Understanding Tongue Cancer: Symptoms, Causes, Diagnosis, and Treatment

Key Takeaways

  • Two distinct types exist: front-of-tongue cancer (more visible, better prognosis) and base-of-tongue cancer (near throat, often HPV-related in younger patients under 50).
  • HPV type 16 causes approximately 70% of base-of-tongue cancers and responds better to treatment than tobacco-related cases, with 5-year survival rates exceeding 85%.
  • Persistent symptoms lasting more than 2-3 weeks warrant immediate evaluation—including non-healing sores, white/red patches, unexplained tongue pain, or difficulty moving the tongue normally.
  • Surgical treatment may require partial glossectomy (tongue removal), potentially affecting speech and swallowing; speech therapy typically begins within 48-72 hours post-surgery.
  • Men are twice as likely to develop this cancer, with peak incidence between ages 55-64, though HPV-related cases increasingly affect younger adults in their 30s and 40s.

Tongue cancer is a type of oral cancer that occurs when cells in the tongue divide uncontrollably, forming a tumor. There are two main types of tongue cancer: oral tongue cancer, which affects the part of the tongue you can see, and oropharyngeal cancer, which develops at the base of the tongue near the throat. While tongue cancer is less common than many other cancers, it primarily affects older adults and is rare in children.

Symptoms of Tongue Cancer

One of the first signs of tongue cancer is a persistent white or red patch, lump, or sore on the side of the tongue. Other symptoms may include:

  • Pain in or near the tongue

  • Voice changes, such as hoarseness

  • Difficulty swallowing, chewing, or moving the jaw or tongue

  • Numbness in the tongue or mouth

  • Jaw swelling

  • Persistent sore throat

  • Feeling like something is caught in the throat

  • Swollen lymph nodes in the neck

  • Coughing up blood

  • Weight loss

  • Ear pain

  • Bleeding in the mouth

  • A lump in the back of the mouth, throat, or neck

If you experience a sore on your tongue or in your mouth that doesn't heal within a couple of weeks, consult your doctor. Tongue cancer at the base of the tongue may not present noticeable symptoms, but your dentist or doctor may detect signs during routine checkups.

Causes of Tongue Cancer

The human papillomavirus (HPV) is a common cause of cancers at the base of the tongue. Other factors that may increase the risk of developing tongue cancer include:

  • Tobacco use

  • Alcohol consumption

  • Poor oral hygiene

  • Chewing betel (common in South and Southeast Asia)

  • Personal history of certain cancers

  • Poor diet

  • Repetitive trauma

  • Genetic factors

Tongue cancer is more common in men and people assigned male at birth, those over 45 years old, and individuals with weakened immune systems.

Diagnosing Tongue Cancer

To diagnose tongue cancer, your doctor will examine your mouth and ask about your symptoms. They may recommend various tests, such as:

  • Imaging tests (X-rays, CT, MRI, PET scans, barium swallow)

  • Biopsy (brush biopsy, incisional biopsy)

  • Endoscopy

These tests help determine the stage of the cancer, which indicates the tumor's size and whether it has spread. Staging is crucial for determining the seriousness of the cancer, survival chances, and the most effective treatment options.

Understanding Tongue Cancer: Symptoms, Causes, Diagnosis, and Treatment

Treatment Options for Tongue Cancer

Treatment for tongue cancer depends on the location and size of the tumor. Options may include:

  • Surgery (glossectomy, neck dissection)

  • Reconstructive surgery

  • Radiation therapy

  • Chemotherapy

  • Targeted therapy

  • Immunotherapy

After treatment, regular checkups are necessary to monitor for cancer recurrence. The earlier tongue cancer is diagnosed, the higher the chances of successful treatment. According to the National Cancer Institute, the 5-year relative survival rate for tongue cancer is 69.7%.

Coping with Tongue Cancer

Facing a serious illness like tongue cancer can be challenging, but there are ways to cope. Ask your doctor questions about your cancer and treatment options, and seek reliable sources of information, such as the American Cancer Society and the National Institute of Dental and Craniofacial Research. Stay connected with friends and family, involve them in your life, and accept their offers of help. Consider talking to a counselor or joining a support group for valuable support during this challenging time.

Preventing Tongue Cancer

To reduce your risk of developing tongue cancer, consider the following:

  • Get vaccinated for HPV, depending on your age and doctor's recommendation

  • Use latex condoms during sexual activity

  • Avoid tobacco use in any form

  • Don't chew betel

  • Limit alcohol consumption

  • Maintain good oral hygiene

By understanding the symptoms, causes, diagnosis, and treatment options for tongue cancer, as well as ways to cope and prevent the disease, you can be better prepared to face this serious illness. Remember, early detection and proper treatment are key to improving outcomes and quality of life.

The Bottom Line

Early detection dramatically improves outcomes, with localized cases having 5-year survival rates above 80% compared to 39% for advanced stages. Any tongue abnormality persisting beyond 2 weeks requires prompt medical evaluation since early-stage treatment often preserves normal function. If you're experiencing persistent tongue symptoms or have concerns about oral changes, Doctronic can help connect you with appropriate specialists quickly.

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