In most patients, there may be a few to no symptoms in the early stages of tongue cancer. Patients may not experience any tongue cancer symptoms at all, especially if it’s in the back of the tongue. Oral cancer affecting the front tongue is often visible. A few early signs and symptoms of tongue cancer are
- Painful sores in the mouth: Most commonly, tongue cancer starts as a painful sore in the mouth that doesn’t heal even after a few weeks.
- Lesions/lump or ulcer on the tongue: Any kind of abnormal growth on the tongue should be viewed as a warning sign if it does not heal within a week. The lesion may appear on the tongue or under the tongue where the tongue rests on the floor of the mouth.
- A patch on the tongue
- Patches on the tongue are most commonly either red (erythroplakia) or white (leukoplakia).
- Red patches are more likely to be cancer than white patches. However, any patch in the mouth that is persistent for several weeks should be biopsied by a specialist.
- Difficulty speaking (dysarthria): This can occur when a tumor changes the way the tongue moves.
- Difficulty swallowing: This can be caused by anything from a bad cold to tongue cancer to other forms of oral cancer. However, if the condition persists or gets worse, it is better to get checked.
- Painful chewing: If it hurts when chewing food and there is no other underlying cause of soreness that can be identified (for example, a sore tooth), it’s good to consult a doctor to rule out tongue cancer.
- Cancer quickly kills nerve cells as it spreads.
- Numbness, especially in, under or on top of the tongue, may indicate a more serious problem if it doesn’t go away on its own.
- Recurrent bleeding from the mouth
- Growths in the mouth that are cancer tend to bleed easily when accidentally scraped while brushing teeth or eating certain foods.
- If there is a taste of blood in the mouth even without brushing or eating anything for a while, this symptom could indicate a more serious problem one that needs medical attention.
- Bad breath: As cancers grow larger, dead cells within the tumor (necrotic cancer) lead to a bad smell from the mouth (halitosis).
In some cases, the first sign of tongue cancer could be a lump in the neck. This means that the tumor has spread to lymph nodes in the neck. However, in tongue cancers, primary cancer in the mouth is usually noticed before it reaches these lymph nodes. In a few cases, patients may complain of earaches and tongue pain, which could be a symptom that cancer has advanced.
What is tongue cancer?
Tongue cancer is a serious and potentially deadly form of oral cancer. Tongue cancer or mouth cancer may start on the floor of the mouth, in the cells of the tongue, in the throat (at the base of the tongue) or anywhere in the mouth. The different types of tongue cancer may include
- The most common type of tongue cancer is squamous cell carcinoma. More than 90 percent of mouth cancers are squamous cell carcinoma. Squamous cell carcinoma is cancer that starts from abnormal cells on the surface layer of the lips or the lining of the mouth.
- If the cancer is discovered at an early stage before invading past the deepest layer of the mouth lining, then it is called carcinoma in situ and has a good prognosis when removed.
- Another subtype is called verrucous carcinoma. This subtype usually has a slow growth pattern and is less likely to spread to lymph nodes in the neck or other parts of the body.
Possible risks and causes of tongue cancer
The exact cause of tongue cancer is unknown. Certain chemicals or viruses may irritate the tongue lining and thus, cause cancerous changes in the deoxyribonucleic acid (DNA) of the cells. The causes are
- Inadequate oral hygiene or inadequate oral care
- Tobacco use (most common), including cigarettes, cigars and chewing tobacco
- Alcohol consumption
- Human papillomavirus (HPV) 16 and 18
- Being African-American
- Males are more likely to get tongue cancer and it's more likely to occur in those who are 40 years of age or older
- Family history of oral cancer
- The seed of the areca tree is often chewed by people from Southeast Asia and is known to cause tongue cancer
- Excessive sunlight exposure is associated with melanoma of the lip
- Plummer-Vinson syndrome, which is a condition that can occur in people with long-term iron deficiency anemia. People with this condition have problems swallowing due to small, thin growths of tissue that partially block the upper esophagus.
Treatment for tongue cancer
The severity of cancer plays an important role in treatment options. The treatment options are
- Surgery is usually the first treatment.
- Radiation therapy with or without chemotherapy is often necessary afterward.
- Targeted therapy may be an option for some tumors.
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