Tongue Cancer

What is tongue cancer?

Tongue cancer occurs when cells on your tongue start to grow and divide uncontrollably. Your tongue starts at your hyoid bone (located where your chin meets your neck) and ends at the floor of your mouth.

When cancer affects the front part of your tongue (the part you can see), healthcare providers call it oral cancer or oral tongue cancer. If you develop cancer on the back portion of your tongue (the part you can’t see), providers call it oropharyngeal cancer or base of tongue cancer.

Types of tongue cancer

Several types of cancer can affect your tongue, but the most common is squamous cell carcinoma (SCC). Squamous cell carcinoma starts in the squamous cells in the outer layer of your skin. Typically, SCC affects the parts of your body most often exposed to the sun. But it can also affect mucous membranes like the inside of your mouth.

How common is tongue cancer?

Tongue cancer is rare overall, making up less than 1% of new diagnoses in the United States. But it’s one of the most common types of head and neck cancers.

Tongue cancer is twice as common in people assigned male at birth (AMAB). It’s also more common in people age 40 and over.

What are the symptoms of tongue cancer?

First, it’s important to note that signs of tongue cancer aren’t always apparent. What cancer looks like and whether you can “see” it depends on the location of the tumor and how far the disease has progressed.

The most common visual tongue cancer symptoms include:

• Red (erythroplakia) or white (leukoplakia) patches on your tongue.
• A lump on the side of your tongue that bleeds easily.
• A red or grayish ulcer on your tongue that doesn’t go away.

Additional tongue cancer symptoms may include:

• Thickening of the skin in your mouth.
• A sore throat that doesn’t go away (chronic pharyngitis).
• Neck pain.
• Ear pain.
• Feeling like there’s something stuck in your throat.
• Numbness in your tongue or other areas of your mouth.
• A burning sensation on your tongue.
• Difficulty or pain chewing.
• Difficulty or pain swallowing.
• Hoarseness.
• Jaw swelling.
• Loose teeth.
• Sudden changes in the way your dentures fit.

What causes tongue cancer?

Experts know that tongue cancer occurs when abnormal cells grow out of control. But they’re still learning why some people get tongue cancer and others don’t — and why these cells grow out of control in the first place. Many researchers believe that DNA mutations (changes) that affect your tongue can cause tongue cancer.

What are the risk factors?

Experts have identified several risk factors for tongue cancer. A risk factor is something that increases your chances of getting a certain condition. The two most significant risk factors include heavy smoking and high alcohol consumption (alcohol use disorder). Your risk goes up drastically if both pertain to you.

Other tongue cancer risk factors include:

• HPV (human papillomavirus). A history of HPV is a leading cause of base of tongue cancer. Less commonly, it can cause oral tongue cancer.
• Chewing tobacco.
• Betel nut.
• Family history of oral or oropharyngeal cancers.
• Personal history of cancer (especially squamous cell carcinoma).

How is tongue cancer diagnosed?

Dentists are often the first to detect tongue cancer during routine exams or oral cancer screenings. Or your primary care physician (PCP) may notice signs during an exam for another condition.

To gather more information, your provider may:

• Shine a fluorescent light into your mouth to see if it reveals any abnormal tissue.
• Use an endoscope (a thin, flexible tube with a camera and light) to look at your mouth and throat.
• Check for swollen lymph nodes.

If a healthcare provider sees visual signs of tongue cancer, they’ll recommend a biopsy. During this procedure, they’ll take a small sample of affected tissue. They’ll send it to a lab, where a pathologist will examine the tissue and look for cancer cells.

Your provider may also order imaging tests like:

• CT (computed tomography) scans.
• MRI (magnetic resonance imaging) scans.
• PET (positron emission tomography) scans.

How is tongue cancer treated?

Tongue cancer treatments depend on a few factors, including the size and location of the tumor and how far the cancer cells have spread. Tongue cancer treatments include:

• Tongue cancer surgery. This usually includes glossectomy (partial or total tongue removal) and, in some cases, neck dissection (lymph node removal) to reduce the risk of metastasis (when cancer spreads from the primary tumor site to another area of your body).
• Radiation therapy. Healthcare providers might use radiation therapy before surgery to shrink a tumor or, more commonly, after surgery to kill any remaining cancer cells. In some cases, oncologists use it as a stand-alone treatment, especially if cancer has already spread to other areas.
• Drug therapies. These may include chemotherapy, immunotherapy and targeted therapy.

Can I prevent tongue cancer?

You can’t prevent tongue cancer altogether. But there are things you can do to significantly reduce your risk:

• Avoid tobacco and alcohol. The best way to prevent tongue cancer is to avoid tobacco and alcohol, as they’re the two most significant risk factors. But stopping after many years of use can still greatly lower your risk for all types of oral and oropharyngeal cancers.
• Get the HPV vaccine. HPV is a leading cause of oropharyngeal cancers. It’s common and it rarely causes symptoms. The HPV vaccine protects against tongue cancer and other cancers linked to HPV, including cancers of the cervix, penis, vagina, vulva and anus.
• Eat plenty of fruits, vegetables and whole grains. Try to get your nutrition from fresh, unprocessed foods and limit your intake of red meat, sugary drinks and highly processed foods. Ask your healthcare provider about a nutrition plan that works for you.
• Visit your dentist regularly. Your dentist can do routine oral cancer screenings during these appointments. In addition, good oral health promotes whole-body health and well-being.

What’s the outlook for people with tongue cancer?

Tongue cancer can be curable with early diagnosis and treatment. That’s why it’s so important to tell your healthcare provider if you develop any new lumps, spots on your tongue or sores that don’t go away.

Speech therapy and reconstructive surgery can help you redevelop language skills and swallowing function after tongue cancer surgery.

Tongue cancer survival rate

The survival rate for tongue cancer depends on whether the cancer has spread to other areas.

Survival rates compare people who have a certain type and stage of cancer to those in the general population. For instance, if the five-year survival rate for a particular type of cancer is 93%, that means that 93% of people with that type and stage of cancer will still be alive five years after their diagnosis.

Keep in mind that survival rates are estimates. They can’t tell you how long you’ll live, or which treatments will work best in your situation. To learn more about survival rates and what they mean for you, talk to your healthcare provider.

When should I see my healthcare provider?

Schedule an appointment with your healthcare provider any time you notice a new lump, bump, spot, ulcer or discoloration on your tongue, especially if symptoms linger for more than two weeks.

In addition, be sure to visit your dentist regularly for cleanings and checkups. For most people, that means every six months. But your dentist will tell you how often you should come in based on your specific needs. If there’s something suspicious going on, they’re likely to detect it during a routine appointment.

What questions should I ask my healthcare provider?

If you received a tongue cancer diagnosis, here are some questions you may want to ask your healthcare provider:

• Do you know what caused the tumor?
• Has the cancer spread? If so, how far?
• What are my next steps?
• What kind of treatment do I need?
• How long will treatment take?
• Should I plan to take time off work or school?
• When will I know if treatment is working?

A note from Cleveland Clinic

Hearing that you or a loved one has tongue cancer can feel scary, hopeless or even devastating. Your healthcare provider is here to help. They can discuss treatment options with you and find resources to offer support every step of the way. Early detection and treatment are key. So, if you notice a new spot or lump on your tongue — or anything else that seems suspicious — tell your healthcare provider.