Tongue Cancer

Several types of cancer grow in the tongue but squamous cell carcinoma is the most common. Squamous cells are thin, flat cells that line the mouth and other organs.

There are two types of tongue cancer: 

  • Cancer of the oral tongue. The front two-thirds of the tongue that you can "stick out" is called the oral tongue. 
  • Cancer of the base of the tongue. The base is the back one-third of the tongue that extends down the throat.
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Symptoms

Oral Tongue Cancer

  • A lump on the side of the tongue that touches the teeth (lateral side)
  • The lump often looks like an ulcer and is grayish-pink to red in color
  • The lump bleeds easily if bitten or touched

Base of the Tongue Cancer

  • The tumor is often difficult to see in the early stages so it is usually diagnosed when it is larger
  • There are few symptoms in the early stages
  • In later stages, the cancer may cause pain, a sense of fullness in the throat, difficulty swallowing, the feeling of a lump in the neck or throat, voice changes or ear pain

Causes and Risk Factors

Some people develop cancer of the tongue with no risk factors. The cancer is more common in older age groups, age 40 and up, although it may be found in young people. It is twice as common in men. Other risk factors are:

  • Smoking and drinking alcohol. Smokers are five times more likely to develop tongue cancer than nonsmokers.
  • Human papillomavirus (HPV), a sexually transmitted disease. HPV 16 and HPV 18 increase the risk of tongue cancer
  • African-American men are at greater risk than Caucasians
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Diagnosis

To make a diagnosis, the doctor will take a medical history and ask specific questions about symptoms. A patient's tongue and neck will be examined and a small, long-handed mirror will be used to look down the throat.

Several tests are used to aid in the diagnosis. These tests include:

  • X-rays of the mouth and throat, including CAT (computed tomography) scans (X-rays that show images in thin sections)
  • PET scans (positron emission tomography) which uses radioactive materials to identify excessive activity in an organ. This may indicate the tumor is growing
  • Biopsy, a small sample of tissue that is removed from a tumor to diagnose cancer. Tongue cancer usually requires a biopsy. After the surgeon removes the tissue, a pathologist will examine the cells under a microscope. There are different methods to obtain a biopsy:
    • Fine Need Aspiration (FNA) biopsy. A thin needle is inserted into the tumor mass and a sample is aspirated (drawn out by suction) into a syringe.
    • Incisional biopsy. A sample is removed with a scalpel (surgical knife)
    • Punch biopsy. A small circular blade removes a round area of tissue