Your mouth is more than just a tool for speaking and eating—it’s a window to your overall health. But what if a subtle, persistent symptom in your mouth turns out to be something more serious?
Tongue cancer, often overlooked, is among the most common types of oral cancer. Early detection is crucial for successful treatment, yet many people are unaware of the warning signs or how to identify them.
In this guide, we’ll delve into what tongue cancer is, how to recognize its symptoms, what it looks like, and effective ways to reduce your risk.
For more detailed information on oral cancers, refer to our comprehensive oral cancer guide.
What is tongue cancer?
Tongue cancer refers to the abnormal growth of cells in the tongue, forming a cancerous tumor. As a type of oral cancer, it develops when cells grow uncontrollably, creating a mass that can invade surrounding tissues and spread to other parts of the body.
Most tongue cancers are squamous cell carcinoma (SCC), which originates in the flat cells lining the tongue and mouth. SCC accounts for approximately 90% of all oral cancers, making it the most prevalent type of tongue cancer. When it affects the tongue, it typically involves the epithelial cells of the mucous membrane in the mouth.
Types of Tongue Cancer
Tongue cancer is categorized into two primary types based on the tumor’s location:
Oral Tongue Cancer (Anterior Tongue Cancer)
This type occurs on the visible front part of the tongue and is easier to detect during routine dental or medical check-ups. Common risk factors include smoking, heavy alcohol consumption, and poor oral hygiene.
Symptoms:
- A sore or ulcer on the front of the tongue that doesn’t heal.
- Pain while eating or swallowing.
- A noticeable lump in the mouth.
Base of Tongue Cancer (Posterior Tongue Cancer)
This type develops at the back of the tongue, often requiring medical imaging or thorough examination for detection. It is frequently associated with human papillomavirus (HPV) infections, particularly in individuals with HPV-related throat cancers.
Symptoms:
- Difficulty swallowing.
- A sensation of something stuck in the throat.
- A persistent sore throat.
- Changes in voice.
Due to its location, base of tongue cancer symptoms may be mistaken for other conditions, complicating early diagnosis.
What does tongue cancer look like?
Tongue cancer can present various signs depending on its location and stage of progression. Recognizing these early indicators is crucial for seeking timely medical attention.
- Red or White Patches: Abnormal cell growth can manifest as red (erythroplakia) or white patches (leukoplakia) on the tongue. These patches are often painless in the early stages but may indicate pre-cancerous or cancerous changes.
- Sores or Ulcers: Persistent sores or ulcers that last longer than two weeks are common warning signs. These may bleed, cause discomfort, or remain painless, depending on their location and severity.
- Lumps: Hard or swollen lumps can develop on the sides or underside of the tongue. These lumps are usually firm to the touch and may be visible or detectable through gentle examination.
- Irregular Lesions: Raised, uneven growths with rough or irregular surfaces may appear anywhere on the tongue. They are more commonly found on the sides or underside.
- Texture Changes: The affected area may feel thick, hard, or rough as the tumor progresses. These changes in texture are often a sign of advanced growth.
What are the symptoms of tongue cancer?
Tongue cancer symptoms can vary depending on the tumor’s location and stage of progression. Early detection is challenging because some signs may be subtle or resemble less serious conditions.
Common Visible Symptoms:
- Red or White Patches: Abnormal patches on the tongue, which may indicate pre-cancerous or cancerous changes.
- Persistent Ulcers: Red or gray sores that do not heal and may bleed easily.
- Lump on the Tongue: A firm, noticeable mass on the side or underside of the tongue.
Other Symptoms to Watch For:
- Thickened or hardened skin in the mouth.
- A sore throat that doesn’t go away.
- Pain in the neck or ears.
- A persistent sensation of something stuck in the throat.
- Numbness in the tongue or mouth.
- A burning sensation on the tongue.
- Difficulty or pain when chewing or swallowing.
- Changes in voice or persistent hoarseness.
- Swelling of the jaw or loose teeth.
- Sudden discomfort or changes in how dentures fit.
Tongue Cancer Causes and Risk Factors
The exact cause of tongue cancer remains unknown, but certain behaviours, conditions, and demographics are associated with an increased risk.
Lifestyle and Behavioural Risks:
- Smoking or Chewing Tobacco: A leading contributor to oral cancers, including tongue cancer.
