spread to other areas.

Survival rates compare people who have a certain type and stage of cancer to those in the general population. For instance, if the five-year survival rate for a particular type of cancer is 93%, that means that 93% of people with that type and stage of cancer will still be alive five years after their diagnoses.

Keep in mind that survival rates are estimates. They can’t tell you how long you’ll live or which treatments will work best in your situation. To learn more about what survival rates mean for you, talk to your healthcare provider.

Can tongue cancer be prevented?

You can’t prevent tongue cancer altogether. But there are things you can do to significantly reduce your risk:

• Avoid tobacco and alcohol. The best way to prevent tongue cancer is to avoid tobacco and alcohol, as they’re the most significant risk factors. But stopping after many years of use can still greatly lower your risk for all types of oral and oropharyngeal cancers.
• Get the HPV vaccine. HPV is a leading cause of oropharyngeal cancers. It’s common and rarely causes symptoms. The HPV vaccine protects against tongue cancer and other cancers linked to HPV, including cancers of the cervix, penis, vagina, vulva and anus.
• Eat plenty of fruits, vegetables and whole grains. Try to get your nutrition from fresh, unprocessed foods and limit your intake of red meat, sugary drinks and highly processed foods. Ask your healthcare provider about a nutrition plan that works for you.
• Visit your dentist regularly. Your dentist can do routine oral cancer screenings during these appointments.