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Tongue Cancer: Symptoms, Stages, Causes, Prevention and Treatment

Team AckoJan 17, 2024

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The World Health Organisation has declared India the "Oral Cancer Capital" of the world. The situation is so severe that Oral or Tongue Cancer has become an epidemic in the country. People who excessively consume alcohol and/or smoke or chew tobacco are at a higher risk of developing Tongue Cancer. Read ahead to know more about the symptoms, diagnosis, causes, treatment and prevention methods of Tongue Cancer.

Tongue

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What is Tongue Cancer?

As the name suggests, Tongue Cancer is a type of cancer that occurs in the tongue. For a very long time, Tongue Cancer has been a severe health concern. There may be different types of Tongue Cancer, but squamous cell carcinoma is the most typical variety. Squamous cells on the tongue's surface are impacted by this, leading to tumours or lesions. Early-stage Tongue Cancer is typically quite challenging to find since it develops in such a sensitive location.

Why is the tongue important for the human body?

The tongue is important for the human body due to the following reasons,

  1. Your tongue is a digestive organ that helps you chew and swallow food by moving it around your mouth. 

  2. It aids in producing various sounds, allowing for more clearly formed speech. 

  3. To ensure that you can breathe properly, your tongue aids in maintaining an open airway. 

The majority of your tongue is formed of muscles and is held inside your mouth by strong tissues and bones. It is covered by mucosa (a layer that surrounds different types of cavities in the human body). Additionally, your tongue is covered in several taste buds and papillae (bumps).

What are the symptoms of Tongue Cancer?

The fact that Tongue Cancer rarely exhibits signs in its early stages is a severe drawback. The symptoms may appear in the case of Tongue Cancer, which initially presents as a sore on the tongue and becomes severe. The following are symptoms of two types of Tongue Cancer — Base of Tongue Cancer and Oral Tongue Cancer.

Base of Tongue Cancer Oral Tongue Cancer
Having trouble moving the tongue A mouth ulcer that doesn't heal easily
Throat discomfort Numbness in the mouth
Ear pain Persistent throat pain
Having trouble swallowing Bleeding in the tongue without any injury
Red or white spots all around the mouth Bleeding in the parts of the tongue that touch the teeth
A lump in the throat, neck, or back of the mouth
Hoarse voice
Muscle pain

What are the causes of Tongue Cancer?

Even researchers are unsure of the precise causes of Tongue Cancer. However, a variety of habits/concerns/issues mentioned below (still a subject of some debate) can be potential risk factors for Tongue Cancer.

  • Excessive consumption of tobacco, especially smoking or chewing.

  • Excessive consumption of alcohol.

  • Human Papillomavirus (HPV), a Sexually Transmitted Disease.

  • Chewing betel leaf excessively.

  • A family history of mouth problems, including Tongue Cancer.

  • Medical history of cancer.

  • According to research, a poor diet (especially a lack of fruits and vegetables) may raise the incidence of all oral cancers.

  • Poor dental hygiene.

  • Tongue Cancer risk might be increased by ongoing discomfort from crooked teeth or improperly fitting dentures.

What are the different stages of Tongue Cancer?

Your doctor will eventually let you know what stage of cancer you have. Simply said, the stage indicates how far along the cancer is and how extensive it is. Knowing the stage aids doctors in describing to you the degree of cancer. Additionally, it aids them in deciding how to proceed with various forms of treatment, such as chemotherapy, radiation therapy, or surgery. Tongue Cancer staging depends upon the following factors.

  1. The size of the lesion or lump on the tongue.

  2. How much cancer has spread to surrounding lymph nodes or local tissues?

  3. Has cancer spread to other body parts?

Following your physical examination, the preliminary findings of your oral tissue biopsy, or the results of imaging testing, your doctor will assign a stage to cancer. It can also change if you undergo additional testing or have surgery. Tongue Cancer has five stages, from zero to four, with four being the most advanced. Here are the details of each stage.

Stage Progress
Stage 0 Tongue Cancer Carcinoma in situ, often known as stage 0, is the lowest point on the scale. It depicts irregular cells that have the potential to develop into cancer in the lining of the mouth or lips.
Stage 1 Tongue Cancer Cancer is said to be at its very early stages at stage 1. The disease has not spread to the lymph nodes, and the tumour is no more than 2 millimetres.
Stage 2 Tongue Cancer A stage 2 tumour has a diameter of at least 2 centimetres but not more than 4 cm. The lymph nodes have not been affected by stage II cancer.
Stage 3 Tongue Cancer This is defined as either being larger than 4 cm in size or having progressed to a neck lymph node.
Stage 4 Tongue Cancer This is the last stage of Tongue Cancer.

