Tongue cancer is a relatively rare malignant tumor. It forms in the front two-thirds of the tongue (the movable part or “oral tongue”), or on the “base of the tongue”. The carcinoma generally develops in the thin, flat squamous cells that line the surface of the tongue. The type of cells that are involved in the cancer helps determine the treatment. The formation of tongue cancer can have different causes. The most common risk factors include smoking and excessive consumption of alcohol.
Carcinoma of the tongue might show symptoms similar to other types of oral cancer. The disease can also be mistaken for a lasting cold, or a persistent sore in the mouth.
Symptoms might be:
- Constant tongue or jaw pain (or both)
- "Foreign body feeling" in the mouth and throat
- Difficulty swallowing or chewing
- Burning feeling of the tongue and mouth
- A red or white spot on the gums, tongue, tonsil, or lining of the mouth
- Difficulty moving the tongue or jaw
- Slurred speech
- Swollen lymph nodes
- Slightly bleeding from the tongue
The earlier tongue cancer is diagnosed the better the chances of healing. Therefore, it is very important to see an otorhinolaryngologist as soon as possible if the tongue pain doesn’t subside, the tongue mobility changes (slurring of speech), or other symptoms mentioned above occur.
The exact causes of tongue cancer are unknown but the following risk factors have been identified:
Risk factors for tongue cancer
- Smoking tobacco
- Consumption of snuff and chewing tobacco
- Excessive alcohol intake
- Age: older than 40
In general, the disease occurs after the age of 40, with men affected more than women.
Tongue cancer belongs to the group of head and neck tumors, and often spreads to neighboring areas such as larynx. Especially tumors in the rear part of the tongue can cause serious tissue damage.
The physician makes a diagnosis by examining the mouth and removing a tissue sample (biopsy) of the tumor for further examination. The diagnostic procedure determines if the suspicious area is cancerous, and – if so – it provides information on the tumor's characteristics. A computed tomography (CT) or magnetic resonance imaging (MRI) clarifies whether there are metastases.
A malicious carcinoma in the oral cavity is initially eliminated by surgery. During the surgical resection of the tumor, the entire carcinoma is removed from the tongue. The doctors use minimally invasive surgical techniques whenever possible to treat this type of cancer. If the neck lymph nodes are already affected, they have to be removed as well.
If the tumor is larger, radiation therapy is required after surgery to destroy the malignant cells and prevent cell proliferation. During radiation therapy, the radiation oncologist uses a high dose with pinpoint accuracy, sparing healthy tissue and shortening procedure times.
Chemotherapy uses anticancer drugs to kill cancer cells in the entire body. It may be an option if the cancer is at a late stage and has already spread to nearby lymph nodes. In this way, the tumor grows slower and the symptoms are controled if the cancer cannot be cured (palliative treatment). Chemotherapy is also often combined with radiation therapy (“chemoradiation”), e.g. if surgery is not possible, or the patient doesn’t want the operation. Several chemotherapy drugs can be combined to attack tumor cells at varying stages of their growth cycles and diminish the chance of drug resistance.
Special drug therapy targets cancerous cells to interfere with cell growth on a molecular level. It is often combined with chemotherapy and/or radiation therapy.
It is not possible to prevent tongue cancer in general. But all those who quit smoking and abstain from excessive alcohol consumption, can reduce the risk of getting the disease. Ill-fitting dentures should also be corrected by a dentist.