Tongue cancer is a disease in which cancer cells grow in the tongue. This type of cancer develops from malignant squamous cells, which tend to spread rapidly.

Cancer occurs when cells in the body (in this case, tongue cells) divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer refers to malignant tumors, which can invade nearby tissues and can spread to other parts of the body. A benign tumor usually does not invade or spread.

Tongue cancer is often grouped with other mouth cancers, such as cancer of the lips, hard palate, cheek lining, floor of the mouth (portion of the mouth underneath the front of the tongue), or gums. These cancers are collectively known as oral cavity cancer.

Causes

The exact cause of tongue cancer is unknown. However, the following lifestyle factors may be related:

• Smoking cigarettes, cigars, or a pipe

• Use of chewing tobacco, snuff, or other tobacco products

• Heavy alcohol consumption

Risk Factors

A risk factor is something that increases your chances of getting a disease or condition.

Risk factors include:

• Sex: Male

• Poor oral and dental hygiene

• Age: 40 and over

• Irritation of the mucous membranes in the mouth due to smoking and drinking

• History of mouth ulcers

• Family history due to genetic predisposition

Symptoms

Symptoms of tongue cancer may include:

• Skin lesion, lump, or ulcer on the tongue

• Difficulty swallowing

• Mouth sores and mouth pain

• Numbness or difficulty moving the tongue

• Change in speech (due to inability to move the tongue over the teeth when speaking)

• Pain with chewing and speaking

• Bleeding from the tongue

Diagnosis

Tongue cancer may be detected by your dentist during a routine dental cleaning, or by your doctor during a routine physical exam.

To confirm the diagnosis, your doctor will ask about your symptoms and medical history, and perform a physical exam. This may include:

• Examination of your tongue for lumps or masses

• Use of a fiberoptic scope—a thin tube with a tiny camera—to examine the base of the tongue

• A tongue biopsy–removal of a sample of tongue tissue to test for cancer cells

• CT scan–a type of x-ray that uses a computer to make pictures of the mouth

• Chest x-ray to determine if the cancer has spread to the lungs

Treatment

Once tongue cancer is found, staging tests are performed to find out if the cancer has spread and, if so, to what extent. Treatment depends on the stage of the cancer, as well as the size and location of the tumor. Treatment may include:

Surgery–surgical removal of the cancerous tumor and nearby tissues, and possibly nearby lymph nodes. This is often the preferred method of treatment when the tumor is on the visible side of the tongue, when it is quite small (less than 2 cm), and when it is lateralized to one side and does not involve the base of the tongue.

Radiation Therapy (or Radiotherapy)–the use of radiation to kill cancer cells and shrink tumors. This method is often used when the cancer is located at the back of the tongue. To cure cancer of the oral tongue with radiation, the patient must have both external beam and a brachytherapy implant. External beam therapy is not enough. Sometimes, chemotherapy is added to radiation, especially when the cancer has spread to the lymph nodes.

Chemotherapy–Chemotherapy is sometimes used in conjunction with radiation to destroy the cancerous growth, especially if surgery is not planned

Rehabilitation and Follow-up–after treatment, your doctor may recommend the following:

• Therapy to improve tongue movement, chewing, and swallowing.

• Speech therapy, if use of the tongue is affected.

• Close monitoring of your mouth, throat, esophagus, and lungs for signs of cancer recurrence or spread.

Prevention

To help prevent tongue cancer:

• Don't smoke or use tobacco products. If you do smoke or use tobacco products, get help to quit.

• Avoid heavy alcohol consumption.

• See your doctor regularly for check-ups and cancer screening exams.

RESOURCES:

American Cancer Society
http://www.cancer.org

CancerNet, National Cancer Institute
http://www.cancer.gov/cancer_information

References:

CancerNet, National Cancer Institute website. Available at: http://www.cancer.gov/cancer_information.