Cancer may have spread to the following parts in the final stage.

  1. Tissues surrounding the tongue.

  2. Jaw or inner lining of the mouth.

  3. A single, big lump on the lymph node on the same side of the neck as the tumour.

  4. Many small lumps on the lymph nodes on the same side of the neck as the tumour.

  5. One or more lumps on the lymph nodes on the side of the neck opposite to the tumour.

Please note.

  • There are high chances of Regional recurrence in stage 4. It refers to cancer returning to the area of the body where it first appeared.

  • Regional relapse, also known as distant recurrence, describes cancer returning to the lymph nodes or another body part.

  • Tumours in stages 3 and 4 are more likely to return than cancers in the early stages.

How to diagnose Tongue Cancer

Your doctor or a dedicated medical team will first gather information on your medical history before making a Tongue Cancer diagnosis.

  • They'll inquire about any personal or family history of cancer, your smoking or alcohol consumption level, and whether you've ever tested positive for the HPV virus. 

  • A medical professional will physically examine your mouth to check for any indications of cancer, for instance, open sores. They will also evaluate the adjacent lymph nodes for edema while doing so.

  • Your doctors will perform a biopsy on the suspected cancerous tissue if they notice any indications of Tongue Cancer. The most popular type of biopsy is an incisional biopsy. Your doctor will take a tiny bit of the tissue during this kind of biopsy using a local anaesthetic.

  • In another method, your doctor might perform a brush biopsy, a more recent type of biopsy. They will perform this biopsy by lightly brushing the suspected cancerous tissue. This causes slight bleeding, which enables your doctor to gather cells for analysis. 

  • Both types of biopsies will have their cells sent to a lab for testing. If you have Tongue Cancer, your doctor may order a CT scan or MRI to determine the depth and extent of the disease.

Treatment for Tongue Cancer

The following can be the treatment options for Tongue Cancer.

  • Surgery: Surgical excision may be the only treatment required for small tongue tumours. If the tumour is large, the neck's lymph nodes may have been affected by its spread. The surgeon might advise removing the neck's affected lymph nodes if this happens.

  • Radiation Therapy: Radiation therapy, especially intensity-modulated radiation therapy, inhibits the division of cancer cells and decreases tumour growth. Additionally, it can reduce or completely remove tumours and kill cancer cells. Compared to traditional radiotherapy methods, intensity-modulated radiation treatment enables the use of higher-efficacy radiation doses with fewer side effects. Patients might need daily treatments for five to six weeks.

  • Partial glossectomy: A portion of the tongue the surgeons suspect is cancerous is removed during a partial glossectomy. It is more common in big tumours. If a significant portion of the tongue is removed after this procedure, patients might need to have tongue reconstruction surgery. After a partial glossectomy, they may experience eating, breathing, and swallowing alterations. For patients to cope with this type of surgery, speech therapy may be necessary.

  • Chemotherapy: Chemotherapy is frequently used in the later stages of Tongue Cancer. It serves as an alternative to radiotherapy and surgery. Doctors can also use it to lessen the likelihood of cancer returning after surgery. Moreover, chemotherapy aids in symptom control when doctors are unable to treat cancer.

How to prevent Tongue Cancer

There are no known techniques to prevent Tongue Cancer. However, doctors have recommended proactive measures to help avoid it based on some prevalent causes.

  1. Limit smoking or chewing tobacco.

  2. Eat a healthy balanced diet that includes a variety of fruits and vegetables.

  3. Take active measures to ensure oral hygiene.

  4. Get vaccinated against HPV.

  5. Visit your dentist at least twice a year.

Frequently asked questions

Here are some questions and answers about Tongue Cancer.

The following are the common questions and their answers regarding Tongue Cancer.

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Can Tongue Cancer be cured?

When detected early, Tongue Cancer has a great chance of being cured, but if it is not identified and treated, it can be fatal. It might eventually spread to different areas of the mouth, head and neck, or even other body parts.

How painful is a tongue biopsy?

Since your tongue is delicate, even numbing medication may not make a needle biopsy comfortable. Following the biopsy, your tongue may feel slightly swollen, tender, or painful. The site of the biopsy may be covered in stitches or have an exposed wound that may need tending.

What is the rate of growth of Tongue Cancer?

This disease spreads swiftly among those who consume alcohol or tobacco, or are older than 50 years of age. Tongue Cancer can progress from Stage 1 to Stage 4 within five years.

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on several secondary sources on the internet. Please consult a doctor before making any health-related decisions.

Sources

https://www.ncbi.nlm.nih.gov/books/NBK562324/

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