Tongue Cancer

What is tongue cancer ?
There are two parts to your tongue, the oral tongue and the base of the tongue. Cancer can develop in either part. The oral tongue is the part you see when you ‘poke your tongue out’ at someone. This is the front two thirds of your tongue. Cancers that develop in this part of the tongue come under a group of cancers called mouth (oral) cancer.

The base of the tongue is the back third of the tongue. This part is very near your throat (pharynx). Cancers that develop in this part are called oropharyngeal cancers (pronounced oar-o-farin-gee-al).

Types of tongue cancer
The most common type of tongue cancer is squamous cell carcinoma (SCCA). Squamous cells are the flat, skin-like cells that cover the lining of the mouth, nose, larynx, thyroid and throat. Squamous cell carcinoma is the name given to a cancer that starts in these cells.

Symptoms of tongue cancer
The symptoms of tongue cancer may include
A red or white patch on the tongue, that will not go away
A sore throat that does not go away
A sore spot on the tongue that does not go away
Pain when swallowing
Numbness in the mouth that will not go away
Unexplained bleeding from the tongue (that is, not caused by biting your tongue or other injury)
Pain in the ear (rare)
Do bear in mind that these symptoms may be due to a less serious medical condition. But it is important to check symptoms with your GP just to make sure.

Risks and causes of tongue cancer
We don’t know the exact causes of most head and neck cancers, but several risk factors have been identified. Smoking tobacco (cigarettes, cigars and pipes) and drinking a lot of alcohol are the main risk factors for cancers of the head and neck in the western world. There is more information about the risks and causes of mouth cancer in the mouth cancer section.

Treating tongue cancer
As with many types of cancer, diagnosing your cancer early means it will be easier to control and possibly cure it. Treating tongue cancer will depend on the size of the cancer and whether or not it has spread to the lymph nodes in your neck. You may have
Surgery
Radiotherapy
Chemotherapy
You may have one of these or a combination of treatments. The best treatment for very small tongue cancers is surgery. For larger tumours that have spread to the lymph nodes in the neck, you will most likely have a combination of surgery and radiotherapy. This means having an operation to remove the cancer from your tongue and the lymph nodes in your neck. You may need to have all the nodes on one or both sides of your neck removed. You may hear your doctor call this operation a radical neck dissection. It lowers the risk of your cancer coming back in the future. You will then have a course of radiotherapy to help get rid of any cancer cells left behind.

If your cancer has grown so big that it affects most of your tongue, you may need to have an operation to remove your tongue (glossectomy). This is a big operation and many doctors may suggest that you first try radiotherapy and chemotherapy to shrink the cancer. If this works, you may not need such major surgery.

If you do have this operation, it will permanently change your ability to speak and swallow. It will also affect the way you look. This is very hard to cope with and you are likely to need a lot of support and help following your operation. It is important to talk to your doctor before your operation and ask lots of questions about how it will affect your speech, appearance and eating and drinking.

There is more detailed information about treatments for mouth and oropharyngeal cancer in the mouth cancer section.

Treatment side effects
All treatments have side effects. Some are temporary but some may be permanent. Surgery to the tongue can cause problems with your speech, eating and drinking, and changes in your appearance.

Radiotherapy to the head and neck area can cause several side effects including a dry, sore mouth and taste changes. There is more information about the side effects of side effects of radiotherapy to the mouth in the mouth cancer section.

Two common chemotherapy drugs are used to treat head and neck cancers. They are
Cisplatin
5 fluorouracil(5FU)
Other drugs used less often include
Carboplatin
Bleomycin
Methotrexate