- Heavy Alcohol Consumption: Drinking excessively increases the risk, especially when combined with tobacco use.
- HPV Infection: Human papillomavirus, a common sexually transmitted infection, is strongly linked to tongue and throat cancers.
- Chewing Betel: A habit prevalent in South and Southeast Asia, linked to a higher risk of oral cancers.
Genetic and Health-Related Factors:
- Family History: A history of tongue, mouth, or squamous cell cancers can elevate risk.
- Personal Cancer History: A prior diagnosis of squamous cell cancers increases susceptibility.
- Genetic Mutations: Certain inherited genetic factors may play a role in tongue cancer development.
Demographic and Physical Risks:
- Age: Risk increases significantly after age 50.
- Gender: Men are approximately twice as likely to develop tongue cancer compared to women.
- Diet: A diet lacking fruits and vegetables can increase vulnerability to oral cancers.
- Poor Oral Hygiene: Neglected dental care or ill-fitting prosthetics can trap harmful substances, exacerbating exposure to carcinogens.
How is tongue cancer diagnosed?
Diagnosing tongue cancer involves a combination of physical examinations, biopsies, and imaging tests to confirm the presence of cancer cells and determine if the disease has spread.
Initial Examination
If a physical exam suggests signs of tongue cancer, further diagnostic steps are taken:
- ENT Specialist Evaluation: An ear, nose, and throat (ENT) doctor examines your head and neck for swollen lymph nodes or lumps on the tongue.
- Endoscopic Examination: A small, flexible tube with a camera (endoscope) may be used to view hard-to-reach areas, such as the back of your tongue.
Additional Checks
- Panendoscopy: If there’s a history of heavy smoking or drinking, doctors might use an endoscope to examine the lungs and esophagus, as tongue cancer can coexist with cancers in these areas.
Biopsy
A biopsy is necessary to confirm the presence of cancer cells.
- Procedure: Depending on the location of the suspicious area, the biopsy may be performed in the doctor’s office or during surgery.
- Pathology Analysis: A pathologist examines the tissue sample under a microscope to check for cancer cells and HPV infection.
Imaging Tests
If cancer is confirmed, imaging tests help determine its spread and stage:
- Chest X-Ray: To check for metastasis to the lungs.
- Ultrasound: Used to examine nearby lymph nodes.
- Barium Swallow: Helps detect abnormalities in the esophagus.
- Computed Tomography (CT): Provides detailed images of the tongue and surrounding tissues.
- Magnetic Resonance Imaging (MRI): Offers high-resolution images of soft tissues.
- Bone Scan: Identifies cancer spread to the bones.
- Positron-Emission Tomography (PET Scan): Detects cancer activity throughout the body.
Treatment Options for Tongue Cancer
Treatment for tongue cancer is tailored to the cancer’s stage, location, and the patient’s overall health. Below are the primary treatment approaches:
Surgery
Surgery involves removing the cancerous tissue from the tongue. In a glossectomy, part or all of the tongue may be removed depending on the tumor’s size. Surgeons may also remove nearby lymph nodes if the cancer has spread.
Following surgery, physical therapy is often required to help patients regain the ability to speak and swallow.
Reconstructive Surgery
Reconstructive surgery restores areas of the mouth or face that were removed during cancer treatment. Surgeons typically use healthy tissue or bone from other parts of the body to rebuild the affected areas, improving both function and appearance.
Radiation Therapy
Radiation therapy uses high-energy beams, such as X-rays or protons, to precisely target and destroy cancer cells. This approach is often combined with other treatments to maximize effectiveness.
Chemotherapy
Chemotherapy uses medication to slow the growth of cancer or eliminate remaining cancer cells after surgery. It is frequently combined with radiation therapy, especially for advanced cases.
Targeted Therapy
Targeted therapy focuses on disrupting specific proteins or chemicals within cancer cells to halt their growth. This treatment is particularly useful for cancers that have recurred or spread.
Immunotherapy
Immunotherapy enhances the immune system’s ability to detect and destroy cancer cells. It is typically recommended for advanced cases where other treatments have proven ineffective.
How can tongue cancer be prevented?
Taking proactive steps to reduce your risk of tongue cancer is essential for maintaining oral and overall health. Here are effective prevention strategies:
Quit Tobacco and Limit Alcohol Consumption
Smoking, chewing tobacco, and excessive alcohol use are major risk factors for tongue cancer. Quitting these habits can significantly lower your risk. Seek support through nicotine replacement tools, therapy, or support groups like Alcoholics Anonymous to make sustainable changes.
