What is Cancer of the Tongue?

Find Out When to Call Your Doctor

Squamous cell carcinoma of the tongue (Magnification x400)
Squamous cell carcinoma of the tongue (Magnification x400). Garry DeLong/Oxford Scientific/Getty Images

Broadly speaking, cancer of the tongue is classified as either 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 originates in this portion of the tongue, it's usually called oral cancer.

The bottom third portion 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 directly visualize the base of your own tongue.   

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. The vast majority of tongue cancer is squamous cell carcinoma, although there are other, rare, types of tongue cancer; they are named after the tissue or structure(s) from which they originate.

What Causes Cancer of the Tongue?

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:

At least one study has shown that chronic periodontitis (inflammation of the gum tissues that support your teeth) increases the risk for tongue cancer in men.

However, more research is needed to confirm this finding.

Symptoms of Tongue Cancer

Symptoms of tongue cancer can include:

  • Difficulty swallowing
  • 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.

Diagnosing Cancer of the Tongue

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

Treating Cancer of the Tongue

There are 3 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.

The three kinds of treatment used for tongue cancer are:

  • Surgery: removal of the cancerous tumor and 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)

A Note About Human Papillomavirus (HPV)

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. 

An HPV infection doesn't always become cancerous, however.

Prognosis of Cancer of the Tongue

If you are diagnosed with tongue cancer, your doctor 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 succumb to theirs. A prognosis is only an "educated guess" based on information about patients with illnesses similar to yours. It does not necessarily predict what your own experience will be.

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 doctor as soon as possible. For more specific information on the prognosis of tongue cancer, visit the American Cancer Society.

Sources:

Tezal M, Sullivan MA, Reid ME, et al. Chronic periodontitis and the risk of tongue cancer. Arch Otolaryngol Head Neck Surg. 2007;133(5):450-454.

 “Oral cavity and oral pharyngeal cancer. “  The American Cancer Society (2016).

“Genital HPV Infection - Fact Sheet.” Centers for Disease Control and Prevention (2016).

Najjar T. “Malignant tumors of the base of tongue.”  eMedicine.Medscape.Com (2015).  

Continue Reading