Tongue cancer accounts for approximately 2 to 4 percent of United States cancer diagnoses. It affects the cells on the surface of the tongue and can occur on any portion of the tongue, including in the mouth or throat. This form of cancer has long been associated with heavy alcohol use and smoking; however, an increasing number of cases are being attributed to the human papilloma virus, also known as HPV. Tongue cancers resulting from HPV tend to occur 10 to 15 years after the initial exposure to the virus and often affect individuals at an earlier age than other oral cancers. As with any cancer, early detection and treatment increase the likelihood of a favorable outcome.
Symptoms of Tongue Cancer
Tongue cancers occurring in the mouth are characterized by a painful ulcer or white lesion on the surface of the tongue. Because they are easily visible and can interfere with eating, these cancers are normally diagnosed earlier than tongue cancers that occur in the throat.
The first indication of tongue cancer affecting the throat is typically a mass on the neck indicating that the cancer has spread to the nearby lymph nodes. Other symptoms may include
- A sore throat
- Ear pain
- Difficulty swallowing
- Voice changes
- Bloody sputum
Diagnosing Tongue Cancer
Following a detailed medical history and a physical examination focused on the oral cavity, an endoscopy may be performed to allow the doctor to get a better view of the lesion and the surrounding area. This involves inserting a thin scope with an attached light into the nose. During the procedure, a sample of the suspicious tissue may be obtained for biopsy to confirm the diagnosis. Magnetic resonance imaging, computed tomography, and positron emission tomography can be useful in staging the cancer and assessing the extent to which it may have spread.
Treatment Options for Tongue Cancer
The mode of treatment depends on the type and position of the tumor. If detected early, one mode of treatment may be sufficient. Multiple types of treatments may be required for advanced cancers.
Surgery is highly effective for early-stage tumors in the mouth. In many cases, it is also necessary to remove lymph nodes from the neck. Depending on the size of the tumor, the surgery may also involve reconstructing a portion of the tongue.
Radiation may be used as an adjunct treatment to surgery to treat small tumors in the mouth. It can also be used in combination with chemotherapy to treat large tongue cancers in the mouth and cancers affecting the throat or base of the tongue that are more difficult to reach surgically. The purpose of radiation therapy is to prevent the abnormal cancer cells from multiplying.
Chemotherapy can slow the growth of cancer cells and may help make the tumor more receptive to radiation therapy.
Several potent drugs are available that attack cancer cells at the molecular level. These medications are most often used in combination with radiation or chemotherapy to treat cancers that recur or that have not been responsive to standard therapies alone.