Cancer of the Tongue

What is cancer of the tongue?

Cancer of the tongue is a malignant tumor that begins as a small lump, a firm white patch, or a sore (ulcer) on the tongue. If untreated, the tumor may spread throughout the tongue to the floor of the mouth and to the gum (jaws). As a tumor grows, it becomes more life threatening by spreading (metastasizing) to lymph nodes in the neck and later to the rest of the body.

The general term for this type of cancer is cancer of the oral cavity.

How does it occur?

Tongue cancer is one of the more common and serious types of oral cancer. It mainly occurs in people who smoke cigarettes, pipes, or cigars or use smokeless tobacco. People who drink large amounts of alcohol and use tobacco are especially at risk.

Tongue cancer is rare in people under age 40 and people who do not use tobacco or alcohol. It is most common after age 60.

What are the symptoms?

Tongue cancer begins as a small lump or thick white patch. It may or may not be painful or tender. Over time this lump turns into an ulcer with a firm, raised rim and a center that bleeds easily.

The tongue becomes rigid and hard to move if the tumor grows large enough. Eventually, the tumor may make swallowing and speech difficult.

If the disease is not treated, you may also have:

• pain
• bad breath
• drooling and trouble swallowing
• trouble eating and speaking
• trouble breathing.

How is it diagnosed?

Your healthcare provider will examine your tongue and mouth and ask about the history of the growth on your tongue, especially if you have had it more than 10 days. You may have a tongue biopsy. For a biopsy, your tongue is numbed with an anesthetic and then a small tissue sample is removed from your tongue. The sample will be tested to see if it is malignant (cancerous).

What is the treatment?

Your healthcare provider, usually a surgeon specializing in cancer treatment, will determine your treatment based on the spread of the cancer when it is diagnosed. Your provider may recommend that you have one or more of the following treatments:

• radiation
• surgery to remove the tumor
• anticancer drugs (chemotherapy).

You may need to have surgery to replace tissue in your mouth with tissue from another part of your body.

Speech therapy is often part of the treatment, particularly if it is necessary to remove any portion of your tongue, lymph glands, or jaw to remove all of the cancer.

How long will the effects last?

The effects of tongue cancer depend on the stage at which the growth is found, the treatment, and your health.

• When tongue cancer is found and treated early, about 80% of people can be cured.
• When tongue cancer is found after it has spread into the lymphatic system, the cancer is more harmful. Ask your healthcare provider about the effectiveness of treatment for this advanced stage of the disease.

How can I take care of myself?

Talk to your healthcare provider about any concerns you have regarding the course of your illness and treatments. Ask about side effects you may have from radiation, surgery, or chemotherapy. You may want to make a list of questions at home and take it with you when you visit your provider. Ask a family member or friend to go with you who can listen, too. If you don't understand a word or concept, ask your provider to explain it. Take notes if you need to.

Follow these guidelines:

• If radiation therapy is part of your care, see the dentist recommended by your healthcare provider for special care before treatment starts.
• Be sure that dentures fit properly and that the edges of teeth are smooth so that they do not irritate your mouth or tongue.
• Do not use any type of tobacco.
• Avoid use of alcohol.
• Be sure you understand the treatments your healthcare provider orders. Ask questions and talk about your concerns with your provider.
• Keep all follow-up appointments with your provider.
• If possible, join a cancer support group during your illness and recovery.
• Maintain a hopeful and positive outlook throughout your treatment and recovery.

For more information, contact:

• American Cancer Society, Inc.
  800-ACS-2345 (800-227-2345)
  http://www.cancer.org
• AMC Cancer Research Center and Foundation
  800-525-3777
  http://www.amc.org
• Cancer Information Service
  800-4-CANCER (800-422-6237)
  http://cis.nci.nih.gov

How can I help prevent cancer of the tongue from spreading or recurring?

You may be able to reduce the risk of recurrence or spread of tongue cancer if you:

• Complete the full course of surgical, radiation, and chemotherapy treatments ordered by your healthcare provider.
• Do not use any type of tobacco.
• Avoid heavy use of alcohol.
• See your provider right away if you notice a return of any previous symptoms, such as a lump or ulcer on your tongue that does not heal.
• Take good care of your teeth and gums and have regular dental checkups, particularly if you have had radiation treatment.
• Eat well-balanced meals, exercise regularly, and follow good health practices.