An Overview of Tongue Cancer

Cancer of the tongue makes up 2% of all cancers, but the incidence varies considerably in different parts of the world. Cancer of the tongue occurs more frequently in men than women and is rare under the age of 40.

Overview

Cancer of the tongue generally falls into one of two categories or types of cancer—oral or oropharyngeal cancer. There are two portions of the tongue. Most of it is the part that you normally see and can voluntarily move. If cancer starts in this portion of the tongue, it's usually called oral cancer.

The bottom one-third of the tongue is sometimes called the base of the tongue. It's very close to your throat (pharynx). If cancer originates in this portion of the tongue, it's usually called oropharyngeal cancer. This is the part of your tongue that is firmly attached to other tissue and therefore can't be moved voluntarily. You also can't see the base of your tongue.  

As with other types of cancer, tongue cancer is further classified by the type of tissue from which it originates. Squamous cells, for example, are long, flat, superficial cells that cover the lining of the tongue.

Cancer that arises from squamous cell tissue is called squamous cell carcinoma. Most tongue cancer is squamous cell carcinoma, although there are other, rare, types of tongue cancer, as well. They are named after the tissue or structure from which they originate.

Symptoms

Symptoms of tongue cancer include:

• Difficulty swallowing or speaking
• A feeling that there's something in your throat (a lump or a mass)
• Sore throat
• White or red patches on your tongue
• A feeling of numbness in your mouth
• Unexplained bleeding from your tongue
• Rarely, symptoms of tongue cancer can also include ear pain

You should call your healthcare provider anytime you have unexplained symptoms of tongue cancer. Make sure you visit your dentist every six months as your dentist may be the most likely individual to notice any subtle abnormalities in your mouth and on your tongue.

Causes

Cancer occurs when some of your cells begin to grow abnormally and much too quickly. Many factors can cause or increase your risk of developing cancer. Factors known to increase your risk of tongue cancer include:

• Tobacco use
• Alcohol use
• Chewing betel quid and gutka
• Human papillomavirus (HPV) infection
• Male gender
• Age
• Certain genetic forms of anemia
• A condition called graft-versus-host disease, which occurs in some patients who undergo stem cell transplants

About Human Papillomavirus

HPV is a virus that causes cervical cancer and, more rarely, other types of cancers such as tongue and tonsil cancer. The virus is spread through sexual activity, including oral sex. 

According to the Centers for Disease Control and Prevention (CDC), 50% of men and women will become infected with HPV at some point in their lives. A recent increase in head and neck cancers has been attributed to this virus.

While tongue cancer used to be rare in people under age 55, the American Cancer Society notes that oropharyngeal cancer may increase in younger populations due to HPV-linked cancers becoming more common. An HPV infection doesn't always become cancerous.

HPV vaccines are available but must be given before a young person has become sexually active. They are not yet proven to reduce the risk of mouth and throat cancers, but it is believed that they will.

Diagnosis

If you have symptoms of tongue cancer that don't go away, see your healthcare provider. If your practitioner suspects tongue cancer, he or she may order one or more tests to diagnose it.

Sometimes healthcare providers use a small, thin tube with a camera on it (called a flexible fiberoptic laryngoscope) to see into the back of the mouth and examine the lymph nodes in this area. Tissue biopsies may be necessary to confirm the diagnosis and type of tongue cancer (for example, squamous cell).

Treatment

There are three ways to treat tongue cancer and they may be used alone or in combination. People diagnosed early may need only surgical treatment, whereas those with advanced tongue cancer may need two or even all three types of treatment.

The three kinds of treatment used for tongue cancer are:

• Surgery: Removal of the cancerous tumor and the surrounding tissue
• Radiotherapy: Uses high-energy particles from radioactive elements to kill cancerous cells left behind after surgery
• Chemotherapy: Uses drugs to destroy cancerous cells and tissues (the two most common types of chemotherapy agents are cisplatin and fluorouracil)

Prognosis

If you are diagnosed with tongue cancer, your healthcare provider may give you a prognosis—an understanding of the probable course of your disease. It's important to keep in mind that some people with a very poor prognosis are able to recover from their illness, while others with a very positive prognosis may not survive.

In general, if cancer of the tongue is diagnosed at an early stage, it can be cured, but this becomes less likely the longer it is present and goes without treatment. For this reason, if you have symptoms of tongue cancer, you should see your healthcare provider as soon as possible.