Tongue cancer - Symptoms and causes (2024)

Overview

Tongue cancer is a type of cancer that starts as a growth of cells on the tongue. The tongue begins in the throat and extends into the mouth. It's made up of muscles and nerves that help with movement and function, such as taste. The tongue aids in speaking, eating and swallowing.

Tongue cancer that starts in the mouth is different from tongue cancer that starts in the throat.

• In the mouth, tongue cancer is called oral tongue cancer. Tongue cancer in the mouth can cause symptoms right away. A doctor, dentist or other member of your health care team might notice it first because this part of the tongue is easily seen and examined.
• In the throat, tongue cancer is called oropharyngeal tongue cancer. It may grow for a while before it causes symptoms. When symptoms happen, they tend to be symptoms that have many possible causes. If you have a sore throat or ear pain, your health care team might first check for causes other than cancer. Cancer at the back of the tongue is hard to see and examine. For these reasons, the cancer often isn't diagnosed right away. It's often found after the cancer cells have spread to the lymph nodes in the neck.

Several types of cancer can affect the tongue. Tongue cancer most often begins in the thin, flat cells that line the surface of the tongue, called squamous cells. Tongue cancer that starts in these cells is called squamous cell carcinoma.

Your health care team considers the type of cancer cells when making a treatment plan. The team also considers the location and size of the cancer. Tongue cancer treatment typically involves surgery and radiation therapy. Other options might be chemotherapy and targeted therapy.

Symptoms

Tongue cancer might not cause symptoms at first. Sometimes it's found by a doctor or dentist who examines the mouth for signs of cancer as part of a checkup.

When tongue cancer happens in the mouth, the first sign is often a sore on the tongue that doesn't heal. Other symptoms may include pain or bleeding in the mouth and a lump or thickening on the tongue.

When tongue cancer happens in the throat, the first sign can be swollen lymph nodes in the neck. Other symptoms may include coughing up blood, weight loss and ear pain. There also may be a lump in the back of the mouth, throat or neck.

Other tongue cancer symptoms may include:

• A red or white patch on the tongue or lining of the mouth.
• A sore throat that doesn't go away.
• A feeling that something is caught in the throat.
• Numbness of the mouth or tongue.
• Difficulty or pain with chewing, swallowing, or moving the jaws or tongue.
• Swelling of the jaw.
• A change in voice.

When to see a doctor

Make an appointment with a doctor, dentist or other health care professional if you have any symptoms that worry you.

Causes

Tongue cancer starts when healthy cells in the tongue develop changes in their DNA. A cell's DNA contains the instructions that tell the cell what to do. The changes tell the cells to grow out of control and to continue living when healthy cells would die as part of their natural life cycle. This makes a lot of extra cells. The cells can form a growth, called a tumor. In time, the cells can break away and spread to other areas of the body.

It's not always clear what causes the changes that lead to tongue cancer. For some tongue cancers that happen in the throat, human papillomavirus, also called HPV, can be involved. HPV is a common virus that's transmitted through sexual contact. Tongue cancer in the throat that's caused by HPV tends to respond better to treatment compared with tongue cancer in the throat that's not related to HPV.

Risk factors

The most common factors that can increase the risk of tongue cancer include:

• Tobacco use. Tobacco is the single largest risk factor for tongue cancer. All forms of tobacco, including cigarettes, cigars, pipes, chewing tobacco and snuff, increase the risk.
• Consuming alcohol. Frequent and heavy drinking increases the risk of tongue cancer. Using alcohol and tobacco together increases the risk even more.
• Being exposed to HPV. In recent years, tongue cancer in the throat has become more common in those exposed to specific types of HPV.

Other factors may include:

• Being male. Men are more likely to develop tongue cancer than women. This may be from higher rates of tobacco and alcohol use in men.
• Increasing age. People older than 45 have an increased risk of tongue cancer. This is typically from years of tobacco and alcohol use.
• Trouble maintaining oral hygiene. Lack of dental care can contribute to tongue cancer. The risk is even higher in those who use alcohol and tobacco.
• Having a weak immune system. This can happen if you take medicine to control the immune system, such as after an organ transplant. It also can be caused by illness, such as infection with HIV.

Prevention

You can reduce your risk of tongue cancer by:

• Don't use tobacco. If you don't use tobacco, don't start. If you currently use tobacco of any kind, talk with your health care team about strategies to help you quit.
• Limit alcohol intake. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men.
• Consider the HPV vaccine. Receiving a vaccination to prevent HPV infection may reduce your risk of HPV-related cancers, such as tongue cancer. Ask your health care team whether an HPV vaccine is appropriate for you.
• Have regular health and dental exams. During your appointments, your dentist, doctor or other member of your health care team can check your mouth for signs of cancer and precancerous changes.

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