Get Vaccinated Against HPV
The human papillomavirus (HPV) is linked to an increased risk of tongue and other oral cancers. HPV vaccines are available for individuals aged 9 to 45 and are a proven preventive measure.
Adopt a Healthy Lifestyle
A diet rich in fruits and vegetables provides essential nutrients that may lower your risk of oral cancers. Avoid sun exposure and tanning beds, which can contribute to skin and oral cancers.
Maintain Good Oral Hygiene
Regular dental visits are crucial for detecting early signs of oral cancers. Replace ill-fitting dentures that could cause irritation or trap harmful substances like alcohol and nicotine against your gums and teeth.
Stay Informed and Proactive
Know your risk factors and pay attention to persistent symptoms. Early detection through regular dental screenings and self-examinations can significantly improve outcomes.
When to consult a healthcare professional
Early detection is crucial for successfully treating tongue cancer. If you notice any of the following symptoms, it’s essential to consult a healthcare professional immediately:
Persistent Sores or Pain
Sores or ulcers on the tongue that don’t heal within two weeks or bleed easily may indicate a serious issue, such as tongue cancer. Even if they’re painless initially, persistent oral lesions require evaluation by a dentist or doctor.
Trouble Swallowing or Speaking
Difficulty swallowing (dysphagia) or speaking (dysphonia) could suggest cancer affecting the tongue or surrounding areas. If these symptoms worsen over time, they may signal cancer progression.
Unexplained Changes in Your Mouth
Be alert for lumps, swelling, or changes in the color or texture of your tongue. Additional warning signs include a persistent sore throat, numbness in the tongue, or a lump under the jaw, which could indicate cancer spread to nearby lymph nodes.
The Importance of Early Detection
Detecting tongue cancer early significantly improves treatment outcomes. Early-stage treatments are often less invasive and more effective, whereas delayed diagnosis may require aggressive interventions, such as surgery or chemotherapy.
Regular self-examinations and dental check-ups are vital for identifying early warning signs. If you notice any persistent or unexplained changes in your mouth, seek medical advice promptly to ensure the best possible outcome.
Advancements in Tongue Cancer Treatment
Recent advancements in tongue cancer treatment offer new possibilities for less invasive and more effective therapies. As research progresses, doctors are finding innovative methods to treat and manage tongue cancer, resulting in better outcomes and an improved quality of life for patients.
Below are some of the most promising developments:
Robotic Surgery
Robotic-assisted surgery has transformed the treatment of oral cancers, including tongue cancer. This advanced technique allows for precise removal of cancerous tissue through small incisions, reducing recovery time and minimizing complications. It is particularly beneficial for tumors located in hard-to-reach areas of the tongue or mouth.
Personalized Radiation Therapy
Innovations in radiation therapy now allow for highly personalized treatment plans. Techniques such as intensity-modulated radiation therapy (IMRT) ensure accurate targeting of tumors while sparing healthy tissues. This approach reduces side effects, such as dry mouth and difficulty swallowing.
Researchers are also exploring how combining radiation with treatments like immunotherapy can enhance success rates.
3D Printing for Surgical Planning and Reconstruction
The use of 3D printing in tongue cancer treatment has revolutionized surgical planning and reconstruction. Detailed 3D models of a patient’s mouth and tongue enable surgeons to plan procedures with greater accuracy, improving tumor removal and post-surgical reconstruction.
Additionally, 3D-printed implants and prosthetics help patients regain functionality and appearance after treatment.
Conclusion
Tongue cancer is a serious condition, but it is highly treatable if detected early. Recognizing the signs, understanding the risks, and seeking prompt medical attention significantly improve the chances of successful treatment.
If you notice any concerning symptoms or require an oral cancer screening, don’t wait. At Enhance Dental Centre, we offer compassionate, expert care to support your oral health needs.
Regular screenings and early detection are essential in preventing severe conditions like tongue cancer. Schedule a consultation today to discuss your oral health and arrange your oral cancer screening services. Your health is our priority, and we are here to help you address any potential concerns as early as possible.
At Enhance Dental Centre, we employ the latest technologies that can sometimes detect early signs of certain cancers. Book your consultation today!
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