Tongue cancer 

Overview

Tongue cancer occurs when cells on the tongue grow uncontrollably and form a tumor, similar to other malignancies. Squamous cells, the thin, flat cells that line the surface of the tongue, are where tongue cancer most frequently develops. Older adults are more susceptible to this condition than children.

The tongue extends from the throat into the mouth and is composed of nerves and muscles that support movement and various functions, including taste, speaking, eating, and swallowing. Many types of cancer can affect the tongue, although tongue cancer is less common compared to many other forms of mouth cancers.

Tongue cancer has two types: one that affects the visible protruding part of the tongue and another that occurs where the tongue joins the neck, at the base.

• Oral tongue cancer: This type of cancer develops in the mouth and is often easily detected since this part of the tongue is readily visible and inspectable, leading to immediate symptoms.
• Oropharyngeal tongue cancer: This type is frequently discovered after cancer cells have already spread to the lymph nodes in the neck. Detecting cancer at the back of the tongue can be challenging due to its hidden location, which often results in delayed diagnosis. It can silently develop for some time before showing symptoms, which, when they do appear, such as a sore throat or ear pain, can be similar to symptoms of many other conditions.

The standard treatment approach for tongue cancer typically includes a combination of surgery and radiation therapy, with potential alternatives such as chemotherapy and targeted therapy. The choice of treatment depends on the type of cancer cells present, as well as the size and location of the cancer.

Symptoms

Tongue cancer typically presents different signs depending on its type or location. Oral tongue cancer frequently starts with a persistent sore on the tongue that doesn’t heal, along with potential discomfort, bleeding, or a lump on the tongue. The sore may appear pinkish-red and may bleed when bitten or touched.

With oropharyngeal tongue cancer, swollen lymph nodes in the neck may be the initial symptom. The presence of a lump in the mouth, throat, or neck, coughing up blood, unexplained weight loss, and ear pain are some of the accompanying symptoms.

Other symptoms may include:

• White or red patches on the tongue or inside the mouth.
• A constant and painful sore throat.
• Feeling like there’s something stuck in your throat.
• Numbness in your mouth or on your tongue.
• Difficulty or pain when chewing, swallowing, or moving your jaw or tongue.
• Swelling in your jaw.
• Changes in your voice.

People who experience persistent sore on their tongue or in their mouth that doesn’t improve within a few weeks should see their healthcare provider for proper diagnosis and treatment.
It is generally recommended to do a routine dental checkup or a regular medical examination since potential signs of tongue cancer are usually detected during these exams.

Causes

Tongue cancer begins when normal tongue cells undergo DNA changes, prompting them to grow uncontrollably and evade natural cell death. This excessive cell growth can result in the formation of a tumor, which may eventually break away and spread to other parts of the body.

The exact causes of these DNA changes leading to tongue cancer are often unclear. In some cases of throat-related tongue cancer, human papillomavirus (HPV), a common sexually transmitted virus, may play a role. It’s worth noting that HPV-related throat tongue cancer generally responds better to treatment compared to cases not linked to HPV.

Risk factors

It is believed that genes may influence one’s risk of developing tongue cancer. Other common risk factors include:

• Alcohol use: The risk of tongue cancer is higher in people who regularly and excessively drink alcohol.
• Tobacco use: Consuming cigars, pipes, chewing tobacco, snuff, and all other tobacco products raises one’s risk for tongue cancer. This is a major risk factor for tongue cancer.
• Age: As a result of prolonged tobacco and alcohol consumption over the years, individuals above the age of 45 face a higher likelihood of developing tongue cancer.
• Gender: The incidence of tongue cancer is more common in men than in women, which can be attributed to the higher number of tobacco and alcohol consumption among men.
• Getting HPV infected: People who have been exposed to specific types of HPV are more likely to develop tongue cancer in the throat.
• Poor oral hygiene: Not maintaining good oral and gum health can lead to a higher risk of tongue cancer.
• Compromised immune system: This can be triggered by health conditions, such as contracting HIV infection. This may also occur if one uses immunosuppressive medication, such as after receiving an organ transplant.